Oligoastrocytoma pathophysiology: Difference between revisions

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==Overview==
==Overview==
Oligoastrocytomas are mixed tumors that arises from the proliferation of both [[oligodendrocyte]]s and [[astrocyte]]s.<ref name=pathogenesis>Introduction of oligodendroglioma and oligoastrocytoma. American Brain Tumor Association. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 16, 2015</ref> Genes associated with the pathogenesis of oligoastrocytoma and anaplastic oligoastrocytoma include ''[[Isocitrate dehydrogenase|IDH1]]'', ''[[p53]]'', ''[[EGFR]]'', ''[[ATRX]]'', ''[[EGFR]]'', ''[[PTEN]]'', ''[[Ogt|MGMT]]'', ''CIC'', and ''[[Far upstream element-binding protein 1|FUBP1]]''.<ref name="pmid12107116">{{cite journal| author=Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J et al.| title=Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets. | journal=Am J Pathol | year= 2002 | volume= 161 | issue= 1 | pages= 313-9 | pmid=12107116 | doi=10.1016/S0002-9440(10)64183-1 | pmc=PMC1850690 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12107116  }} </ref><ref name="pmid25143301">{{cite journal| author=Sahm F, Reuss D, Koelsche C, Capper D, Schittenhelm J, Heim S et al.| title=Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma. | journal=Acta Neuropathol | year= 2014 | volume= 128 | issue= 4 | pages= 551-9 | pmid=25143301 | doi=10.1007/s00401-014-1326-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25143301  }} </ref><ref name="pmid18507036">{{cite journal| author=Viana-Pereira M, Lopes JM, Little S, Milanezi F, Basto D, Pardal F et al.| title=Analysis of EGFR overexpression, EGFR gene amplification and the EGFRvIII mutation in Portuguese high-grade gliomas. | journal=Anticancer Res | year= 2008 | volume= 28 | issue= 2A | pages= 913-20 | pmid=18507036 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18507036  }} </ref><ref name="pmid12006525">{{cite journal| author=Ermoian RP, Furniss CS, Lamborn KR, Basila D, Berger MS, Gottschalk AR et al.| title=Dysregulation of PTEN and protein kinase B is associated with glioma histology and patient survival. | journal=Clin Cancer Res | year= 2002 | volume= 8 | issue= 5 | pages= 1100-6 | pmid=12006525 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12006525  }} </ref><ref name="pmid23948976">{{cite journal| author=van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG et al.| title=MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951. | journal=Clin Cancer Res | year= 2013 | volume= 19 | issue= 19 | pages= 5513-22 | pmid=23948976 | doi=10.1158/1078-0432.CCR-13-1157 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23948976  }} </ref><ref name="pmid22869205">{{cite journal| author=Jiao Y, Killela PJ, Reitman ZJ, Rasheed AB, Heaphy CM, de Wilde RF et al.| title=Frequent ATRX, CIC, FUBP1 and IDH1 mutations refine the classification of malignant gliomas. | journal=Oncotarget | year= 2012 | volume= 3 | issue= 7 | pages= 709-22 | pmid=22869205 | doi= | pmc=PMC3443254 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22869205  }} </ref><ref name="pmid16018821">{{cite journal| author=Liang Y, Bollen AW, Nicholas MK, Gupta N| title=Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas. | journal=BMC Clin Pathol | year= 2005 | volume= 5 | issue=  | pages= 6 | pmid=16018821 | doi=10.1186/1472-6890-5-6 | pmc=PMC1182359 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16018821  }} </ref><ref name=pathoOA1>{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref> 30-70% of oligoastrocytomas show loss of heterozygosity (LOH) of [[chromosome 1|1p]] and [[chromosome 19|19q]].<ref name="pmid12107116">{{cite journal| author=Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J et al.