title: [Tuberous sclerosis complex with refractory epilepsy: a clinicopathologic study of 14 cases].
abstract: OBJECTIVE
  To study the clinicopathologic features of tuberous sclerosis complex (TSC).
  
  
  METHODS
  The clinicopathologic data of the patients diagnosed as TSC with refractory epilepsy and resection of epileptic focus were retrospectively analyzed.
  
  
  RESULTS
  Fourteen cases were included, the mean age was (15.8±12.9) years, with a male predominance (male to female ratio=10:4). Frontal lobe was the most common (13/14) site of involvement. MRI showed multiple patchy long T1 and long T2 signals. CT images showed multiple subependymal high density calcified nodules in nine cases. Histology showed mild to severe disruption of the cortical lamination, cortical and subcortical tubers with giant cells and/or dysmorphic neurons. The giant cells showed strong immunoreactivity for vimentin and nestin, while the dysmorphic neurons partially expressed MAP2 and NF. Vimentin also stained strongly the "reactive" astrocytes. Thirteen cases had follow-up information: Engel class I in six cases, Engel class II in six cases, and Engel class III in one case.
  
  
  CONCLUSIONS
  Diagnosis of TSC relies on combined pathologic, clinical and neuroradiological features. Immunohistochemical staining can be helpful. Resection of epileptic focus is an effective method to treat refractory epilepsy in TSC.
authors.affiliation: Department of Pathology, Beijing Haidian Hospital (Haidian Section of Peking University Third Hospital), Beijing 100080, China.
authors.forename: Le
authors.initials: L
authors.lastname: Liang
authors.forename: Hui
authors.initials: H
authors.lastname: Leng
authors.forename: Wei
authors.initials: W
authors.lastname: Xing
authors.forename: Yanke
authors.initials: Y
authors.lastname: Guo
authors.forename: Jing
authors.initials: J
authors.lastname: Fu
authors.forename: Kangping
authors.initials: K
authors.lastname: Ma
mesh_terms: D000293:Adolescent; D001253:Astrocytes / Q000737:chemistry / Q000473:pathology; D002648:Child; D000069279:Drug Resistant Epilepsy / Q000601:surgery; D004827:Epilepsy / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D017034:Epilepsy, Frontal Lobe / Q000150:complications / Q000378:metabolism / Q000473:pathology; D005260:Female; D015726:Giant Cells / Q000737:chemistry / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D064231:Nestin / Q000032:analysis; D009474:Neurons / Q000378:metabolism / Q000473:pathology; D012189:Retrospective Studies; D014402:Tuberous Sclerosis / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D014746:Vimentin / Q000032:analysis
chemical_list: D064231:Nestin; D014746:Vimentin