Oligoastrocytoma pathophysiology
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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
- Oligoastrocytomas are mixed tumors that arises from the proliferation of both oligodendrocytes and astrocytes.[1]
- Oligoastrocytomas are low-grade (grade II) tumors and anaplastic oligoastrocytomas are high-grade (grade III) tumors that occur in the brain.[19]
Genetics
- Development of oligoastrocytoma is the result of multiple genetic mutations.
- Oligoastrocytomas are mixed tumors that have overlapping molecular genetics with both oligodendrogliomas and astrocytomas.[2]
- 30-70% of oligoastrocytomas show loss of heterozygosity (LOH) of 1p and 19q.[2][9][10]
- Genes associated with the pathogenesis of oligoastrocytoma and anaplastic oligoastrocytoma include:[2][3][4][5][6][7][8][9]
Gross Pathology
- 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 matter junction.[9]
- Oligoastrocytomas are commonly found in the supratentorial region.
- Common intracranial sites associated with oligoastrocytoma include:[20][21][22][2]
Microscopic Pathology
Low-Grade Oligoastrocytoma
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
- Fried-egg shaped cells
- Composed of minigemistocytes
- Round nucleus
- Distinct cell borders
- Moderate-to-marked nuclear atypia with speckled "salt-and-pepper" chromatin pattern and perinuclear halo
- Focal microcalcification
- Astrocytes
- Star-shaped cells
- Composed of gemistocytes
- Multinucleated giant cells
- Ovoid nucleus
- Nuclear atypia
Anaplastic Oligoastrocytoma
On microscopic histopathological analysis, anaplastic oligoastrocytoma is characterized by:[11][12][13]
- Significant or brisk mitotic activity (≥ 6 mitoses per 10 high power field)
- Marked cytologic and nuclear atypia
- Necrosis
- Apoptotic cells
- Microvacular proliferation
- 'Glomeruloid' vessels or endothelial hyperplasia
Gallery
-
![Biopsy specimen of an oligoastrocytoma (HE stain).[23]](/images/b/b0/Oligoastrocytoma_histology_HE_stain.jpg)
Biopsy specimen of an oligoastrocytoma (HE stain).[23]
![Biopsy specimen of an oligoastrocytoma (HE stain).[23]](/index.php/File:Oligoastrocytoma_histology_HE_stain.jpg)
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]](/images/b/b0/Oligoastrocytoma_IHC_1.jpg)
Histology of oligoastrocytoma cells demonstrating positivity to tumor marker GFAP.[24]
-
![Histology of oligoastrocytoma cells demonstrating positivity to tumor marker Ki-67.[25]](/images/4/4b/Oligoastrocytoma_IHC_2.jpg)
Histology of oligoastrocytoma cells demonstrating positivity to tumor marker Ki-67.[25]
![Histology of oligoastrocytoma cells demonstrating positivity to tumor marker GFAP.[24]](/index.php/File:Oligoastrocytoma_IHC_1.jpg)
![Histology of oligoastrocytoma cells demonstrating positivity to tumor marker Ki-67.[25]](/index.php/File:Oligoastrocytoma_IHC_2.jpg)
References
- ↑ 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
- ↑ 2.0 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.
- ↑ 3.0 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.
- ↑ 4.0 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.
- ↑ 5.0 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.
- ↑ 6.0 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.
- ↑ 7.0 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.
- ↑ 8.0 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.
- ↑ 9.0 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.
- ↑ 10.0 10.1 Cause of oligoastrocytoma. American Brain Tumor Association 2015. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 21, 2015
- ↑ 11.0 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
- ↑ 12.0 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.
- ↑ 13.0 13.1 13.2 13.3 Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015
- ↑ 14.0 14.1 Love, S.; Loius, D. & Ellison, D.W. (2008), Greenfield's neuropathology, 1 (8th ed.), Boca Raton, Florida: Hodder Arnold
- ↑ 15.0 15.1 Histology of anaplastic oligoastrocytes. Dr. Frank Gaillard. Radiopaedia 2015. http://radiopaedia.org/cases/anaplastic-oligoastrocytoma. Accessed on October 19, 2015
- ↑ 16.0 16.1 IHC of oligoastrocytoma. Librepathology 2015. http://librepathology.org/wiki/index.php/Oligoastrocytoma. Accessed on October 16, 2015
- ↑ 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.
- ↑ 18.0 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.
- ↑ 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
- ↑ 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
- ↑ 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.
- ↑ Oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015
- ↑ Classification and external sources of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015
- ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
- ↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC