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oligodendroglioma pathology outlines

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2012 Jan. 14(1):109-16. Tambi Jarmi, MD Resident Physician, Department of Internal Medicine, Carraway Methodist Medical Center Share cases and questions with Physicians on Medscape consult. Jain SU, Do TJ, Lund PJ, et al. These cells make a substance that protects nerve cells and helps with the flow of electrical signals in the brain and spinal cord. (2002). (2017). As part of an ongoing phase 1 trial to treat recurrent malignant gliomas (NCT03152318), investigators hope that the rQNestin34.5v.2 drug will spread to a glioma cell, kill it, and then make a copy of itself and spread again. ; Perry, A.; Reifenberger, G.; von Deimling, A.; Figarella-Branger, D.; Cavenee, WK. Bookshelf CIMP + and MGMT-STP27 methylated tumors had a clear benefit from adjuvant PCV; the median OS in the RT and RT-PCV arms was 3.27 vs. 9.51 years (P < 0.0033), respectively for CIMP + tumors and 1.98 vs. 8.65 years (P < 0.0001) for MGMT-STP27 methylated tumors (van den Bent et al., 2013b). 13:861-873. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. %%EOF J. Shin, D.-W., Lee, S., Song, S. W., Cho, Y. H., Hong, S. H., Kim, J. H., 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 (. ; Singh, A.. "Immunohistochemical expression of IDH1 in gliomas: a tissue microarray-based approach.". Through the formation of homo- and hetero-dimers with other bHLH transcription factors, TCF12 modulates the transcription of specific genes that are intrinsic to the oligodendrocyte lineage (Fu et al., 2009) and are involved in neural development (Uittenbogaard and Chiaramello, 2002). (2018). Seizure characteristics and outcomes in 508 Chinese adult patients undergoing primary resection of low-grade gliomas: a clinicopathological study. Clin. Thus, prognostic markers should be assessed while accounting for other genetic alterations. Acad. PMC [QxMD MEDLINE Link]. TCF12 is mutated in anaplastic oligodendroglioma. 18:636. doi: 10.1200/jco.2000.18.3.636, Smith, J. S., Wang, X.-Y., Qian, J., Hosek, S. M., Scheithauer, B. W., Jenkins, R. B., et al. 79, 153157. 14:722396. doi: 10.3389/fnmol.2021.722396. Commun. As expected, patients with an IDH mutation and 1p19q co-deletion showed significant benefit in OS. Consequences of IDH1/2 mutations in gliomas and an assessment of inhibitors targeting mutated IDH proteins. Oligodendroglial tumors. Notices 2012:530179. Temporal lobe tumoral epilepsy: characteristics and predictors of surgical outcome. [3] This risk classification may change in the future as our understanding of the contributions of genetic markers to survivability evolves. "Codeletion of 1p and 19q determines distinct gene methylation and expression profiles in IDH-mutated oligodendroglial tumors.". NCT03434262 is a phase 1 study assessing the efficacy of different drugs on children and young adults. The efficacy and safety of other novel therapeutic drugs such as rQNestin34.5v.2 (an oncolytic viral vector) is also being assessed. Oligodendroglioma High Quality Pathology Images of Neuropath: Glial Tumors of Oligodendroglioma . In addition to being a surrogate for oligodendroglial lineage, TERT mutations seem to have some prognostic significance (Dahlin et al., 2016). Bethesda, MD 20894, Web Policies (2017) studied the status of both TERT and ATRX mutations along with their prognostic values in cohorts including grade II/III astrocytomas. Another DNA-binding protein found mutated in AO is FUBP1. The goal of surgery is to obtain tissue to determine the tumor type and to remove as much tumor as possible without causing more symptoms for the person. Kleihus P, Cavenee WK. 108, 227235. Neuro Oncol. Biochim. Oligodendroglial tumors are rare tumors that constitute part of the neuro epithelial tumors of the central nervous system. 12,142 Images : Last Update : Apr 23, 2023. Cancer 91, 417422. Biophys. 