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oligodendroglioma pathology outlines

    oligodendroglioma pathology outlines

    doi: 10.1215/15228517-2008-073, Wang, P., Wu, J., Ma, S., Zhang, L., Yao, J., Hoadley, K. A., et al. 2022 Dec 23;13:587. doi: 10.25259/SNI_792_2022. 55, 48334836. Salvage chemotherapy with paclitaxel for recurrent primary brain tumors. Neurol. Acting as a tumor-suppressor gene, missense mutations affecting CIC are mostly found within the DNA-binding domain thereby inhibiting its binding to regulatory elements. Development. Oligodendrogliomas. Although one survey showed that 34% of neuro-oncologists suggested delaying XRT in patients with 1p19 co-deletions (Abrey et al., 2007), clinical trials addressing the efficacy of delayed XRT in this subset of patients are needed. Neurosurg Focus. (2012). Hence, surgeons should biopsy patients suspected to have AO and attempt tumor resection, as with all other high-grade gliomas. 8, 183188. Cancer Res. 0000225257 00000 n (2013). Mason WP. Exp. Share cases and questions with Physicians on Medscape consult. ROS and brain gliomas: an overview of potential and innovative therapeutic strategies. Treatments are decided by the patients healthcare team based on the patients age, remaining tumor after surgery, tumor type, and tumor location. Arch Pathol Lab Med 131:242251. 19, 6974. Loss of FUBP1 expression in gliomas predicts FUBP1 mutation and is associated with oligodendroglial differentiation, IDH1 mutation and 1p/19q loss of heterozygosity. Although surgery can help relieve symptoms by decreasing the mass effect of the tumor, the tumors predilection to the frontal lobe hinders its maximal resection. Molecular subtypes of anaplastic oligodendroglioma: implications for patient management at diagnosis. Clinicopathologic correlations in the oligodendroglioma. Rodriguez, FJ. doi: 10.1046/j.1460-9568.2003.02639.x, Lee, C.-C., Chen, W.-S., Chen, C.-C., Chen, L.-L., Lin, Y.-S., Fan, C.-S., et al. 59, 495503. 131, 803820. Li S, Yan C, Huang L, Qiu X, Wang Z, Jiang T. Molecular prognostic factors of anaplastic oligodendroglial tumors and its relationship: a single institutional review of 77 patients from China. Surgery to remove the tumor. It has been observed that in IDH-mutant cell lines, repressive histone methylation precedes global DNA hypermethylation. Dual-genotype astrocytoma/oligodendroglioma are very rare. The trial compared outcomes in patients who received radiation therapy alone versus radiation therapy (RT) plus chemotherapy with procarbazine, CCNU, and vincristine (PCV). 0000013354 00000 n A neuropathologist should then review the tumor tissue. 17, 20172022. Copyright 1999 2023 GoDaddy Operating Company, LLC. Elens, I., De Vleeschouwer, S., Pauwels, F., and Van Gool, S. (2012). (May 2019). Cell 81, 323330. Int. Cancer Res 2006; 66:9852. Low-risk patients might defer treatment with radiation and chemotherapy and followed with surveillance only, while high-risk patients may benefit with upfront adjuvant treatment. Accounting to up to 5% of all neuroepithelial tumors ( Ostrom et al., 2017 ), oligodendroglial tumors have an incidence rate of around 1,000 new cases per year in the United States. Oligodendrogliomas are a type of glioma that are believed to originate from the oligodendrocytes of the brain or from a glial precursor cell. Stephen A Berman, MD, PhD, MBA is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, Phi Beta KappaDisclosure: Nothing to disclose. 1988 May 1. 0000000016 00000 n Upregulating mutations in the TERT promoter commonly occur in adult malignant gliomas and are strongly associated with total 1p19q loss. [QxMD MEDLINE Link]. The PFS HR was 3.33 with a 95% CI 1.318.45 (P = 0.011) while the OS HR was 2.78 with a 95% CI 0.5813.22 (P = 0.20) (Jaeckle et al., 2021). Human telomerase reverse transcriptase (TERT) mutations have been found to be present in 77% of grades II and III oligodendrogliomas and 82% of tumors with 1p19q co-deletion (Koelsche et al., 2013). This site needs JavaScript to work properly. Few calcifications are present. A t(1;19)(q10;p10) mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. 0000277542 00000 n It has also been reported that 2-HG can inhibit p53 via microRNA activated by HIF-2, driving tumorigenesis (Jiang et al., 2018). doi: 10.1212/01.wnl.0000262034.26310.a2, Kaminska, B., Czapski, B., Guzik, R., Krl, S. K., and Gielniewski, B. [2]. (1995). 