From Editor's Desk
Indian J Pathol Microbiol. 2022 May;65(Supplement):S1. doi: 10.4103/0377-4929.345062.NO ABSTRACTPMID:35562127 | DOI:10.4103/0377-4929.345062 (Source: Indian Journal of Pathology and Microbiology)
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Ranjan Agrawal Source Type: research

The Evolving World Health Organization (WHO) classification of tumors of the central nervous system (CNS): Challenges and opportunities
Indian J Pathol Microbiol. 2022 May;65(Supplement):S2-S4. doi: 10.4103/0377-4929.345063.NO ABSTRACTPMID:35562128 | DOI:10.4103/0377-4929.345063 (Source: Indian Journal of Pathology and Microbiology)
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Chitra Sarkar Megha Uppin Anita Mahadevan Source Type: research

World Health Organization Classification of Tumors of the Central Nervous System 5 < sup > th < /sup > Edition (WHO CNS5): What's new?
Indian J Pathol Microbiol. 2022 May;65(Supplement):S5-S13. doi: 10.4103/ijpm.ijpm_48_22.ABSTRACTThe latest fifth edition of the World Health Organization classification of central nervous system tumors (WHO CNS5) has been built on the prior WHO 2016 classification as well as recommendations put forward by seven updates of the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT). Various new tumor types and subtypes have been recognized which are of clinical significance. Tumor groups have been restructured and the nomenclature of some tumor types has also been revised. The use of terms 'e...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Swati Mahajan Vaishali Suri Saumya Sahu Mehar C Sharma Chitra Sarkar Source Type: research

A review of adult-type diffuse gliomas in the WHO CNS5 classification with special reference to Astrocytoma, IDH-mutant and Oligodendroglioma, IDH-mutant and 1p/19q codeleted
Indian J Pathol Microbiol. 2022 May;65(Supplement):S14-S23. doi: 10.4103/ijpm.ijpm_34_22.ABSTRACTThe fifth edition of the World Health Organization (WHO) Classification of Tumors of the Central Nervous System (WHO CNS5) features several changes in the classification, diagnostic criteria, nomenclature, and grading of diffuse gliomas. Adult-type diffuse gliomas are genetically defined and include astrocytoma, isocitrate dehydrogenase (IDH)-mutant, oligodendroglioma, IDH-mutant and 1p/19q codeleted, and glioblastoma, IDH-wildtype. This review briefly discusses two tumor types: astrocytoma, IDH-mutant, and oligodendroglioma, I...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Vani Santosh Shilpa Rao Source Type: research

Glioblastoma: Changing concepts in the WHO CNS5 classification
Indian J Pathol Microbiol. 2022 May;65(Supplement):S24-S32. doi: 10.4103/ijpm.ijpm_1109_21.ABSTRACTGlioblastoma is the most common malignant central nervous system (CNS) tumor in adults. Acute common clinical symptoms include headache, seizure, behavior changes, focal neurological deficits, and signs of increased intracranial pressure. The classic MRI finding of glioblastoma is an irregularly shaped, rim-enhancing or ring-enhancing lesion with a central dark area of necrosis. This constellation of features correlates with microscopic findings of tumor necrosis and microvascular proliferation. Besides these common features,...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Jie Chen Pengcheng Han Sonika Dahiya Source Type: research

Circumscribed astrocytic gliomas: Contribution of molecular analyses to histopathology diagnosis in the WHO CNS5 classification
We present a brief and critical review of the pathological and molecular characteristics of these often well-demarcated tumors that can occur in adults as well as in the pediatric population.PMID:35562132 | DOI:10.4103/ijpm.ijpm_1019_21 (Source: Indian Journal of Pathology and Microbiology)
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Yazg ı Köy Tarik Tihan Source Type: research

Pediatric-type diffuse low grade gliomas: Histomolecular profile and practical approach to their integrated diagnosis according to the WHO CNS5 classification
Indian J Pathol Microbiol. 2022 May;65(Supplement):S42-S49. doi: 10.4103/ijpm.ijpm_1043_21.ABSTRACTLow-grade gliomas are the most common primary central nervous system (CNS) neoplasms in the pediatric age group. The majority of these tumors are circumscribed, while diffuse low-grade gliomas are relatively rare. The pediatric type diffuse low-grade gliomas (pDLGG) have a distinctly different biological behavior, molecular profile, and clinical outcome as compared to their adult counterpart. In the 5th edition of World Health Organization (WHO) CNS classification, pDLGGs are subclassified into four distinct histomolecular en...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Suvendu Purkait Swati Mahajan Mehar C Sharma Chitra Sarkar Vaishali Suri Source Type: research