6, 2127. Oligodendroglioma. (2006). Pathophysiology Cell of origin is unknown, although the commonality of IDH mutation across IDH mutant astrocytoma and oligodendroglioma suggests a common histogenesis in these tumors; similarly, single cell sequencing of IDH mutant gliomas suggests this as well ( Acta Neuropathol 2009;118:469, Science 2017;355:eaai8478 ) Etiology To establish the diagnosis of AO, a pathological sample is crucial. It was shown by Uhm (2010) that IDH mutations lead to the acquisition of a new enzymatic function that catalyzes the formation of D-2HG from alpha-KG. government site. PCV and TMZ are also used in cases of recurrence but result in lower response rates and disease-free survival. Diffuse gliomas histopathologically form a, Example of how molecular reclassification, Example of how molecular reclassification may affect tumor grade. van den Bent MJ. Neuro Oncol. 0000225968 00000 n In a population of patients with oligodendroglial tumors, four cases exhibited absent CIC expression with no detectable mutations, suggesting that alterations affecting CIC could occur through other unidentified mechanisms (Chan et al., 2014). J Clin Oncol. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1425. Packer RJ, Sutton LN, Rorke LB, et al. PFA ependymoma-associated protein EZHIP inhibits PRC2 activity through a H3 K27M-like mechanism. Case Report: Single-Cell Transcriptomic Analysis of an Anaplastic Oligodendroglioma Post Immunotherapy. Oligodendroglial tumors are rare tumors that constitute part of the neuro epithelial tumors of the central nervous system. (1994). (1994) and showed that the median time to progression for patients was at least 25.2 months for complete responders, 14.2 months for partial responders and 6.8 months for stable patients. NCT04708548 is an ongoing European cross-sectional study that is looking at health-related quality of parameters and outcomes in survivors after being treated with surgery, chemotherapy and/or RT. doi: 10.1200/jco.2003.06.023. Similarly in a retrospective study by Fujii et al. ; Hartmann, C.; Felsberg, J.; Platten, M. et al. Am. 0000017366 00000 n New York: Oxford University Press; 2000. This content does not have an Arabic version. J. Neurosurg. (2010). Nature 483, 479483. (1995). Mol. PLoS One 8:e68782. Mod. 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. While IDH-WT tumors retained a poor prognosis and showed no benefit from PCV treatment, improved OS was seen in IDH mutant non-co-deleted tumors, and astrocytic tumors when treated with PCV plus RT. (Aug 2013). JmjC demethylases are one of the many dioxygenases regulated by -KG and inhibited by 2-HG. J. Mol. Oncol. Accessibility 2008 Aug. 15(8):946-9. doi: 10.1200/jco.1995.13.8.2066. (2001). However, we cannot answer medical or research questions or give advice. doi: 10.1101/gad.294991.116, Ascierto, P. A., McArthur, G. A., Drno, B., Atkinson, V., Liszkay, G., Di Giacomo, A. M., et al. 0000230069 00000 n Neurosurg Focus. National Library of Medicine Cancer is a genetic disease that is, cancer is caused by certain changes to genes that control the way our cells function. If you would like to reproduce some or all of this content, see Reuse of NCI Information for guidance about copyright and permissions. These cells make a substance that protects nerve cells and helps with the flow of electrical signals in the brain and spinal cord. 2006 Jun 20. Such tumors may demonstrate necrosis among its diagnostic features. 2022 Nov 22;15(3):e23. Results of this trial raise the possibility that the chemosensitivity seen in these tumors might be due to the IDH mutation that is common to both oligodendroglial and low-grade astrocytic gliomas. PLoS One 11:e0163067. van den Bent, M. J., Dubbink, H. J., Marie, Y., Brandes, A. 0000124566 00000 n Daumas-Duport C, Scheithauer BW, Chodkiewicz JP, et al. (2011). (2013). B., Gillespie, S. M., Venteicher, A. S., and Stemmer-Rachamimov, A. O. Please confirm that you would like to log out of Medscape. Eur. Douglas E Ney, MD is a member of the following medical societies: American Academy of Neurology, American Society of Clinical Oncology, Society for Neuro-OncologyDisclosure: Nothing to disclose. This image demonstrates no contrast enhancement. CORE - Aggregating the world's open access research papers Distribution of TERT promoter mutations in pediatric and adult tumors of the nervous system. Cancer. Genes may be mutated (changed) in many types of cancer, which can increase the growth and spread of cancer cells. 