| title=Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets. | journal=Am J Pathol | year= 2002 | volume= 161 | issue= 1 | pages= 313-9 | pmid=12107116 | doi=10.1016/S0002-9440(10)64183-1 | pmc=PMC1850690 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12107116  }} </ref><ref name=pathoOA1>{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref><ref name=OAsymp3>Cause of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015</ref> On gross pathology, oligoastrocytoma is characterized by soft, well-defined, grey-tan, mucoid or hemorrhagic, calcified mass with or without necrosis, which may expand the [[gyrus]] and cause blurring of the grey-white junction.<ref name=pathoOA1>{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref> On microscopic histopathological analysis, oligoastrocytoma is characterized by [[Cell|highly cellular lesions]] composed of both [[oligodendrocyte|oligodendroglial]] and [[astrocyte|astrocytic]] components.<ref name=patho1>Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015</ref><ref name="pmid15026604">{{cite journal| author=Naugle DK, Duncan TD, Grice GP| title=Oligoastrocytoma. | journal=Radiographics | year= 2004 | volume= 24 | issue= 2 | pages= 598-600 | pmid=15026604 | doi=10.1148/rg.242035069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15026604  }} </ref><ref name=pathowiki>Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015</ref><ref name=bookneuropathologyoligoastro>{{Citation| last1 = Love| first1 = S.| last2 = Loius| first2 = D.| last3 = Ellison| first3 = D.W.| lastauthoramp = yes| title = Greenfield's neuropathology| publisher = Hodder Arnold| place = Boca Raton, Florida| volume = 1| edition = 8th| year = 2008}}</ref><ref name=histoOA>Histology of anaplastic oligoastrocytes. Dr. Frank Gaillard. Radiopaedia 2015. http://radiopaedia.org/cases/anaplastic-oligoastrocytoma. Accessed on October 19, 2015</ref> In addition to the histological features of oligoastrocytoma, [[anaplastic|anaplastic oligoastrocytoma]] also has significant or brisk [[mitoses|mitotic activity]], marked [[atypia|cytologic and nuclear atypia]], [[necrosis]], [[apoptosis]], and microvacular proliferation.<ref name=patho1>Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015</ref><ref name="pmid15026604">{{cite journal| author=Naugle DK, Duncan TD, Grice GP| title=Oligoastrocytoma. | journal=Radiographics | year= 2004 | volume= 24 | issue= 2 | pages= 598-600 | pmid=15026604 | doi=10.1148/rg.242035069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15026604  }} </ref><ref name=pathowiki>Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015</ref> Oligoastrocytoma is demonstrated by positivity to tumor markers such as [[Microtubule-associated protein|MAP2]], [[GFAP]], [[isocitrate dehydrogenase|IDH1]], [[OLIG1|OLIG-1 protein]], [[OLIG2|OLIG-2 protein]], and [[AIF1|Iba-2 protein]].<ref name=IHC>IHC of oligoastrocytoma. Librepathology 2015. http://librepathology.org/wiki/index.php/Oligoastrocytoma. Accessed on October 16, 2015</ref><ref name="pmid22821367">{{cite journal| author=Kolenda-Roberts HM, Harris N, Singletary E, Hardisty JF| title=Immunohistochemical characterization of spontaneous and acrylonitrile-induced brain tumors in the rat. | journal=Toxicol Pathol | year= 2013 | volume= 41 | issue= 1 | pages= 98-108 | pmid=22821367 | doi=10.1177/0192623312452492 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22821367  }} </ref><ref name="pmid16018821">{{cite journal| author=Liang Y, Bollen AW, Nicholas MK, Gupta N| title=Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas. | journal=BMC Clin Pathol | year= 2005 | volume= 5 | issue=  | pages= 6 | pmid=16018821 | doi=10.1186/1472-6890-5-6 | pmc=PMC1182359 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16018821  }} </ref><ref name="Grier2006">{{cite journal|last1=Grier|first1=J. T.|title=Low-Grade Gliomas in Adults|journal=The Oncologist|volume=11|issue=6|year=2006|pages=681–693|issn=1083-7159|doi=10.1634/theoncologist.11-6-681}}</ref><ref name=pathoOA1>{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref>
