It has been suggested that
gangliogliomas represent a neoplastic transformation of a dysplastic focus or heterotopia. Other theories propose that
gangliogliomas arise from multipotent stem cells with the ability to differentiate along glial and neuronal cell lines. Our goal was to characterize the expression of
nestin, a neuroepithelial precursor/stem cell
antigen, in
gangliogliomas along with other pathological and clinical features of this entity. The clinical and operative features of 18 recent cases meeting the histological criteria for
ganglioglioma were reviewed. The expression of
nestin,
microtubule-associated protein 2 (MAP2), neurofilament, and
glial fibrillary acidic protein (GFAP) was assessed by immunohistochemistry and confocal scanning
laser microscopy. Abundant MAP2- and
nestin-positive neuronal cells were found by immunohistochemistry in all 18
gangliogliomas. GFAP staining was found in reactive and lesional astrocytes but not in cells of neuronal morphology. Confocal microscopy demonstrated colocalization of
nestin and MAP2 in select neuronal cells. The true lineage of
gangliogliomas remains controversial. Our findings confirm the presence of cells within these lesions that harbor a persistent stem cell cytoskeletal
protein (nestin). Further insight into the cytoskeletal derangement of
nestin-positive neuronal cells may shed further light on the pathogenesis of
gangliogliomas and its associated
epilepsy.