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Vol. 24. Num. 6.November - December 2013
Pages 237-284
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Vol. 24. Num. 6.November - December 2013
Pages 237-284
Clinical research
DOI: 10.1016/j.neucir.2013.07.001
Histopathological and immunohistochemical profile in anaplastic gangliogliomas
Perfil histopatológico e inmunohistoquímico en gangliogliomas anaplásicos
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Alfredo E. Romero-Rojasa, Julio A. Diaz-Perezb,c,??
Corresponding author
jdiazperez@ucsd.edu

Corresponding author.
, Sandra I. Chinchilla-Olayaa, Deirdre Amarob, Alfonso Lozano-Castillod, Ligia I. Restrepo-Escobara
a Division of Neuropathology, National Cancer Institute, Bogotá, Colombia
b Department of Pathology, University of California, San Diego, La Jolla, CA, USA
c Department of Pathology, Universidad de Santander, Bucaramanga, Colombia
d Division of Neuroradiology, National University of Colombia, Bogotá, Colombia
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Tables (4)
Table 1. Immunohistochemistry panel used in the study.
Table 2. Clinical and radiologic features with outcomes and survival observed in patients with anaplastic ganglioglioma.
Table 3. Histopathological morphology evaluated with conventional hematoxylin and eosin.
Table 4. Immunophenotypical features evaluated by immunohistochemistry.
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Abstract
Background

The anaplastic ganglioglioma (AG) is the high-grade counterpart of ganglioglioma, a rare mixed tumor composed of neuronal/ganglion and glial cells.

Materials and methods

We describe the histopathology and immunohistochemistry in 7 cases of AG and correlate them with the clinical and radiological features.

Results

Our AG patients correspond to 2.5% of the central nervous system tumor patients evaluated in our institution. The mean age at presentation was 25.7 years, with a male predominance. The most common clinical presentation was generalized tonic–clonic seizures (3/7 cases), in correlation with frequent cortical/subcortical location (6/7 cases). Histopathologically, all our cases showed high-grade features in glial (glial fibrillary acid protein-positive) and neuron-ganglion cells (synaptophysin, PGP-9.5, neurofilament, NSE and CD56-positive), as well as moderate cellularity, frequent mitotic figures and a Ki-67 labeling index >5%. All our patients had poor survival.

Conclusion

We found that a typical histopathological and immunohistochemical profile is constant and can be useful in early diagnosis of these aggressive neoplasms.

Keywords:
Ganglioglioma
Anaplastic ganglioglioma
Histopathology
Immunohistochemistry
Neuroradiology
Neurosurgery
Observational study
Resumen
Antecedentes

El ganglioglioma anaplásico (GA) es la contraparte de alto grado del ganglioglioma, un raro tumor compuesto por una mezcla de células neuronales/ganglionares y gliales.

Materiales y métodos

Se describe la histopatología y la inmunohistoquímica en 7casos de GA.

Resultados

Los casos de GA correspondieron al 2,5% de los tumores del SNC evaluados en nuestra institución. La edad media de presentación fue 25,7 años, con predominio del género masculino. La presentación más frecuente fue como convulsiones generalizadas tónico-clónicas (3/7casos), en correlación con una frecuente localización cortical/subcortical (6/7casos). Histopatológicamente todos los casos mostraron características de alto grado en las células gliales (GFAPpositivas) y ganglio/neuronales (sinaptofisina, PG-9.5, neurofilamentos, NSE y CD56-positivo), además de celularidad moderada, figuras mitóticas frecuentes y Ki-67>5%. Todos los pacientes mostraron baja supervivencia.

Conclusión

Se describe el perfil histopatológico e inmunohistoquímico en GA, el cual es constante y posee utilidad para el diagnóstico precoz de estos tumores agresivos.

Palabras clave:
Ganglioglioma
Ganglioglioma anaplásico
Histopatología
Inmunohistoquímica
Neurorradiología
Neurocirugía
Estudio observacional

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