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    Comments on the letters by Bruce Quinn and Douglas Miller: | American Journal of Neuroradiology  
    


















    


























    
  
  




    
    

  

      


    

      

  
  
  

    

  

    

  

                
    

      

  

    

  
      
  
  

    


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Comments on the letters by Bruce Quinn and Douglas Miller:
  
    	
Michael D.  Norenberg

  
    	
American Journal of Neuroradiology March 1999,  20 (3) 528-529; 

  
  
  



  


  
  



  
      
  
  

    
Patel et al (1) described an unusually large number of spinal cord gangliogliomas. This finding prompted the letter by Dr. Quinn who challenged the accuracy of diagnosis because it appeared to him that these were largely based on the pattern of synaptophysin immunochemistry. Although Miller, as well as other pathologists, found the latter pattern of immunohistochemistry useful, Zhang and Rosenblum (2) and Quinn (3) have challenged the accuracy of synaptophysin staining for the diagnosis of ganglioglioma. Miller responds that synaptophysin immunohistochemistry was only used adjunctively or for confirmation. It is fair to conclude that reliance on synaptophysin immunohistochemistry alone for the diagnosis of ganglioglioma is not justified at this time. This issue is clearly controversial that we hope future studies will clarify. I, however, see little reason to doubt the diagnoses that have been rendered by two senior, highly experienced neuropathologists with extensive experience in neurooncology (Drs. Miller and Rorke). Miller and Rorke based their diagnoses largely on more traditional histologic evaluation, and immunochemical study for glial fibrillary acidic protein to distinguish ganglion cells from abnormal appearing astrocytes.
References
  1. Patel U, Pinto RS, Miller DC,  et al.  MR of spinal cord ganglioglioma. AJNR Am J Neruoradiol 1998;19:879-887
  2. Zhang PJ, Rosenblum MK.  Synaptophysin expression in the human spinal cord. Diagnostic implications of an immunohistochemical study. Am J Surg Pathol 1996;20:273-276
  3. Quinn B.  Synaptophysin staining in normal brain: importance for diagnosis of ganglioglioma. Am J Surg Pathol 1998;22:550-556
  


  
  



  



    

  



  

                
    

      

  

    

  
      
  
  

    


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