31, 344350. 19, 55135522. "Clinicopathologic aspects of 1p/19q loss and the diagnosis of oligodendroglioma.". Neurosurgery 43, 10661073. Turcan, S., Rohle, D., Goenka, A., Walsh, L. A., Fang, F., Yilmaz, E., et al. (2009). Kaye AH, Laws ER Jr, eds. J. Clin. "Clinicopathologic features of pediatric oligodendrogliomas: a series of 50 patients.". Would you like email updates of new search results? [QxMD MEDLINE Link]. The treatment modalities have shifted over time, and recent studies are considering immunotherapy as an option as well. eCollection 2023 Apr. Louis, DN. In a study by Shin et al. Oligodendroglioma is a growth of cells that starts in the brain. At a median follow up of 7.5 years, around 80% (n = 10) patients in Arm C progressed vs. approximately 40% (n = 9) in the other arms. An official website of the United States government. (2016). (2003). Concurrent CIC mutations, IDH mutations, and 1p/19q loss distinguish oligodendrogliomas from other cancers. (2011). [QxMD MEDLINE Link]. ROS and brain gliomas: an overview of potential and innovative therapeutic strategies. What are the grades of oligodendrogliomas? Another factor that increases probability of survival in low-grade gliomas is a high performance status. (2016). J. Neurooncol. Patients with low-grade gliomas can be conventionally stratified into high risk and low risk categories, with risk referring to risk of tumor progression or recurrence. PNETs may also have some swelling around them. "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.". (2013) was the first to conduct a meta-analysis on PFS and OS in gliomas based on IDH mutations. doi: 10.1007/bf00146875, Rasheed, A., Herndon, J. E., Stenzel, T. T., Raetz, J. G., Kendelhardt, J., Friedman, H. S., et al. 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. Oligodendroglioma: pathology, molecular mechanisms and markers For nearly a century, the diagnosis and grading of oligodendrogliomas and oligoastrocytomas has been based on histopathology alone. (2009). 0000126977 00000 n During this type of surgery, you're awakened from a sleep-like state. Pediatric oligodendroglioma is a low-grade glioma that remains relatively rare when compared to adults. Threshold of the extent of resection for WHO Grade III gliomas: retrospective volumetric analysis of 122 cases using intraoperative MRI. at the National Cancer Institute, An official website of the United States government, Oligodendroglioma Diagnosis and Treatment, Finding Your Best Path and Fighting Brain Cancer, 5-year survival rate for oligodendroglioma is 74.1%, Outcomes and Risk Project for Patients with Rare CNS Cancers, Evaluation of the Natural History and Specimen Banking for Patients with CNS Cancers, Virtual Reality Study for Patients with Brain Cancer, Sleep Observation Study for Patients with Brain Cancer, CALM Therapy Intervention Study for Patients with Brain Cancer, Nivolumab for Patients with IDH-Mutant Gliomas, ONC206 for Patients with Rare CNS Neoplasms, A New Web-based Study of Low-Grade Gliomas, Two Sons with a Rare Brain Cancer? (2012). Youmans and Winn Neurological Surgery. 43, 7178. For patients with WHO grade 2 and KPS 60, the majority (90.5% . Exp. K.-Y., Pang, J. C.-S., Chung, N. Y.-F., Li, K. K.-W., Poon, W. S., Chan, D. T.