Oligoastrocytomas are mixed tumors that arise from the proliferation of both [[oligodendrocyte]]s and [[astrocyte]]s.<ref name=pathogenesis>Introduction of oligodendroglioma and oligoastrocytoma. American Brain Tumor Association. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 16, 2015</ref> Genes associated with the pathogenesis of oligoastrocytoma and anaplastic oligoastrocytoma include ''[[Isocitrate dehydrogenase|IDH1]]'', ''[[p53]]'', ''[[EGFR]]'', ''[[ATRX]]'', ''[[EGFR]]'', ''[[PTEN]]'', ''[[Ogt|MGMT]]'', ''CIC'', and ''[[Far upstream element-binding protein 1|FUBP1]]''.<ref name="pmid12107116">{{cite journal| author=Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J et al.| title=Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets. | journal=Am J Pathol | year= 2002 | volume= 161 | issue= 1 | pages= 313-9 | pmid=12107116 | doi=10.1016/S0002-9440(10)64183-1 | pmc=PMC1850690 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12107116  }} </ref><ref name="pmid25143301">{{cite journal| author=Sahm F, Reuss D, Koelsche C, Capper D, Schittenhelm J, Heim S et al.| title=Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma. | journal=Acta Neuropathol | year= 2014 | volume= 128 | issue= 4 | pages= 551-9 | pmid=25143301 | doi=10.1007/s00401-014-1326-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25143301  }} </ref><ref name="pmid18507036">{{cite journal| author=Viana-Pereira M, Lopes JM, Little S, Milanezi F, Basto D, Pardal F et al.| title=Analysis of EGFR overexpression, EGFR gene amplification and the EGFRvIII mutation in Portuguese high-grade gliomas. | journal=Anticancer Res | year= 2008 | volume= 28 | issue= 2A | pages= 913-20 | pmid=18507036 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18507036  }} </ref><ref name="pmid12006525">{{cite journal| author=Ermoian RP, Furniss CS, Lamborn KR, Basila D, Berger MS, Gottschalk AR et al.| title=Dysregulation of PTEN and protein kinase B is associated with glioma histology and patient survival. | journal=Clin Cancer Res | year= 2002 | volume= 8 | issue= 5 | pages= 1100-6 | pmid=12006525 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12006525  }} </ref><ref name="pmid23948976">{{cite journal| author=van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG et al.| title=MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951. | journal=Clin Cancer Res | year= 2013 | volume= 19 | issue= 19 | pages= 5513-22 | pmid=23948976 | doi=10.1158/1078-0432.CCR-13-1157 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23948976  }} </ref><ref name="pmid22869205">{{cite journal| author=Jiao Y, Killela PJ, Reitman ZJ, Rasheed AB, Heaphy CM, de Wilde RF et al.| title=Frequent ATRX, CIC, FUBP1 and IDH1 mutations refine the classification of malignant gliomas. | journal=Oncotarget | year= 2012 | volume= 3 | issue= 7 | pages= 709-22 | pmid=22869205 | doi= | pmc=PMC3443254 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22869205  }} </ref><ref name="pmid16018821">{{cite journal| author=Liang Y, Bollen AW, Nicholas MK, Gupta N| title=Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas. | journal=BMC Clin Pathol | year= 2005 | volume= 5 | issue=  | pages= 6 | pmid=16018821 | doi=10.1186/1472-6890-5-6 | pmc=PMC1182359 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16018821  }} </ref><ref name=pathoOA1>{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref> 30-70% of oligoastrocytomas show loss of heterozygosity (LOH) of [[chromosome 1|1p]] and [[chromosome 19|19q]].<ref name="pmid12107116">{{cite journal| author=Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J et al.