The significance of intratumoural neurones and neuronal differentiation in diffuse gliomas: a case series

Abstract

We describe four patients, ranging from 26– 40 years of age, who presented with seizures and large, poorly circumscribed cerebral tumours on magnetic resonance imaging. The resected tumours demonstrated a histopathology similar to low-grade glioma, but with admixed mature neurones. Immunohistochemistry demonstrated expression of putative neuronal antigens in the neuronal component as well as in tumour cells which did not show neuronal morphology. These tumours did not have the usual radiological and pathological features typical of gangliogliomas, but demonstrated an infiltrative pattern of growth and subsequent progressive behaviour. The term ganglioglioma, with its implication of good prognosis, is therefore inappropriate for tumours of this type. The expression of “neuronal” antigens by astrocytomas requires further investigation.