13, 20662071. For patients with WHO grade 2 and KPS 60, the majority (90.5% . In practice, (neuro)pathologists who readily accept the existence of mixed gliomas will more liberally diagnose oligoastrocytomas, while those who are skeptical that this entity exists will designate the vast majority of diffuse gliomas as either astrocytic or oligodendroglial (, Example of how molecular reclassification may affect tumor grade. This in turn provides evidence that IDH mutations could allow cells to remain in a vulnerable state, and prone to additional DNA alterations. 6, 19. (2001). Lancet Oncol. Nature 483, 479483. 10(13):4303-6. These are the precursors to cells called oligodendrocytes, which wrap around nerve cells in the brain and spinal cord to form insulation. Megyesi JF, Kachur E, Lee DH, et al. Prominent anaplastic features (necrosis, microvascular proliferation or brisk mitotic activity) are compatible with anaplastic oligodendroglioma, Strict mitotic activity criteria do not currently exist, Some authors suggest 6 mitotic figures per 10 high power fields in resection specimens for grade 3 designation (, Fewer mitotic figures might be sufficient for grade 3 designation in small biopsy specimens if other anaplastic features (vascular proliferation or necrosis) or significant nuclear atypia are present, Magnetic resonance imaging (MRI), followed by stereotactic brain biopsy or surgical resection, Immunohistochemistry for IDH1 R132H (positive in > 90% of tumors) (, Droplet digital polymerase chain reaction (ddPCR), MRI techniques to detect 2-hydroxyglutarate and therefore, Mixed density (hypodense and isodense) located in cortex or subcortical white matter (, High attenuation areas, likely from calcifications, Heterogeneous on T1 and T2 weighted imaging, Contrast enhancement present in < 20% of WHO grade 2 tumors and > 70% of WHO grade 3 tumors (, Elevated 2HG by magnetic resonance spectroscopy could serve as radiologic surrogate of, Slow growing and relatively long overall survival, Median overall survival: 11.6 years; 10 year overall survival rate: 51 - 63% (, Longer median survival compared with grade 2, Macroscopically complete surgical resection, Local recurrence and malignant transformation are common, 26 year old man presents with nausea, headache and rash (, 43 year old woman with headaches, blurry vision and a right parietal mass (, 44 year old man with sudden right sided optic neuritis (, 55 year old man with mass lesion in the superior left temporal gyrus (, Adjuvant chemotherapy (temozolomide) and radiotherapy, Given to patients with symptomatic or progressive tumors, tumors with CNS WHO grade 3 histology or those with large postoperative residual tumor, Mucoid change can give a gelatinous consistency, Areas of cystic degeneration, calcifications, hemorrhage or necrosis can be seen, Moderately cellular, diffusely infiltrating neoplasm, Glia with mild to moderate nuclear atypia, Calcifications, perineuronal satellitosis or perivascular accumulation of tumor cells may be seen, Will not see perinuclear halos on frozen section or smear preparations, Anaplastic features (necrosis, vascular proliferation, mitoses) may be seen in WHO grade 3 tumors, Closely packed cells with small, round, monotonous nuclei (slightly larger than a normal oligodendrocyte), Perinuclear clearing (fried egg appearance), Will not be seen on frozen sections or smear preparations, Network of thin walled, branching blood vessels (chicken wire vasculature), Microcalcifications (calcospherites) are characteristic, Presence of perineural, perivascular or subpial aggregates of tumor cells (secondary structures of Scherer), Occasional mitoses and moderate nuclear atypia are still consistent with grade 2 designation (, Not uncommon to find well differentiated / fibrillary astrocytic morphology (. The second is diminished intracellular drug transport through the overexpression of ATP-binding cassette transporter proteins such as P-gp (MDR1), MRP1, and MRP5 (Calatozzolo et al., 2012; Alms et al., 2014). CIC and FUBP1 mutations in oligodendrogliomas, oligoastrocytomas and astrocytomas. (2017). Widespread dissemination in a gliomatosis cerebri fashion is very rare (DDx: Diffuse leptomeningeal glioneuronal tumour). Adekunle M Adesina, MD, PhD Professor, Medical Director, Section of Neuropathology, Director, Molecular Neuropathology Laboratory, Texas Children's Hospital, Department of Pathology and Immunology, Baylor College of Medicine If you want to understand your prognosis, talk to your doctor. Another currently ongoing phase I study (NCT04135807) is assessing the efficacy of an implantable microdevice in the brain before tumor resection is initiated. 19, (Suppl._5) v1v88. 