| title=Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets. | journal=Am J Pathol | year= 2002 | volume= 161 | issue= 1 | pages= 313-9 | pmid=12107116 | doi=10.1016/S0002-9440(10)64183-1 | pmc=PMC1850690 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12107116  }} </ref><ref name=pathoOA1>{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref><ref name=OAsymp3>Cause of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015</ref> On gross pathology, oligoastrocytoma is characterized by a soft, well-defined, grey-tan, mucoid or hemorrhagic, calcified mass with or without necrosis, which may expand the [[gyrus]] and cause blurring of the grey-white junction.<ref name=pathoOA1>{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref> On microscopic histopathological analysis, oligoastrocytoma is characterized by [[Cell|highly cellular lesions]] composed of both [[oligodendrocyte|oligodendroglial]] and [[astrocyte|astrocytic]] components.<ref name=patho1>Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015</ref><ref name="pmid15026604">{{cite journal| author=Naugle DK, Duncan TD, Grice GP| title=Oligoastrocytoma. | journal=Radiographics | year= 2004 | volume= 24 | issue= 2 | pages= 598-600 | pmid=15026604 | doi=10.1148/rg.242035069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15026604  }} </ref><ref name=pathowiki>Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015</ref><ref name=bookneuropathologyoligoastro>{{Citation| last1 = Love| first1 = S.| last2 = Loius| first2 = D.| last3 = Ellison| first3 = D.W.| lastauthoramp = yes| title = Greenfield's neuropathology| publisher = Hodder Arnold| place = Boca Raton, Florida| volume = 1| edition = 8th| year = 2008}}</ref><ref name=histoOA>Histology of anaplastic oligoastrocytes. Dr. Frank Gaillard. Radiopaedia 2015. http://radiopaedia.org/cases/anaplastic-oligoastrocytoma. Accessed on October 19, 2015</ref> In addition to the histological features of oligoastrocytoma, [[anaplastic|anaplastic oligoastrocytoma]] also has significant or brisk [[mitoses|mitotic activity]], marked [[atypia|cytologic and nuclear atypia]], [[necrosis]], [[apoptosis]], and microvacular proliferation.<ref name=patho1>Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015</ref><ref name="pmid15026604">{{cite journal| author=Naugle DK, Duncan TD, Grice GP| title=Oligoastrocytoma. | journal=Radiographics | year= 2004 | volume= 24 | issue= 2 | pages= 598-600 | pmid=15026604 | doi=10.1148/rg.242035069 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15026604  }} </ref><ref name=pathowiki>Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015</ref> Oligoastrocytoma is demonstrated by positivity to tumor markers such as [[Microtubule-associated protein|MAP2]], [[GFAP]], [[isocitrate dehydrogenase|IDH1]], [[OLIG1|OLIG-1 protein]], [[OLIG2|OLIG-2 protein]], and [[AIF1|Iba-2 protein]].<ref name=IHC>IHC of oligoastrocytoma. Librepathology 2015. http://librepathology.org/wiki/index.php/Oligoastrocytoma. Accessed on October 16, 2015</ref><ref name="pmid22821367">{{cite journal| author=Kolenda-Roberts HM, Harris N, Singletary E, Hardisty JF| title=Immunohistochemical characterization of spontaneous and acrylonitrile-induced brain tumors in the rat. | journal=Toxicol Pathol | year= 2013 | volume= 41 | issue= 1 | pages= 98-108 | pmid=22821367 | doi=10.1177/0192623312452492 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22821367  }} </ref><ref name="pmid16018821">{{cite journal| author=Liang Y, Bollen AW, Nicholas MK, Gupta N| title=Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas. | journal=BMC Clin Pathol | year= 2005 | volume= 5 | issue=  | pages= 6 | pmid=16018821 | doi=10.1186/1472-6890-5-6 | pmc=PMC1182359 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16018821  }} </ref><ref name="Grier2006">{{cite journal|last1=Grier|first1=J. T.|title=Low-Grade Gliomas in Adults|journal=The Oncologist|volume=11|issue=6|year=2006|pages=681–693|issn=1083-7159|doi=10.1634/theoncologist.11-6-681}}</ref><ref name=pathoOA1>{{cite book | last = Adesina | first = Adekunle | title = Atlas of pediatric brain tumors | publisher = Springer | location = New York | year = 2010 | isbn = 9781441910622 }}</ref>


