OBJECTIVETo study the immunohistochemical expression and diagnostic significance of CD34 in brain tumors of patients with refractory epilepsy.

METHODSImmunohistochemical study for CD34 was performed on formalin-fixed paraffin-embedded tissue blocks of 54 cases of brain tumors occurring in patients with refractory epilepsy. The tumor types included ganglioglioma (GG, number = 21), dysembryoplastic neuroepithelial tumor (DNT, number = 8), tumors/lesions which had the transitional features that between glioneuronal hamartia and mixed neuronal-glial tumor (number = 21) and pleomorphic xanthoastrocytoma (PXA, number = 4). Cases of glioblastoma (number = 4) and oligoastrocytoma (number = 5) were used as controls.

RESULTSTwenty of the 21 cases of GG, 1 of the 8 cases of DNT, 16 of the 21 cases of tumors/lesions which had the transitional features and 3 of the 4 cases of PXA showed cytoplasmic and membranous positivity for CD34. The adjoining brain tissues in 9 of the 18 cases of GG, 6 of the 16 cases of tumors/lesions which had the transitional features and 1 of the 3 cases of PXA also expressed CD34. In contrast, only 1 case of glioblastoma showed membranous positivity for CD34.

CONCLUSIONSCD34 preferred to staining for GG and PXA. Which represent a valuable tool for distinguishing GG, PXA and DNT, oligoastrocytoma, glioblastoma.

Antigens, CD34 ; metabolism ; Astrocytoma ; complications ; metabolism ; pathology ; surgery ; Brain Neoplasms ; complications ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Epilepsy ; etiology ; Ganglioglioma ; complications ; metabolism ; pathology ; surgery ; Glioblastoma ; complications ; metabolism ; pathology ; Humans ; Neoplasms, Neuroepithelial ; complications ; metabolism ; pathology ; surgery

To investigate the epileptogenic foci in dysembryoplastic neuroepithelial tumor (DNT) in the temporal lobe, we studied extraoperative electrocorticography (ECoG) with subdural electrode arrays from nine patients with intractable epilepsy due to temporal DNT. Ictal onset zones and irritative zones were decided by the ECoG. The locations of these zones were compared to the location of the tumor. The number of ictal onset zone and irritative zone was 2.1+/-0.93 and 2.9+/-.45 in a patient with a DNT. They were detected more frequently in the adjacent tissues of the tumor (88.9%) rather than within the tumor or in mesial temporal area (66.7%). Mesial temporal involvement was found in 6 patients (66.7%) as an ictal onset zone, and in 5 (55.6%) as an irritative zone. The 7 patients (77.8%) had ictal onset zone in areas different from active irritative zone. The surgical outcome was better, when ictal onset zone was completely resected rather than partially removed. Temporal DNT can make multiple ictal onset zones and irritative zones in different regions including the mesial temporal area. Deliberate resection of epileptogenic foci, including all ictal onset zones and irritative zones, ensures excellent seizure control.
Adolescent ; Adult ; Brain/pathology ; Brain Neoplasms/*complications/surgery ; Child ; Electroencephalography/*methods ; Epilepsy, Temporal Lobe/*etiology/*pathology/surgery ; Female ; Human ; Male ; Middle Aged ; Models, Anatomic ; Neoplasms, Neuroepithelial/*complications/surgery ; Subdural Space ; Temporal Lobe/pathology ; Time Factors

OBJECTIVETo discuss the diagnosis and treatment of dysembryoplastic neuroepithelial tumor (DNT).

METHODSFrom November 2001 to February 2005, 18 patients were admitted. The data of the 18 patients were reviewed.

RESULTEpilepsy was the main complaint. There was no mass effect on MRI. Multinodular and specific glioneuronal element was typical in pathological examination, seizure could be controlled by operation.

CONCLUSIONSDNT is benign tumor which could be treated by surgery, total removal of tumor and using intraoperative electrocorticography could improve the result of operation.

Adolescent ; Adult ; Brain Neoplasms ; complications ; diagnosis ; pathology ; surgery ; Child ; Child, Preschool ; Epilepsy ; etiology ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasms, Neuroepithelial ; complications ; diagnosis ; pathology ; surgery ; Retrospective Studies

OBJECTIVETo study the clinicopathologic features, immunophenotype and histogenesis of dysembryoplastic neuroepithelial tumor (DNT).

METHODSFourteen cases of DNT were retrieved from the archival files of the Department. The histopathologic features and immunohistochemical findings were retrospectively studied. The long-term follow-up data were analyzed.

RESULTSEleven of the 14 cases studied were located in the temporal lobe. Histologically, the tumor consisted of a heterogeneous admixture of neuronal and glial cells (including 1 simple form case, 8 complex form cases and 5 non-specific form cases). The specific glioneuronal element was seen in 9 cases. Variable degrees of cortical dysplasia (CD) were found in 10 out of the 11 cases which had sufficient tissue samples for thorough histologic examination. The morphologic appearance of CD included the presence of heterotopic neurons in molecular layer and/or white matter (7 cases), persistent subpial granular cell layer (4 cases), dyslamination (10 cases) and cellular abnormalities. Immunohistochemically, the oligodendroglial-like cells expressed Olig2. Some of which were positive for nestin, MAP-2, neurofilament and glial fibrillary acidic protein, but negative for NeuN. Long-term follow up revealed that 12 patients had class I postoperative seizure and 2 patients had class II seizure. No tumor recurrence was detected.

CONCLUSIONSDNT is frequently associated with CD. The morphologic diagnosis can be confirmed by immunohistochemical study using a panel of antibodies.

Adolescent ; Adult ; Anticonvulsants ; therapeutic use ; Basic Helix-Loop-Helix Transcription Factors ; metabolism ; Brain Neoplasms ; complications ; metabolism ; pathology ; surgery ; Child ; Child, Preschool ; Epilepsy ; drug therapy ; etiology ; Female ; Follow-Up Studies ; Humans ; Infant ; Intermediate Filament Proteins ; metabolism ; Male ; Malformations of Cortical Development ; complications ; pathology ; Microtubule-Associated Proteins ; metabolism ; Neoplasms, Neuroepithelial ; complications ; metabolism ; pathology ; surgery ; Nerve Tissue Proteins ; metabolism ; Nestin ; Oligodendrocyte Transcription Factor 2 ; Oligodendroglia ; pathology ; Retrospective Studies ; Young Adult

Adolescent ; Adult ; Antigens, Nuclear ; metabolism ; Brain Diseases ; complications ; diagnosis ; pathology ; surgery ; Brain Neoplasms ; pathology ; Child ; Child, Preschool ; Diagnosis, Differential ; Epilepsy ; etiology ; Female ; Ganglioglioma ; pathology ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Infant ; Magnetic Resonance Imaging ; Male ; Malformations of Cortical Development ; classification ; complications ; diagnosis ; pathology ; surgery ; Malformations of Cortical Development, Group I ; Microtubule-Associated Proteins ; metabolism ; Neoplasms, Neuroepithelial ; pathology ; Nerve Tissue Proteins ; metabolism ; Neurofilament Proteins ; metabolism ; Retrospective Studies ; Vimentin ; metabolism ; Young Adult