24(18):2715-22. First, like most primary brain neoplasms in adults, this neoplasm is usually in the supratentorial brain, most commonly in the frontal lobes. 45(5):232-8; discussion 238-9. Oligodendroglioma, IDH mutant and 1p/19q codeleted is CNS tumour that is typically in the cerebral hemispheres. doi: 10.1002/1097-0142(20010115)91:2<417::aid-cncr1016>3.0.co;2-9, Chinot, O.-L., Honore, S., Dufour, H., Barrie, M., Figarella-Branger, D., Muracciole, X., et al. Amide Proton Transfer-Chemical Exchange Saturation Transfer Imaging of Intracranial Brain Tumors and Tumor-like Lesions: Our Experience and a Review. 2016 Apr 7. (2016). Smith, J. S., Perry, A., Borell, T. J., Lee, H. K., OFallon, J., Hosek, S. M., et al. -, Arita H, Narita Y, Fukushima S, Tateishi K, Matsushita Y, Yoshida A, Miyakita Y, Ohno M, Collins VP, Kawahara N, et al. (2014). Oncol. J. Clin. However, a clear distinction of both grades is not always possible. Targeting the RTK-PI3K-mTOR axis in malignant glioma: overcoming resistance. Investigators of this trial will be testing the in vitro sensitivity of individual primary tumors to anti-mir-10b treatment. doi: 10.1038/modpathol.2013.165, Chang, E. F., Potts, M. B., Keles, G. E., Lamborn, K. R., Chang, S. M., Barbaro, N. M., et al. (2021). Would you like email updates of new search results? The classic appearance of the oligodendroglioma is that of a round to oval, water-clear cytoplasm ringing about round to lobulated nuclei. ; Hartmann, C.; Felsberg, J.; Platten, M. et al. doi: 10.1200/jco.1991.9.5.860, Zaatreh, M. M., Firlik, K. S., Spencer, D. D., and Spencer, S. S. (2003). Disclaimer. More studies, however, are needed to explore molecular pathways in oligodendroglioma and AO specifically after the 2016 classification. 0000248012 00000 n A rare, giant, anaplastic oligodendroglioma. [QxMD MEDLINE Link]. The retinoblastoma protein and cell cycle control. This transition to an integrated morphological and molecular diagnosis may result in the disappearance of oligoastrocytoma as an entity, but brings new challenges as well. J. Clin. [QxMD MEDLINE Link]. Curr Treat Options Neurol. doi: 10.1200/JCO.2001.19.9.2449, Cloughesy, T. F., Filka, E., Kuhn, J., Nelson, G., Kabbinavar, F., Friedman, H., et al. Molecular classification of anaplastic oligodendroglioma using next-generation sequencing: a report of the prospective randomized EORTC Brain Tumor Group 26951 phase III trial. 2005 Jun. Int J Cancer. doi: 10.1016/j.celrep.2015.11.029, Warnick, R. E., Prados, M. D., Mack, E. E., Chandler, K. L., Doz, F., Rabbitt, J. E., et al. Ann Neurol. Contributed by Jared T. Ahrendsen, M.D., Ph.D. Dysembryoplastic neuroepithelial tumor (DNET), WHO Classification of Tumours Editorial Board: Central Nervous System Tumours, 5th Edition, 2022, CNS WHO 2021 definition: diffusely infiltrating glioma with, Diffusely infiltrating glial neoplasm with, Morphology resembles nonneoplastic oligodendrocytes with round monotonous nuclei and perinuclear halos, Chicken wire vasculature, microcalcifications and microcysts are characteristic (, Astrocytic differentiation does not preclude diagnosis if molecular features are present, Small gemistocytes (mini gemistocytes) with rounded bellies of eosinophilic, eccentrically placed cytoplasm are occasionally seen, especially in grade 3 tumors (, Presence of other atypical features (including multinucleated giant cells, sarcomatous features, neurocytic differentiation or ganglion-like cells) does not preclude a diagnosis of oligodendroglioma if the requisite molecular features are present (, Most epidemiologic data is based on histologic, rather than molecular, classification of oligodendroglioma, Incidence of 0.23 cases per 100,000 population in the United States (, Incidence of CNS WHO grade 3 oligodendroglioma is 0.11. The HR was 3.12 with a 95% CI of 1.267.19 (P = 0.014) (Jaeckle et al., 2021). Central nervous system cancer. He, J., Olson, J. J., and James, C. D. (1995). Although a mutated IDH1 cannot generate NADPH since it has lost its normal catalytic activity, it gains the function of producing D-(R)-2-hydroxyglutarate. (2012) showed that an IDH1 mutation can induce a methylation profile known as the G-CIMP signature, which is a glioma specific methylation pattern at CpG islands. Distribution of TERT promoter mutations in pediatric and adult tumors of the nervous system. 0000144370 00000 n This in turn allows tumor proliferation in low oxygen conditions (Zhao et al., 2009; Koivunen et al., 2012). Hartmann, C.; von Deimling, A. Giannini, C.; Scheithauer, BW. -, Aldape K, Burger PC, Perry A (2007) Clinicopathologic aspects of 1p/19q loss and the diagnosis of oligodendroglioma. Symptoms related to oligodendrogliomas depend on the tumors location. 