Relationship between focal cortical dysplasia and epilepsy-associated low-grade tumors: an immunohistochemical study

APMIS. 2013 Jan;121(1):22-9. doi: 10.1111/j.1600-0463.2012.02938.x. Epub 2012 Jul 3.

Abstract

We retrospectively analyzed 29 seizure-associated temporal lobe low-grade tumors to evaluate the utility of CD34 and bcl-2 expression in clarifying the relationship of these tumors with different classes of focal cortical dysplasia (FCD). CD34 immunostained 75% of gangliogliomas (GG) and 60% of pleomorphic xanthoastrocytomas. FCD type IIIb [i.e. abnormal cortical layering associated with a glioneuronal tumor, according to the new International League Against Epilepsy (ILAE) classification] presented CD34-immunopositive cells in 2/9 (22.2%) cases, whereas FCD type II in 6/7 (85.7%) cases, a difference statistically significant (p = 0.0117). Bcl-2 immunostained 9/12 (75%) gangliogliomas and 2/3 (66.6%) gangliocytomas. The cases of FCD type IIIb resulted negative for Bcl-2, whereas 4/7 cases (57.1%) of FCD type II showed immunopositive cells. These differences in Bcl-2 expression between FCD type IIIb and FCD type II resulted statistically significant (p = 0.0088). Abnormal cortical layering, overall, represents the kind of FCD more commonly associated with seizure-related low-grade tumors, whereas FCD type II is more frequently associated with GG. The profile of CD34 and Bcl-2 expression exhibited by GG is more similar to that observed in FCD type II. Such immunoprofile suggests the existence of a common pathogenesis linking glioneuronal tumors and FCD type II.

MeSH terms

  • Adolescent
  • Adult
  • Antigens, CD34 / biosynthesis
  • Brain Diseases / metabolism*
  • Brain Diseases / pathology
  • Brain Neoplasms / metabolism*
  • Brain Neoplasms / pathology
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Epilepsy / metabolism*
  • Epilepsy / pathology
  • Female
  • Humans
  • Immunohistochemistry
  • Male
  • Malformations of Cortical Development / metabolism*
  • Malformations of Cortical Development / pathology
  • Malformations of Cortical Development, Group I
  • Middle Aged
  • Neoplasm Grading
  • Proto-Oncogene Proteins c-bcl-2 / biosynthesis
  • Retrospective Studies
  • Young Adult

Substances

  • Antigens, CD34
  • Proto-Oncogene Proteins c-bcl-2

Supplementary concepts

  • Focal cortical dysplasia of Taylor