Regular paper

Acta Neuropathologica

, Volume 97, Issue 5, pp 481-490

The CD34 epitope is expressed in neoplastic and malformative lesions associated with chronic, focal epilepsies

  • I. BlümckeAffiliated withDepartment of Neuropatholgoy, University of Bonn Medical Center, Sigmund-Freud Str. 25, D-53105 Bonn, Germany e-mail: umt908@uni-bonn.de, Tel.: +49-228-287-6603, Fax: +49-228-287-4331
  • , K. GienckeAffiliated withDepartment of Neuropatholgoy, University of Bonn Medical Center, Sigmund-Freud Str. 25, D-53105 Bonn, Germany e-mail: umt908@uni-bonn.de, Tel.: +49-228-287-6603, Fax: +49-228-287-4331
  • , Eva WardelmannAffiliated withDepartment of Pathology, University of Bonn Medical Center, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
  • , Stefan BeyenburgAffiliated withDepartment of Epileptology, University of Bonn Medical Center, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
  • , Thomas KralAffiliated withDepartment of Neurosurgery, University of Bonn Medical Center, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
  • , Nanette SariogluAffiliated withDepartment of Pediatric Pathology, Rudolph-Virchow Medical Center, Humboldt University Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
  • , Torsten PietschAffiliated withDepartment of Neuropatholgoy, University of Bonn Medical Center, Sigmund-Freud Str. 25, D-53105 Bonn, Germany e-mail: umt908@uni-bonn.de, Tel.: +49-228-287-6603, Fax: +49-228-287-4331
  • , Helmut K. WolfAffiliated withDepartment of Pathology, University of Mainz Medical Center, Langenbeckstr. 1, D-55131 Mainz, Germany
  • , Johannes SchrammAffiliated withDepartment of Neurosurgery, University of Bonn Medical Center, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
    • , Christian E. ElgerAffiliated withDepartment of Epileptology, University of Bonn Medical Center, Sigmund-Freud-Str. 25, D-53105 Bonn, Germany
    • , Otmar D. WiestlerAffiliated withDepartment of Neuropatholgoy, University of Bonn Medical Center, Sigmund-Freud Str. 25, D-53105 Bonn, Germany e-mail: umt908@uni-bonn.de, Tel.: +49-228-287-6603, Fax: +49-228-287-4331

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Abstract

The etiology and pathogenesis of complex focal lesions associated with chronic, intractable epilepsy are largely unknown. Some data indicate that malformative changes of the central nervous system may preceed the development of gangliogliomas and other epilepsy-associated neoplasms. In the present immunhistochemical study, we have examined epilepsy-associated lesions for CD34, a stem cell marker transiently expressed during early neurulation. Surprisingly, most tissue samples from patients with chronic epilepsy (n = 262) revealed neural cells immunoreactive for CD34. Prominent immunoreactivity was detected in gangliogliomas (74%), low-grade astrocytomas (62%) and oligodendrogliomas (59%). Only 52% of non-neoplastic, malformative pathologies, such as glio-neuronal hamartias or hamartomas showed solitary or small clusters of CD34-immunoreactive cells. None of the adult control tissues (n = 22), none of the specimens obtained from the developing human brain (n = 44) and none of those tumor samples from patients without epilepsy (n = 63) contained CD34-immunoreactive neural cells. However, a malignant teratoma with microscopic features of early neural differentiation displayed a focal CD34-immunoreactive staining pattern. The majority of CD34-immunoreactive cells co-localized with S-100 protein and a small subpopulation was also immunoreactive for neuronal antigens. CD34 may, thus, represent a valuable marker for the diagnostic evaluation of neoplastic and/or malformative pathological changes in epilepsy patients. The CD34 immunoreactivity of these lesions indicates an origin from dysplastic or atypically differentiated neural precursors. Further studies may elucidate the functional significance of CD34 expression during the pathogenesis of epilepsy-related focal lesions as well as during neurogenesis.

Key words Stem cell Tumor Malformation Epilepsy Ganglioglioma