Acta Neuropathologica

, Volume 108, Issue 1, pp 24–30

Value and limits of immunohistochemistry in differential diagnosis of clear cell primary brain tumors

  • Oskar Koperek
  • Ellen Gelpi
  • Peter Birner
  • Christine Haberler
  • Herbert Budka
  • Johannes A. Hainfellner
Regular Paper

DOI: 10.1007/s00401-004-0856-9

Cite this article as:
Koperek, O., Gelpi, E., Birner, P. et al. Acta Neuropathol (2004) 108: 24. doi:10.1007/s00401-004-0856-9
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Abstract

Clear cell histology is the hallmark of oligodendroglioma (OG) but also characterizes clear cell ependymoma (CCE) and central neurocytoma (CN). Immunohistochemistry for glial and neuronal proteins may support differential diagnosis. We investigated systematically diagnostic value and limits of immunohistochemistry using representative tumor specimens (>1 cm in diameter) of well-defined OGs, CCEs, and CNs (n=10, respectively). Antibodies comprised anti-neuron specific nuclear protein (NEUN), anti-synaptophysin, anti-neuron-specific enolase, anti-microtubule-associated protein 2, anti-phosphorylated neurofilament protein, anti-non-phosphorylated neurofilament protein, anti-glial fibrillary acidic protein (GFAP), anti-S100 protein, anti-vimentin (VIM), and anti-epithelial membrane antigen (EMA). Among the panel of antibodies anti-NEUN, anti-VIM and anti-EMA proved most useful for differential diagnosis. Prominent (>90%) anti-NEUN immunolabeling of tumor cells clearly distinguished CNs from OGs and CCEs. Anti-VIM immunolabeling and a characteristic cytoplasmic dot-like anti-EMA immunoreactivity pattern of tumor cells were detectable only in OGs and CCEs. Furthermore, prominent anti-VIM immunoreactivity and anti-EMA cell membrane staining including ring-like staining pattern is characteristic for CCEs. Additionally, a widespread gliofibrillary and minigemistocytic cytoplasmic anti-GFAP immunostaining pattern is restricted to some OGs. Our data indicate that immunohistochemistry using anti-NEUN, anti-VIM, and anti-EMA on representative tumor specimens allows clear-cut distinction of CNs vs OGs and CCEs. Anti-VIM, anti-EMA, and anti-GFAP support differential diagnosis of OGs vs CCEs. Nevertheless, it is noted that due to focal expression of glial proteins in CNs and, conversely, of neuronal proteins in OGs and CCEs, immunohistochemistry is of limited value on small tumor specimens.

Keywords

Clear cell ependymoma Oligodendroglioma Central neurocytoma Immunohistochemistry 

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Oskar Koperek
    • 1
    • 2
  • Ellen Gelpi
    • 1
  • Peter Birner
    • 2
  • Christine Haberler
    • 1
  • Herbert Budka
    • 1
  • Johannes A. Hainfellner
    • 1
  1. 1.Institute of NeurologyUniversity of Vienna, AKHViennaAustria
  2. 2.Institute of Clinical PathologyUniversity of Vienna, AKHViennaAustria

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