==Pathophysiology==
==Pathophysiology==

Revision as of 16:14, 2 November 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Oligoastrocytomas are mixed tumors that arise from the proliferation of both oligodendrocytes and astrocytes.[1] Genes associated with the pathogenesis of oligoastrocytoma and anaplastic oligoastrocytoma include IDH1, p53, EGFR, ATRX, EGFR, PTEN, MGMT, CIC, and FUBP1.[2][3][4][5][6][7][8][9] 30-70% of oligoastrocytomas show loss of heterozygosity (LOH) of 1p and 19q.[2][9][10] On gross pathology, oligoastrocytoma is characterized by a soft, well-defined, grey-tan, mucoid or hemorrhagic, calcified mass with or without necrosis, which may expand the gyrus and cause blurring of the grey-white junction.[9] On microscopic histopathological analysis, oligoastrocytoma is characterized by highly cellular lesions composed of both oligodendroglial and astrocytic components.[11][12][13][14][15] In addition to the histological features of oligoastrocytoma, anaplastic oligoastrocytoma also has significant or brisk mitotic activity, marked cytologic and nuclear atypia, necrosis, apoptosis, and microvacular proliferation.[11][12][13] Oligoastrocytoma is demonstrated by positivity to tumor markers such as MAP2, GFAP, IDH1, OLIG-1 protein, OLIG-2 protein, and Iba-2 protein.[16][17][8][18][9]

Pathophysiology

Pathogenesis

Genetics

Gross Pathology

Microscopic Pathology

On microscopic histopathological analysis, oligoastrocytoma is characterized by:[11][12][13][14][15]

  • Highly cellular lesions composed of both oligodendroglial and astrocytic components
  • Two types of pattern: biphasic and diffuse
    • Biphasic pattern demonstrates oligodendroglial and astrocytic differentiation, whereas diffuse pattern demonstrates intermingling of both the components
  • Oligodendrocytes
  • Astrocytes
    • Star-shaped cells
    • Composed of gemistocytes
    • Multinucleated giant cells
    • Ovoid nucleus
    • Nuclear atypia

On microscopic histopathological analysis, anaplastic oligoastrocytoma is characterized by:[11][12][13]

Gallery

  • Biopsy specimen of an oligoastrocytoma (HE stain).[23]

    Biopsy specimen of an oligoastrocytoma (HE stain).[23]

Immunohistochemistry

Oligoastrocytoma is demonstrated by positivity to tumor markers such as:[16][17][8][18][9]

Gallery

  • Histology of oligoastrocytoma cells demonstrating positivity to tumor marker GFAP.[24]

    Histology of oligoastrocytoma cells demonstrating positivity to tumor marker GFAP.[24]

  • Histology of oligoastrocytoma cells demonstrating positivity to tumor marker Ki-67.[25]

    Histology of oligoastrocytoma cells demonstrating positivity to tumor marker Ki-67.[25]

