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→Grading: update
Jensflorian (talk | contribs) (→Classic ependymoma: Update) |
Jensflorian (talk | contribs) (→Grading: update) |
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===Grading=== | ===Grading=== | ||
Easy: | Easy: | ||
*Subependymoma = WHO grade | *Subependymoma = CNS WHO grade 1. | ||
*Myxopapillary ependymoma = WHO grade | *Myxopapillary ependymoma = CNS WHO grade 2. | ||
Grade | Not so easy: | ||
All other ependymomas: WHO CNS Grade 2 vs. Grade 3 depends on: | |||
*Cellular density. | *Cellular density. | ||
*Mitoses. | *Mitoses (no clear cut-off). | ||
*Necrosis. | *Necrosis (not prognostic). | ||
*Microvascular proliferation. | *Microvascular proliferation. | ||
*Poor interobserver reliability<ref>{{Cite journal | last1 = Ellison | first1 = DW. | last2 = Kocak | first2 = M. | last3 = Figarella-Branger | first3 = D. | last4 = Felice | first4 = G. | last5 = Catherine | first5 = G. | last6 = Pietsch | first6 = T. | last7 = Frappaz | first7 = D. | last8 = Massimino | first8 = M. | last9 = Grill | first9 = J. | title = Histopathological grading of pediatric ependymoma: reproducibility and clinical relevance in European trial cohorts. | journal = J Negat Results Biomed | volume = 10 | issue = | pages = 7 | month = May | year = 2011 | doi = 10.1186/1477-5751-10-7 | PMID = 21627842 }}</ref> | *Poor interobserver reliability<ref>{{Cite journal | last1 = Ellison | first1 = DW. | last2 = Kocak | first2 = M. | last3 = Figarella-Branger | first3 = D. | last4 = Felice | first4 = G. | last5 = Catherine | first5 = G. | last6 = Pietsch | first6 = T. | last7 = Frappaz | first7 = D. | last8 = Massimino | first8 = M. | last9 = Grill | first9 = J. | title = Histopathological grading of pediatric ependymoma: reproducibility and clinical relevance in European trial cohorts. | journal = J Negat Results Biomed | volume = 10 | issue = | pages = 7 | month = May | year = 2011 | doi = 10.1186/1477-5751-10-7 | PMID = 21627842 }}</ref> | ||
| Line 148: | Line 146: | ||
Notes: | Notes: | ||
*Many tumours fall between grade | *Many tumours fall between grade 2 and grade 3. | ||
*Rare cases with sarcomatous or cartilaginous components.<ref>{{Cite journal | last1 = Vajtai | first1 = I. | last2 = Kuhlen | first2 = D. | last3 = Kappeler | first3 = A. | last4 = Mariani | first4 = L. | last5 = Zimmermann | first5 = A. | last6 = Paulus | first6 = W. | title = Rapid spontaneous malignant progression of supratentorial tanycytic ependymoma with sarcomatous features - "Ependymosarcoma". | journal = Pathol Res Pract | volume = 206 | issue = 7 | pages = 493-8 | month = Jul | year = 2010 | doi = 10.1016/j.prp.2009.07.013 | PMID = 19853384 }}</ref><ref>{{Cite journal | last1 = Boukas | first1 = A. | last2 = Joshi | first2 = A. | last3 = Jenkins | first3 = A. | last4 = Holliman | first4 = D. | title = Extensive cartilaginous metaplasia of recurrent posterior fossa ependymoma: case report and review of the literature. | journal = Pediatr Neurosurg | volume = 49 | issue = 2 | pages = 93-8 | month = | year = 2013 | doi = 10.1159/000356931 | PMID = 24401698 }}</ref> | *Rare cases with sarcomatous or cartilaginous components.<ref>{{Cite journal | last1 = Vajtai | first1 = I. | last2 = Kuhlen | first2 = D. | last3 = Kappeler | first3 = A. | last4 = Mariani | first4 = L. | last5 = Zimmermann | first5 = A. | last6 = Paulus | first6 = W. | title = Rapid spontaneous malignant progression of supratentorial tanycytic ependymoma with sarcomatous features - "Ependymosarcoma". | journal = Pathol Res Pract | volume = 206 | issue = 7 | pages = 493-8 | month = Jul | year = 2010 | doi = 10.1016/j.prp.2009.07.013 | PMID = 19853384 }}</ref><ref>{{Cite journal | last1 = Boukas | first1 = A. | last2 = Joshi | first2 = A. | last3 = Jenkins | first3 = A. | last4 = Holliman | first4 = D. | title = Extensive cartilaginous metaplasia of recurrent posterior fossa ependymoma: case report and review of the literature. | journal = Pediatr Neurosurg | volume = 49 | issue = 2 | pages = 93-8 | month = | year = 2013 | doi = 10.1159/000356931 | PMID = 24401698 }}</ref> | ||