Oligodendroglioma pathophysiology: Difference between revisions
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===Microscopic Pathology=== | ===Microscopic Pathology=== | ||
On microscopic histopathological analysis, oligodendroglioma is characterized by:<ref name=micro>Microscopic features of oligodendroglioma. Libre Pathology. http://librepathology.org/wiki/index.php/Oligodendroglioma</ref><ref name=turk>{{Citation |last=Tihan |first=Tarik|last=Ersen|first=Ayca |year=2008 |title=Pathology of malignant gliomas: Challenges of everyday practice and the WHO 2007 |publisher=Turkish Journal of Pathology |publication-place= |page= |url=http://www.turkjpath.org/text.php3?id=645 |accessdate=9 October, 2015 | On microscopic histopathological analysis, oligodendroglioma is characterized by:<ref name=micro>Microscopic features of oligodendroglioma. Libre Pathology. http://librepathology.org/wiki/index.php/Oligodendroglioma</ref><ref name=turk>{{Citation |last=Tihan |first=Tarik|last=Ersen|first=Ayca |year=2008 |title=Pathology of malignant gliomas: Challenges of everyday practice and the WHO 2007 |publisher=Turkish Journal of Pathology |publication-place= |page= |url=http://www.turkjpath.org/text.php3?id=645 |accessdate=9 October, 2015 }}</ref> | ||
*Diffusely growing tumor | *Diffusely growing tumor | ||
*Highly cellular lesion composed of cells resembling ''fried eggs'' with: | *Highly cellular lesion composed of cells resembling ''fried eggs'' with: |
Revision as of 17:37, 9 October 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Oligodendroglioma Microchapters |
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Treatment |
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Overview
Pathophysiology
Pathogenesis
- Oligodendroglioma does not arise from the bipotential oligodendrocytes, although tumor cells look very similiar.[1]
- Oligodendroglioma arises from the tripotential glial precursor cells.
Genetics
- Development of oligodendroglioma is the result from multiple genetic mutations.
- Genes associated with the pathogenesis of oligodendroglioma include:[2][3][4][5][6][7][8][9]
Gross Pathology
- On gross pathology, oligodendroglioma is characterized by a well-circumscribed, gelatinous, gray mass which may expand a gyrus and remodel the skull.[10]
- Other characteristic gross pathological features associated with oligodendroglioma include:[10]
- Calcification (70-90%; one of the most frequently calcifying tumors)
- Focal hemorrhage
- Cystic (20%)
- Common intracranial sites associated with oligodendroglioma include:[11]
- Cerebral hemispheres - distribution between frontal, parietal, temporal, and occipital lobe approximates 3:2:2:1.
- Posterior fossa (rare)
- Intramedullary spinal cord (very rare)
Microscopic Pathology
On microscopic histopathological analysis, oligodendroglioma is characterized by:[12][13]
- Diffusely growing tumor
- Highly cellular lesion composed of cells resembling fried eggs with:
- Round nucleus - key feature
- Distinct cell borders
- Moderate-to-marked nuclear atypia with speckled ‘salt-and-pepper' chromatin pattern
- Clear cytoplasm
- Some oligodendrogliomas have eosinophilic cytoplasm with focal perinuclear clearing
- Acutely branched capillary sized vessels - "chicken-wire" like appearance
- Abundant, delicate appearing; may vaguely resemble a paraganglioma at low power
- Calcifications - striking feature
- Perifocal edema - rare
- Few tumors may exhibit eosinophilic granular bodies
- Some tumors may show a spongioblastoma-like growth pattern
On microscopic histopathological analysis, anaplastic oligodendroglioma is characterized by:[12]
- Focal or diffusely increased cell density
- Atypical to frankly pleomorphic cells or multinucleated giant cells
- Tumor cells may be plasmacytoid (i.e. have a plasma cell-like appearance)
- Also called as minigemistocytes
- Significant or brisk mitotic activity (>= 6 mitoses per 10 HPF)
- Necrosis
- Microvacular proliferation
- Either in the form of 'glomeruloid' vessels or endothelial hyperplasia
Immunohistochemistry
