A simplified approach for molecular classification of glioblastomas (GBMs): experience from a tertiary care center in India
This study aims to establish a simplified molecular classification of glioblastomas (GBMs) based on molecular genetic alterations. GBM cases (n-114) were evaluated for IDH-1 and TP53 mutation by Sanger sequencing, PDGFRA and EGFR amplification by FISH, NF1 and YKL40 expression by qRT-PCR. Subsequently they were classified into four subgroups: classical like (CL), proneural like (PN), mesenchymal like (MES) and neural like (NEU). CL subtype was most frequent (39 %), followed by PN (32 %) and MES (20 %) subtypes. PN subtype had significantly younger age at presentation and longest survival (median PFS—82.5 weeks; 1 and...
Source: Brain Tumor Pathology - February 10, 2016 Category: Neurology Source Type: research
Calcification on CT is a simple and valuable preoperative indicator of 1p/19q loss of heterozygosity in supratentorial brain tumors that are suspected grade II and III gliomas
This study was designed to clarify whether the preoperative finding of calcification on CT was correlated with 1p/19q LOH in patients with suspected WHO grade II and III gliomas. This study included 250 adult patients who underwent resection for primary supratentorial tumors at Tokyo Women’s Medical University Hospital. The tumors were suspected, based on MRI findings, to be WHO grade II or III gliomas. The presence of calcification on the patients’ CT images was qualitatively evaluated before treatment. After surgery, the resected tumors were examined to determine their 1p/19q status and mutations of IDH1 and p53. The...
Source: Brain Tumor Pathology - February 5, 2016 Category: Neurology Source Type: research
Bevacizumab changes vascular structure and modulates the expression of angiogenic factors in recurrent malignant gliomas
Abstract
Bevacizumab (BV), a monoclonal antibody against vascular endothelial growth factor (VEGF), is currently used in the treatment of malignant glioma. To understand mechanisms of resistance to BV, we investigated morphological changes in tumor vessels and expression of angiogenic factors, such as VEGF, Flt-1, basic fibroblast growth factor (bFGF), and platelet-derived growth factor-BB (PDGF-BB), in four autopsied tumors after BV treatment. Three patients had glioblastomas; the fourth had a secondary glioblastoma that developed from a diffuse astrocytoma. BV was administered because of recurrence foll...
Source: Brain Tumor Pathology - January 29, 2016 Category: Neurology Source Type: research
Analysis of EZH2: micro-RNA network in low and high grade astrocytic tumors
In this study, we measured EZH2 levels in low (Gr-II,DA) and high grade (Gr-IV,GBM) astrocytic tumors and found significant increased EZH2 transcript level with grade(median DA-8.5, GBM-28.9).However, a different trend was reflected in protein levels, with GBMs showing high EZH2 LI(median-26.5) compared to DA (median 0.3). This difference in correlation of EZH2 protein and RNA levels suggested post-transcriptional regulation of EZH2, likely mediated by miRNAs. We selected eleven miRNAs that strongly predicted to target EZH2 and measured their expression. Three miRNAs (miR-26a-5p,miR27a-3p and miR-498) showed significant co...
Source: Brain Tumor Pathology - January 8, 2016 Category: Neurology Source Type: research
‘Papillary’ solitary fibrous tumor/hemangiopericytoma with nuclear STAT6 expression and NAB2 - STAT6 fusion
This report describes clinicopathological findings, including genetic data of STAT6, in a solitary fibrous tumor (SFT)/hemangiopericytoma (HPC) of the central nervous system in an 83-year-old woman with a bulge in the left forehead. She noticed it about 5 months before, and it had grown rapidly for the past 1 month. Neuroradiological studies disclosed a well-demarcated tumor that accompanied the destruction of the skull. The excised tumor showed a prominent papillary structure, where atypical cells were compactly arranged along the fibrovascular core (‘pseudopapillary’). There was rich vasculature, some of which rese...
Source: Brain Tumor Pathology - January 8, 2016 Category: Neurology Source Type: research
A mixed choroid plexus papilloma and ependymoma
We report a novel case of a mixed choroid plexus papilloma (CPP) and ependymoma with cartilaginous differentiation. This kind of mixed tumor has not been previously reported in the English literature. The patient was a 5-year-old girl, who presented with a 1-week history of fever and numbness of the right lower limb. Magnetic resonance imaging of the brain with gadolinium revealed a heterogeneously enhancing mass in the occipital horn of the left lateral ventricle. Histologically, the tumor showed an intermixed CPP area and a low-grade papillary ependymoma-like area, which was studded with cartilage islands and psammoma bo...
Source: Brain Tumor Pathology - December 15, 2015 Category: Neurology Source Type: research
Pilomyxoid astrocytomas with rare rosenthal fibers
Abstract
Pilomyxoid astrocytomas (PMAs) were first officially described in 2007. Since then, intermediate pilomyxoid tumors with histopathological features typical of both PMAs and pilocytic astrocytomas (PAs) have been described. However, we found evidence of tumors that are histologically like PMAs but contain rare Rosenthal fibers, which have been reported in PAs but not in PMAs. We retrospectively analyzed four such cases involving a 16-year-old adolescent with a 3-cm recurring suprasellar tumor, an 11-year-old boy with a nonrecurring 3-cm mass in the left cerebellum, an 18-year-old adolescent with a ...
