Neuron-specific enolase as an immunohistochemical tool for the diagnosis of Hirschsprungʼs disease

Immunohistochemical staining of paraffin-embedded sections of rectal biopsies and of surgical specimens of the colon for neuron-specific enolase (NSE) by the peroxidase-antiperoxidase (PAP) technique greatly facilitates the diagnosis of Hirschsprung's disease. Axons were stained in normal and in aganglionic colon. The perikarya of normal ganglion cells from unaffected patients were strongly positive for NSE and were easily recognizable even when the nerve cells were immature. This technique, therefore, simplifies the task of distinguishing hypoganglionic from aganglionic colon. The hypertrophic submucosal axonal bundles characteristic of Hirschsprung's disease were also readily demonstrable.