Microscopic distinction of normal choroid plexus (CP) from choroid plexus tumors (CPT) may be difficult, especially in small
samples of well-differentiated CP papillomas. So far, there are no established markers that reliably distinguish normal and
neoplastic CP epithelium. Recently, a correlation between expression/function of glial glutamate transporters EAAT-1 (GLAST)
and EAAT-2 (Glt-1) and tumor proliferation has been reported. Furthermore, we previously found that CPTs frequently express
EAAT-1, but not EAAT-2. We now compared expression of EAAT-1, EAAT-2 and GFAP in non-neoplastic CP (
n = 68) and CPT (
n = 79) by immunohistochemistry. Tissue of normal CP was obtained from 50 autopsy cases (20 normal and 30 pathologic brains)
and 18 neurosurgical specimens that included 17 fetal, 21 pediatric and 30 adult cases. In non-neoplastic postnatal CP (
n = 51), focal expression of EAAT-1 was found in only two pediatric cases (4%). In CPT, expression of EAAT-1 was found in 64
of 79 (81%) tumor samples and was significantly age-dependent (
P < 0.0001). Hence, EAAT-1 expression distinguishes neoplastic from normal CP, both in children (
P = 0.0032) and in adults (
P < 0.0001). Immunostaining for EAAT-2 in selected samples from cases of different ages showed that normal CP (
n = 15) or CPT (
n = 16) lacked EAAT-2 expression. GFAP expression was found in 3 of 32 (10%) normal CP and in 28 of 73 (38%) tumor samples.
In conclusion, in contrast to neoplastic CP samples, expression of EAAT-1 is exceptionally rare in non-neoplastic CP. Thus,
EAAT-1 is superior to GFAP as a helpful diagnostic tool in CP samples.
Keywords Normal choroid plexus - Choroid plexus papillomas - Atypical choroid plexus papillomas - Choroid plexus carcinoma - Excitatory amino acid transporter-1 - Diagnosis