| Yayang Chen,Bin Li,Boning Luo,Xiaoying Tian,Zhi Li. Non-specific histological variant of dysembryoplastic neuroepithelial tumor: a diagnostic challenge. Oncol Transl Med, 2016, 2: 104-109. |
| Non-specific histological variant of dysembryoplastic neuroepithelial tumor: a diagnostic challenge |
| Received:December 16, 2015 Revised:June 05, 2016 |
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| KeyWord:brain tumor; dysembryoplastic neuroepithelial tumor; cortical dysplasia; differential diagnosis |
| Author Name | Affiliation | E-mail | | Yayang Chen | Department of Pathology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, China | lizhi@mail.sysu.edu.cn | | Bin Li | Department of Pathology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, China | lizhi@mail.sysu.edu.cn | | Boning Luo | Sun Yat-sen University, Guangzhou 510080, China | lizhi@mail.sysu.edu.cn | | Xiaoying Tian | ptist University. Kowloon Tong, Hong Kong, China | lizhi@mail.sysu.edu.cn | | Zhi Li | Department of Pathology, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, China | lizhi@mail.sysu.edu.cn |
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| Abstract: |
| Objective The accurate diagnosis of the non-specific variant of dysembryoplastic neuroepithelial tumor
(DNT) is very difficult because it is characterized by absence of the histological hallmark of the “specific
glioneuronal element” in lesions. We herein present two cases of the non-specific form of DNT to analyze
the clinical, radiological, and histological features of this unusual subtype of DNT.
Methods A 16-year-old and a 23-year-old patient had been treated for pharmacoresistant epilepsy for
several years before undergoing referral to the hospital for further examination and treatment. Magnetic
resonance imaging (MRI) revealed that both patients had a small, well-demarcated cystic lesion within the
cortex of the brain without obvious contrast enhancement or peritumoral edema. The lesions were totally
resected and routinely examined using histological and immunohistochemical analysis.
Results Both lesions exhibited similar histological appearances with cyst formation and mural nodule
architecture. The glial nodules were mainly composed of oligodendrocyte-like components, and partly of
piloid cells resembling pilocytic astrocytoma. The cortex adjacent to the lesion in both cases was found to
have the histological features of focal cortical dysplasia (FCD) Type I. Immunohistochemically, the oligodendrocyte-like components were diffusely positive for Syn and Olig-2, but staining for CD34, p53, and IDH1
R132H was negative. The Ki-67 (MIB-1) labeling index was low, approximately 1%. There was no 1p/19q
co-deletion in either lesion by fluorescence in situ hybridization (FISH) assay. Neither patient received
postoperative adjuvant treatment, and both underwent regular follow-up for at least 24 months. No signs of
recurrence or epileptic attacks were observed during the follow-up period.
Conclusion The non-specific variant of DNT is a diagnostic challenge for pathologists in clinical practice,
and differentiation from some low-grade gliomas needs to be considered. The careful inspection of radiologic and histopathologic findings, accompanied by analysis of patients’ clinical manifestations, may be
helpful in making an accurate diagnosis. |
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