Histopathologic and immunohistochemical features of neuroblastoma: a tool for evaluating prognosis.

To investigate the relationship of morphologic appearance with other parameters such as age at diagnosis, primary site and clinical stage in regard to the prognosis, we examined a total of 20 neuroblastomas of various sites from children undergoing treatment at the Catholic University of Rome and Regina Elena Cancer Institute of Rome. We used a histopathologic classification, developed by Shimada et al. (JNCI, 1984), based on the presence of Schwann cells and ganglio-neuromatous component, neuroblastic maturation and transition to ganglionic forms, and number of mitotic and karyorrhetic nuclei. We observed a 100% 2-year survival for patients in the favorable groups (13 patients) and 0% 2-year survival for children (7 patients) in the group with unfavorable histology. Furthermore, immunohistochemical evaluation of neural markers such as NSE, S-100 protein and neurofilaments offered additional important information. Our results confirm that the combination of pathologic, immunohistochemical and clinical criteria can be usefully employed to predict the outcome of neuroblastomas.