Oligodendroglioma is demonstrated by positivity to tumor markers such as:[14][15]
- MAP2
- GFAP
- S-100
- EMA
- IDH1-R132H
- ATRX
- Ki-67
- NSE
- Synaptophysin
Gallery
-
Oligodendroglioma low magnification showing the characteristic small, branching, chicken wire-like blood vessels.H&E stain.[16]
-
Oligodendroglioma high magnification showing highly cellular lesion composed of cells resembling fried eggs with distinct cell borders moderate-to-marked nuclear atypia, and a clear cytoplasm. Acutely branched capillary sized vessels - "chicken-wire" like appearance.[16]
-
Low power magnification of oligodendroglioma biopsy specimen showing discrete infiltration of the surrounding brain (HE stain, x40 mag).[17]
-
Histopathology of anaplastic oligodendroglioma showing minigemistocytes and mitoses among tumor cells with perinuclear halo. HE stain.[17]
-
Histopathology of anaplastic oligodendroglioma (MAP2 staining) showing perinuclear immunoreactivity of tumor cells.[17]
-
Histopathology of anaplastic oligodendroglioma (IDH1-R132H staining) showing immunoreactivity of tumor cells indicating presence of the isocitrate dehydrogenase 1-R132H mutation.[17]
References
- ↑ General features of oligodendroglioma. Libre Pathology. http://librepathology.org/wiki/index.php/Oligodendroglioma#cite_note-1
- ↑ Molecular genetics of oligodendroglioma. https://en.wikipedia.org/wiki/Oligodendroglioma
- ↑ Bettegowda C, Agrawal N, Jiao Y, Sausen M, Wood LD, Hruban RH; et al. (2011). "Mutations in CIC and FUBP1 contribute to human oligodendroglioma". Science. 333 (6048): 1453–5. doi:10.1126/science.1210557. PMC 3170506. PMID 21817013.
- ↑ Prognosis and treatment of oligodendroglioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligodendroglioma
- ↑ Yip S, Butterfield YS, Morozova O, Chittaranjan S, Blough MD, An J; et al. (2012). "Concurrent CIC mutations, IDH mutations, and 1p/19q loss distinguish oligodendrogliomas from other cancers". J Pathol. 226 (1): 7–16. doi:10.1002/path.2995. PMC 3246739. PMID 22072542.
- ↑ Labreche K, Simeonova I, Kamoun A, Gleize V, Chubb D, Letouzé E; et al. (2015). "TCF12 is mutated in anaplastic oligodendroglioma". Nat Commun. 6: 7207. doi:10.1038/ncomms8207. PMC 4490400. PMID 26068201.
- ↑ Suri V, Jha P, Agarwal S, Pathak P, Sharma MC, Sharma V; et al. (2011). "Molecular profile of oligodendrogliomas in young patients". Neuro Oncol. 13 (10): 1099–106. doi:10.1093/neuonc/nor146. PMC 3177666. PMID 21937591.
- ↑ Hagel C, Laking G, Laas R, Scheil S, Jung R, Milde-Langosch K; et al. (1996). "Demonstration of p53 protein and TP53 gene mutations in oligodendrogliomas". Eur J Cancer. 32A (13): 2242–8. PMID 9038605.
- ↑ Schmoldt A, Benthe HF, Haberland G (1975). "Digitoxin metabolism by rat liver microsomes". Biochem Pharmacol. 24 (17): 1639–41. PMID doi:10.1016/S0090-3019(03)00167-8 Check
|pmid=
value (help). - ↑ 10.0 10.1 Gross appearance of oligodendroglioma. Dr Henry Knipe and Dr Frank Gaillard et al. http://radiopaedia.org/articles/oligodendroglioma
- ↑ Gross/radiologic findings of oligodendroglioma. Libre Pathology. http://librepathology.org/wiki/index.php/Oligodendroglioma
- ↑ 12.0 12.1 Microscopic features of oligodendroglioma. Libre Pathology. http://librepathology.org/wiki/index.php/Oligodendroglioma
- ↑ Ersen, Ayca (2008), Pathology of malignant gliomas: Challenges of everyday practice and the WHO 2007, Turkish Journal of Pathology, retrieved 9 October, 2015 Check date values in:
|accessdate=
(help) - ↑ IHC of oligodendroglioma. Libre Pathology. http://librepathology.org/wiki/index.php/Oligodendroglioma
- ↑ Hilbig A, Barbosa-Coutinho LM, Netto GC, Bleil CB, Toscani NV (2006). "[Immunohistochemistry in oligodendrogliomas]". Arq Neuropsiquiatr. 64 (1): 67–71. doi:/S0004-282X2006000100014 Check
|doi=
value (help). PMID 16622556. - ↑ 16.0 16.1 Images of microscopic appearance of oligodendroglioma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligodendroglioma
- ↑ 17.0 17.1 17.2 17.3 Images of oligodendroglioma. Libre Pathology 2015. http://librepathology.org/wiki/index.php/Oligodendroglioma