References

  1. ↑ 1.0 1.1 Introduction of oligodendroglioma and oligoastrocytoma. American Brain Tumor Association. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 16, 2015
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J; et al. (2002). "Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets". Am J Pathol. 161 (1): 313–9. doi:10.1016/S0002-9440(10)64183-1. PMC 1850690. PMID 12107116.
  3. ↑ 3.0 3.1 Sahm F, Reuss D, Koelsche C, Capper D, Schittenhelm J, Heim S; et al. (2014). "Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma". Acta Neuropathol. 128 (4): 551–9. doi:10.1007/s00401-014-1326-7. PMID 25143301.
  4. ↑ 4.0 4.1 Viana-Pereira M, Lopes JM, Little S, Milanezi F, Basto D, Pardal F; et al. (2008). "Analysis of EGFR overexpression, EGFR gene amplification and the EGFRvIII mutation in Portuguese high-grade gliomas". Anticancer Res. 28 (2A): 913–20. PMID 18507036.
  5. ↑ 5.0 5.1 Ermoian RP, Furniss CS, Lamborn KR, Basila D, Berger MS, Gottschalk AR; et al. (2002). "Dysregulation of PTEN and protein kinase B is associated with glioma histology and patient survival". Clin Cancer Res. 8 (5): 1100–6. PMID 12006525.
  6. ↑ 6.0 6.1 van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG; et al. (2013). "MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951". Clin Cancer Res. 19 (19): 5513–22. doi:10.1158/1078-0432.CCR-13-1157. PMID 23948976.
  7. ↑ 7.0 7.1 Jiao Y, Killela PJ, Reitman ZJ, Rasheed AB, Heaphy CM, de Wilde RF; et al. (2012). "Frequent ATRX, CIC, FUBP1 and IDH1 mutations refine the classification of malignant gliomas". Oncotarget. 3 (7): 709–22. PMC 3443254. PMID 22869205.
  8. ↑ 8.0 8.1 8.2 8.3 Liang Y, Bollen AW, Nicholas MK, Gupta N (2005). "Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas". BMC Clin Pathol. 5: 6. doi:10.1186/1472-6890-5-6. PMC 1182359. PMID 16018821.
  9. ↑ 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 Adesina, Adekunle (2010). Atlas of pediatric brain tumors. New York: Springer. ISBN 9781441910622.
  10. ↑ 10.0 10.1 Cause of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015
  11. ↑ 11.0 11.1 11.2 11.3 Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015
  12. ↑ 12.0 12.1 12.2 12.3 Naugle DK, Duncan TD, Grice GP (2004). "Oligoastrocytoma". Radiographics. 24 (2): 598–600. doi:10.1148/rg.242035069. PMID 15026604.
  13. ↑ 13.0 13.1 13.2 13.3 Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015
  14. ↑ 14.0 14.1 Love, S.; Loius, D. & Ellison, D.W. (2008), Greenfield's neuropathology, 1 (8th ed.), Boca Raton, Florida: Hodder Arnold
  15. ↑ 15.0 15.1 Histology of anaplastic oligoastrocytes. Dr. Frank Gaillard. Radiopaedia 2015. http://radiopaedia.org/cases/anaplastic-oligoastrocytoma. Accessed on October 19, 2015
  16. ↑ 16.0 16.1 IHC of oligoastrocytoma. Librepathology 2015. http://librepathology.org/wiki/index.php/Oligoastrocytoma. Accessed on October 16, 2015
  17. ↑ 17.0 17.1 Kolenda-Roberts HM, Harris N, Singletary E, Hardisty JF (2013). "Immunohistochemical characterization of spontaneous and acrylonitrile-induced brain tumors in the rat". Toxicol Pathol. 41 (1): 98–108. doi:10.1177/0192623312452492. PMID 22821367.
  18. ↑ 18.0 18.1 Grier, J. T. (2006). "Low-Grade Gliomas in Adults". The Oncologist. 11 (6): 681–693. doi:10.1634/theoncologist.11-6-681. ISSN 1083-7159.
  19. ↑ Mixed Gliomas. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on#ixzz3okGrTzyi. Accessed on October 16, 2015
  20. ↑ Location of oligoastrocytoma. Dr. Bruno Di Muzio and Dr. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 19, 2015
  21. ↑ Shimizu T, Saito N, Aihara M, Kurihara H, Nakazato Y, Ueki K; et al. (2004). "Primary spinal oligoastrocytoma: a case report". Surg Neurol. 61 (1): 77–81, discussion 81. PMID 14706386.
  22. ↑ Oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015
  23. ↑ Classification and external sources of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015
  24. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
  25. ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC


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