Source: Brain Tumor Pathology - December 15, 2015 Category: Neurology Source Type: research
Epithelioid/rhabdoid glioblastoma: a highly aggressive subtype of glioblastoma
Abstract
Epithelioid glioblastoma (GBM) and rhabdoid GBM are rare variants that are morphologically similar, but there is no consensus on the characteristics of each disease. These tumors have aggressive features of early recurrence and leptomeningeal dissemination and tend to develop in younger patients compared to typical GBM. The prognosis is normally worse than typical GBM, even with intensive chemoradiotherapy after surgical resection. Thus, accurate diagnosis and effective therapy for epithelioid/rhabdoid GBM are required. Four consecutive patients aged 16–48 years were diagnosed with epithelioid...
Source: Brain Tumor Pathology - December 14, 2015 Category: Neurology Source Type: research
A case of cerebral astroblastoma with rhabdoid features: a cytological, histological, and immunohistochemical study
This report describes novel cytological, histopathological, and immunohistochemical features of the rare tumor. (Source: Brain Tumor Pathology)
Source: Brain Tumor Pathology - November 27, 2015 Category: Neurology Source Type: research
A case of osteoclast-like giant cell-rich epithelioid glioblastoma with BRAF V600E mutation
Abstract
Epithelioid glioblastomas (E-GBMs) are rare, highly aggressive tumors consisting of closely packed tumor cells with smooth, round cell borders and abundant eosinophilic cytoplasm. They tend to affect younger patients compared with conventional GBM. BRAF V600E mutation is characteristically found in approximately 50 % of all E-GBMs, compared with a low frequency of this mutation in conventional GBM. Here, we report an unusual case of glioma involving the right frontal lobe, basal ganglia and thalamus in an HIV-positive 30-year-old man on antiretroviral therapy. The lesion was composed of abundant...
Source: Brain Tumor Pathology - November 24, 2015 Category: Neurology Source Type: research
Rapid immunocytochemistry based on alternating current electric field using squash smear preparation of central nervous system tumors
In this study, we established the rapid immunocytochemistry (R-ICC) protocol for squash smears of CNS tumors using AC electric field that takes only 22 min, and demonstrated its usefulness for semi-quantitative Ki-67/MIB-1 labeling index and CD 20 by R-ICC for intraoperative diagnosis. R-ICC by AC electric field may become a substantial tool for compensating R-IHC and will be applied for broad antibodies in the future. (Source: Brain Tumor Pathology)
Source: Brain Tumor Pathology - November 6, 2015 Category: Neurology Source Type: research
Findings from frozen sections of spinal subependymomas: Is it possible to differentiate this diagnosis from other common spinal tumors?
In this study, we analyzed frozen sections of spinal subependymomas to identify potential histological clues of spinal subependymomas to differentiate them from tumors that mimic spinal subependymoma. We reviewed the frozen sections and the corresponding permanent slides for 7 cases of spinal subependymoma. The spinal subependymomas showed several characteristic patterns, including, most importantly, an eccentric or both central and eccentric location in the axial plane. Histologically, they showed a (1) well-demarcated and multinodular mass with (2) low or moderate cellularity, (3) a microlobular pattern, and (4) small cl...
Source: Brain Tumor Pathology - October 29, 2015 Category: Neurology Source Type: research
A distinctive pediatric case of low-grade glioma with extensive expression of CD34
(Source: Brain Tumor Pathology)
Source: Brain Tumor Pathology - October 26, 2015 Category: Neurology Source Type: research
Brain metastasis: clinical characteristics, pathological findings and molecular subtyping for therapeutic implications
Abstract
Metastases are the most common brain tumors especially in adults. Although they are generally considered a single disease entity which is universally fatal in patients with advanced cancer, brain metastases are remarkably heterogeneous both clinically and pathologically. As members of the multidisciplinary clinical team for the diagnosis and management of metastatic brain tumors, pathologists must be familiar not only with clinicopathologic features of brain metastases but also with any characteristic and clinically significant molecular findings. We discuss here the epidemiology, general gross a...
Source: Brain Tumor Pathology - October 24, 2015 Category: Neurology Source Type: research
BRAF V600E-mutated diffuse glioma in an adult patient: a case report and review
Abstract
Recent advances in genomic technology and genome-wide analysis have identified key molecular alterations that are relevant to the diagnosis and prognosis of brain tumors. Molecular information such as mutations in isocitrate dehydrogenase (IDH) genes or 1p/19q co-deletion status will be more actively incorporated into the histological classification of diffuse gliomas. BRAF V600E mutations are found frequently in circumscribed low-grade gliomas such as pleomorphic xanthoastrocytoma (PXA) and extra-cerebellar pilocytic astrocytoma, or epithelioid glioblastomas (E–GBM), a rare variant of GBM. Thi...
Source: Brain Tumor Pathology - October 7, 2015 Category: Neurology Source Type: research
