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WHO diagnostic guidelines
Jensflorian (talk | contribs) (→Microscopic: fix wikilinks) |
Jensflorian (talk | contribs) (WHO diagnostic guidelines) |
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* First description of the tumor in 1926. | * First description of the tumor in 1926. | ||
*WHO Grade II: ICD-O: 9450/3. | The WHO 2016 classification recognizes four tumor subtypes:<ref>{{Cite journal | last1 = Louis | first1 = DN. | last2 = Perry | first2 = A. | last3 = Reifenberger | first3 = G. | last4 = von Deimling | first4 = A. | last5 = Figarella-Branger | first5 = D. | last6 = Cavenee | first6 = WK. | last7 = Ohgaki | first7 = H. | last8 = Wiestler | first8 = OD. | last9 = Kleihues | first9 = P. | title = The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. | journal = Acta Neuropathol | volume = 131 | issue = 6 | pages = 803-20 | month = Jun | year = 2016 | doi = 10.1007/s00401-016-1545-1 | PMID = 27157931 }}</ref> | ||
*WHO Grade III | *Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, WHO Grade II (ICD-O: 9450/3). | ||
*Anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted, WHO Grade III (ICD-O: 9451/3). | |||
*Oligodendroglioma, NOS, WHO Grade II (ICD-O: 9450/3). | |||
*Anaplastic oligodendroglioma, NOS, WHO Grade III (ICD-O: 9451/3). | |||
==Gross/radiologic== | ==Gross/radiologic== | ||
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# WHO grade II. | # WHO grade II. | ||
#*This is most oligodendrogliomas. | #*This is most oligodendrogliomas. | ||
#*Without genetic testing for [[IDH-1]] and LOH 1p/19q, the tumor is called Oligodendroglioma, NOS. | |||
# WHO grade III. | # WHO grade III. | ||
#*Features for calling high grade:<ref name=Ref_PSNP98>{{Ref PSNP|98}}</ref> | #*Features for calling high grade:<ref name=Ref_PSNP98>{{Ref PSNP|98}}</ref> | ||
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#**Necrosis. | #**Necrosis. | ||
#**High mitotic rate (6 mitoses/10 HPF for whatever "HPF" means, see [[HPFitis]]). | #**High mitotic rate (6 mitoses/10 HPF for whatever "HPF" means, see [[HPFitis]]). | ||
#*Without genetic testing for [[IDH-1]] and LOH 1p/19q, the tumor is called Anaplastic oligodendroglioma, NOS. | |||
==IHC== | ==IHC== | ||
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==Molecular pathology== | ==Molecular pathology== | ||
Combined losses of 1p and 19q both | Combined losses of 1p and 19q both is required for final diagnosis and is prognostic and therapeutic relevant:<ref name=pmid18565359>{{cite journal |author=Fontaine D, Vandenbos F, Lebrun C, Paquis V, Frenay M |title=[Diagnostic and prognostic values of 1p and 19q deletions in adult gliomas: critical review of the literature and implications in daily clinical practice] |language=French |journal=Rev. Neurol. (Paris) |volume=164 |issue=6-7 |pages=595–604 |year=2008 |pmid=18565359 |doi=10.1016/j.neurol.2008.04.002 |url=}}</ref><ref>{{Cite journal | last1 = Wiestler | first1 = B. | last2 = Capper | first2 = D. | last3 = Hovestadt | first3 = V. | last4 = Sill | first4 = M. | last5 = Jones | first5 = DT. | last6 = Hartmann | first6 = C. | last7 = Felsberg | first7 = J. | last8 = Platten | first8 = M. | last9 = Feiden | first9 = W. | title = Assessing CpG island methylator phenotype, 1p/19q codeletion, and MGMT promoter methylation from epigenome-wide data in the biomarker cohort of the NOA-04 trial. | journal = Neuro Oncol | volume = 16 | issue = 12 | pages = 1630-8 | month = Dec | year = 2014 | doi = 10.1093/neuonc/nou138 | PMID = 25028501 }}</ref><ref>{{Cite journal | last1 = Cairncross | first1 = G. | last2 = Wang | first2 = M. | last3 = Shaw | first3 = E. | last4 = Jenkins | first4 = R. | last5 = Brachman | first5 = D. | last6 = Buckner | first6 = J. | last7 = Fink | first7 = K. | last8 = Souhami | first8 = L. | last9 = Laperriere | first9 = N. | title = Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: long-term results of RTOG 9402. | journal = J Clin Oncol | volume = 31 | issue = 3 | pages = 337-43 | month = Jan | year = 2013 | doi = 10.1200/JCO.2012.43.2674 | PMID = 23071247 }}</ref> | ||
*Greater chemosensitivity | *Greater chemosensitivity | ||
*Better prognosis. | *Better prognosis. | ||
Note: | Note: | ||
*Consider underdiagnosed Glioblastoma, when tumor is IDH1/2 wildtype and has no LOH 1p/19q and | *Consider underdiagnosed Glioblastoma, IDH-wildtype when tumor is IDH1/2 wildtype and has no LOH 1p/19q and no ATRX loss. | ||
* | *[[IDH-1]] mutant, but non-codeleted tumors are no longer classified as oligodendrogliomas on molecular basis. These tumors are classified either as IDH-mutant astrocytoma or glioblastoma, depending on histologic features present. | ||
==See also== | ==See also== | ||
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[[Category:Neuropathology tumours]] | [[Category:Neuropathology tumours]] | ||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:WHO grade II tumours]] | |||