Dysembryoplastic neuroeptihelial tumor (DNT): an immunohistochemical and ultrastructural study

Abstract

To assess the range of differentiation of the cells comprising dysembryoplastic neuroepithelial tumor (DNT), particularly the oligodendrocyte-like cells (OLC), 14 DNT were immunochemically studied with a spectrum of neuronal and glial markers. Eight tumors were also studied ultrastructurally. Neurofilament protein, class III beta-tubulin, and synaptophysin preparations stained a few OLC in two, six and one lesion, respectively. In addition, many OLC within a single cortical nodule were reactive for class III beta-tubulin. The vast majority of OLC were strongly S-100 protein positive. Glial fibrillary acidic protein labeled a fair number of OLC in two cases and one nodule consisted almost entirely of immunoreactive astrocytes. Ultrastructurally, many OLC resembled oligodendrocytes in exhibiting microtubules, prominent Golgi and short cell processes; pericellular lamination of cell processes, a characteristic of oligodendroglia, was noted in only one tumor. In two cases, OLC with astrocytic features were seen to contain small numbers of intermediate filaments. In four cases, a few OLC resembled immature neurons with scant dense-core granules or synapses. This study confirms the glioneuronal nature of DNT, a lesion composed of heterogeneous cells, many resembling oligodendrocytes and a few showing early astrocytic and neuronal differentiation. Although their relation to OLC is unclear, the presence and peculiar distribution of mature neurons is nonetheless an integral diagnostic feature of the lesion.