2005 Sep 17-23. doi: 10.1016/s1470-2045(16)30122-x, Batchelor, T. T., Gilbert, M. R., Supko, J. G., Carson, K. A., Nabors, L. B., Grossman, S. A., et al. (2021). Ruas, M., and Peters, G. (1998). Tambi Jarmi, MD is a member of the following medical societies: American College of Physicians, American Medical AssociationDisclosure: Nothing to disclose. In the case of permitted digital reproduction, please credit the National Cancer Institute as the source and link to the original NCI product using the original product's title; e.g., Oligodendroglioma Diagnosis and Treatment was originally published by the National Cancer Institute.. J. Neurooncol. 0000255421 00000 n Although 9p losses can be found in many gliomas, they more commonly occur in higher grade tumors (grades 3 and 4), which make the CDKN2A gene or p16 protein (CDKN2A product) potential players involved in the malignant progression and anaplastic transformation of low-grade gliomas into higher grades (He et al., 1995; Ueki et al., 1996; Watanabe et al., 2001). May have neuronal "islands" (Synapto +ve, NeuN +ve). Evidence from in vivo models have demonstrated reduced levels of STAT1 and CXCL10 in IDH-mutant gliomas. IDH mutations have also been implicated in the regulation of the recruitment of inflammatory cells to tumor sites, specifically through D-2HG. Pembrolizumab Monotherapy Effective for Rare Melanoma, For Uninsured People With Cancer, Securing Care Can Be Like Spinning a Roulette Wheel, Nonmelanoma Skin Cancers You Need to Know. doi: 10.1007/s11095-013-1264-4, Amankulor, N. M., Kim, Y., Arora, S., Kargl, J., Szulzewsky, F., Hanke, M., et al. doi: 10.1371/journal.pone.0193213, Ohgaki, H., and Kleihues, P. (2009). [QxMD MEDLINE Link]. The platelet-derived growth factor (PDGF) signaling system has been associated with the development and malignant progression of AO. Analysis from the initial study design. Ostrom QT, Gittleman H, Liao P, Vecchione-Koval T, Wolinsky Y, Kruchko C, et al. Response rate and prognostic factors of recurrent oligodendroglioma treated with procarbazine, CCNU, and vincristine chemotherapy. Diffuse gliomas histopathologically form a, Example of how molecular reclassification, Example of how molecular reclassification may affect tumor grade. Numbers may be higher when stringent classifiation criteria are not applied. 123, 853860. In the cytosol, the product of the reaction catalyzed by IDH1, alpha-KG, has been reported to be involved in multiple cellular pathways including hypoxia sensing, lipogenesis and epigenetic modification through its action on alpha-KG dependent dioxygenases such as TET and JmjC and other enzymes (Mason et al., 1996; Buckner et al., 2003; Abrey et al., 2006; Taliansky-Aronov et al., 2006). (2016). Note: If molecular testing fails, cases should be classified as Oligodendroglioma, NOS. Sci. Sagittal gadolinium-enhanced T1-weighted magnetic resonance image of a low-grade oligodendroglioma. Procarbazine, CCNU, vincristine (PCV) chemotherapy for benign oligodendroglioma. Oligodendroglioma with ganglioglioma-like maturation: the histopathological diagnostic challenge of a brain neoplasm with aberrant neuronal component - A case report and review of the literature. Am. Anaplastic oligodendrogliomas frequently take on eosinophilic cytoplasm and hyperchromasia of the nuclei. [QxMD MEDLINE Link]. Cairncross JG, Berkey B, Shaw E. Phase III trial of chemotherapy plus radiotherapy compared with radiotherapy alone for pure and mixed anaplastic oligodendrogliomas: intergroup Radiation Therapy Oncology Group Trial 9402. (2006). 479-91. Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951. Bello MJ, Vaquero J, de Campos JM, et al. Neuro Oncol. [QxMD MEDLINE Link]. Acutely branched capillary sized vessels - "chicken-wire" like appearance. Mason WP, DeAngelis LM. official website and that any information you provide is encrypted 0000349212 00000 n doi: 10.1212/wnl.46.1.203, Michaud, K., de Tayrac, M., DAstous, M., Paquet, C., Gould, P. V., and Saikali, S. (2018). 2012 Jun;123(6):853-60. doi: 10.1007/s00401-012-0993-5. Neurobiol. Genes Dev. Impact of 9p deletion and p16, Cyclin D1, and Myc hyperexpression on the outcome of anaplastic oligodendrogliomas. The 2016 World Health Organization classification of tumors of the central nervous system: A summary. California: University of California. Ann. Pathol. Oligodendrogliomas have a fried egg appearance under the microscope with sheets of round nuclei surrounded by clear cytoplasm.

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