-M., et al. Treat. N Engl J Med. Epileptogenic tumors affecting children and young adults are a morphologically diverse collection of neuroepithelial neoplasms that, as a group, exhibit varying levels of glial and/or neuronal differentiation. doi: 10.1093/neuonc/nox158. doi: 10.3171/2017.3.JNS162383, Fulton, D., Urtasun, R., and Forsyth, P. (1996). Infiltration of immune cells, specifically T cells, were also reduced in these tumors (Amankulor et al., 2017; Kohanbash et al., 2017). Development. Patients harboring co-deleted tumors can receive either PCV or TMZ. Pan-Weisz, T. M. (2019). Phase 2 study of weekly irinotecan in adults with recurrent malignant glioma: final report of NABTT 97-11. Hence, surgeons should biopsy patients suspected to have AO and attempt tumor resection, as with all other high-grade gliomas. Lancet. This means it begins in the brain or spinal cord. Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, Mayo Clinic on Incontinence - Mayo Clinic Press, NEW Mayo Clinic on High Blood Pressure - Mayo Clinic Press, Mayo Clinic on Hearing and Balance - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Financial Assistance Documents Minnesota, Infographic: Molecular Classification of Gliomas, Intraoperative magnetic resonance imaging (iMRI), Research provides critical information about the size and growth speed of gliomas, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition. Br J Neurosurg. 0000276357 00000 n 17, 15161525. The wildtype (WT) TERT group was associated with good prognosis only in IDH1/IDH2 WT (IDH-WT) grade II/III astrocytomas. www.pathologyoutlines.com/topic/stainsolig2.html, Mozilla/5.0 (iPhone; CPU iPhone OS 15_5 like Mac OS X) AppleWebKit/605.1.15 (KHTML, like Gecko) GSA/218.0.456502374 Mobile/15E148 Safari/604.1. Megyesi JF, Kachur E, Lee DH, et al. doi: 10.1093/neuonc/noaa168, Jiang, B., Zhao, W., Shi, M., Zhang, J., Chen, A., Ma, H., et al. Even though there wasnt any difference in OS, the PFS remained shorter for patients not receiving any RT; even after adjusting for IDH status and RT treatment status. (2003). The goal of surgery is to remove as much of the oligodendroglioma as possible. Oligodendroglioma is a primary central nervous system (CNS) tumor. (2019). Sahm, F., Koelsche, C., Meyer, J., Pusch, S., Lindenberg, K., Mueller, W., et al. 23, 457467. 0000124516 00000 n The tumor may enhance with contrast and is most often seen in anaplastic oligodendrogliomas. 10(13):4303-6. Oligodendrogliomas occur more often in males and are rare in children. Other treatments may be needed after surgery. 0000248012 00000 n This occurs via 2-HGs inhibition of KDM4A, an -KG dependent deoxygenase, and destabilization of DEPTOR, a negative regulator of mTORC1/2, resulting in mTOR pathway activation (Carbonneau et al., 2016). Oligodendroglioma is a molecularly defined diagnosis requiring demonstration of both: Unbalanced translocation between chromosome 1 and 19, resulting in whole arm loss of 1p and 19q chromosomal material (1p / 19q codeletion), Incomplete or partial deletions are not compatible with oligodendroglioma diagnosis, Often absent in teenagers with oligodendroglioma (, Loss of H3K27 trimethylation by immunohistochemistry (. What are the symptoms of oligodendrogliomas? 0000015277 00000 n Brain Tumors: An Encyclopedic Approach. The machine sends beams to exact points in your brain. Oligodendrogliomas arise in the cerebral hemispheres and have a predilection for the frontal lobes. Jorge C Kattah, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, New York Academy of SciencesDisclosure: Nothing to disclose. Astrocyte Oligodendrocyte IDH mutations have also been implicated in the regulation of the recruitment of inflammatory cells to tumor sites, specifically through D-2HG. Molecular analysis of IDH1/2 hotspots and LOH1p/19q testing is required for diagnosis. 0000226081 00000 n Cerebral oligodendroglioma: prognostic factors and life history. 2008 Apr 15. 2023 Mar 29;15(7):2033. doi: 10.3390/cancers15072033. Neurosci. For example, a test may look at the changes in the tumor cells' genetic material, called DNA. 8600 Rockville Pike This comes with a risk of sacrificing important brain centers and hence compromising functionality and quality of life. 36:294-295. doi: 10.1074/jbc.RA117.001385, Johnson, B. E., Mazor, T., Hong, C., Barnes, M., Aihara, K., McLean, C. Y., et al. Science 289:905.

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