Glial fibrillary acidic protein and keratin expression by benign and malignant nerve sheath tumors

Formalin-fixed, paraffin-embedded sections of 59 ultrastructurally confirmed nerve sheath tumors (NSTs) that included 27 benign schwannomas, five neurofibromas, and 27 malignant schwannomas were studied by the avidin-biotin-peroxidase complex method using antibodies directed against glial fibrillary acidic protein (GFAP), keratin, S-100 protein, vimentin, and desmin. GFAP was expressed by 33% of the benign schwannomas, 40% of the neurofibromas, and 7% of the malignant schwannomas. Keratin was expressed by 7% of the benign schwannomas and 4% of the malignant schwannomas. S-100 protein was expressed by 100% of the benign NSTs and by 40% of the malignant schwannomas. Vimentin was observed in 100% of the benign NSTs and in 85% of the malignant schwannomas. None of the cases stained for desmin. GFAP and cytokeratin expression could not be predicted on the basis of tumor light microscopy or ultrastructure. These findings are of practical importance in routine surgical pathology, particularly with respect to the differential diagnosis of gliomas located in the central nervous system and in immunohistochemical studies of peripherally located, poorly differentiated neoplasms.