Paediatric type diffuse high grade gliomas in the WHO CNS5 classification: What the pathologist needs to know?
Indian J Pathol Microbiol. 2022 May;65(Supplement):S50-S58. doi: 10.4103/ijpm.ijpm_1202_21.ABSTRACTPediatric-type of diffuse high-grade gliomas (HGG) are classified as a distinct group in the current fifth edition of WHO classification. This group of high-grade tumors is no more called as glioblastoma (GBM), which has been reserved for adult isocitrate dehydrogenase (IDH)-wild type HGG. These tumors are uncommon as compared to embryonal tumors and low-grade gliomas (LGG). Pediatric-type of diffuse HGG biologically differs from their adult counterparts in that they are therapeutically less sensitive to alkylating chemothera...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Shruti Rao Ayushi Sahay Sridhar Epari Source Type: research

Glioneuronal and neuronal tumors: A review with special reference to the new types in the WHO CNS5 classification
Indian J Pathol Microbiol. 2022 May;65(Supplement):S59-S67. doi: 10.4103/ijpm.ijpm_1061_21.ABSTRACTGlioneuronal and neuronal tumors (GNTs) are slow-growing lower-grade neuroepithelial tumors with mature neuronal and, less consistently, glial differentiation. Their identification has relied solely on histological proof of neuronal differentiation, which was considered to represent the well-differentiated nature of GNTs. However, after discovering the genetic alterations in GNTs, particularly those in the MAP-kinase pathway, it became evident that histological diagnoses are not always concurrent with genetic alterations and ...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Takashi Komori Source Type: research

Overview of recent advances in the classification of ependymomas in WHO CNS5 classification: Simplified approach to their integrated diagnosis
Indian J Pathol Microbiol. 2022 May;65(Supplement):S68-S72. doi: 10.4103/ijpm.ijpm_1212_21.ABSTRACTEpendymomas can arise along the entire neuraxis; however, they possess site-specific unique molecular alterations and a methylome pattern which is directly related with the prognostic outcomes. Since 2016, when the updated fourth edition of World Health Organization (WHO) classification of tumors of the central nervous system was published, it has been emphasized to classify ependymomas by anatomic site and molecular signatures associated genetic alterations so that classification of the disease reflects its underlying biolog...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Rakesh K Gupta Agrima Sharma Mehar C Sharma Source Type: research

Embryonal tumors in the WHO CNS5 classification: A Review
Indian J Pathol Microbiol. 2022 May;65(Supplement):S73-S82. doi: 10.4103/ijpm.ijpm_1049_21.ABSTRACTEmbryonal tumors are a heterogenous group of neoplasms mostly defined by recurrent genetic driver events. They have been, previously, broadly classified as either medulloblastoma or supratentorial primitive neuroectodermal tumors (PNETs). However, the application of DNA methylation/gene expression profiling in large series of neoplasms histologically defined as PNET, revealed tumors, which showed genetic events associated with glial tumors. These findings led to the definitive removal of the term "PNET" in the 2016 World Heal...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Francesca Gianno Evelina Miele Manila Antonelli Felice Giangaspero Source Type: research

Meningiomas - transition from traditional histological grading to molecular profiling in WHO CNS5: A Review
Indian J Pathol Microbiol. 2022 May;65(Supplement):S83-S93. doi: 10.4103/ijpm.ijpm_1085_21.ABSTRACTDespite being the most common primary intracranial tumor, meningiomas are classified largely based on histological features. The current system of grading has been shown to be unsatisfactory due to its poor reproducibility as well as the considerable variability within grades. With the increasing availability of genomic and epigenomic profiling, several markers have been suggested to correlate with the location, histological subtype, and clinical behavior of meningiomas. These developments have enabled the development of targ...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Abhijit Goyal-Honavar Ranjani Jayachandran Geeta Chacko Source Type: research

Miscellaneous newly recognized types of CNS tumors in the WHO CNS5 classification (other than gliomas, glioneuronal and embryonal tumors)
Indian J Pathol Microbiol. 2022 May;65(Supplement):S94-S98. doi: 10.4103/ijpm.ijpm_1038_21.ABSTRACTIn this review, we describe salient features of a few of the newer entities recognized in the fifth edition of World Health Organization (WHO) classification of central nervous system (CNS) tumors. While most of these have been offshoots of the deoxyribonucleic acid (DNA) methylation profiling of CNS tumors with distinct profiling such as desmoplastic myxoid tumor (DMT) of the pineal region, SMARCB1-mutant, these also demonstrate subtle, distinct morphological features, which should be carefully searched for to diagnose them....
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Debajyoti Chatterjee Kirti Gupta Source Type: research

Evaluating neurosurgical biopsies for CNS tumor diagnoses: An algorithmic and pattern based approach
Indian J Pathol Microbiol. 2022 May;65(Supplement):S99-S110. doi: 10.4103/ijpm.ijpm_1081_21.ABSTRACTThe 2016 and 2021 World Health Organization (WHO) Classifications of Tumors of the Central Nervous System (CNS) reflect the importance of integrating molecular analysis into CNS tumor diagnosis and classification, adding to the complexity of any surgical neuropathology practice. On the other hand, our evolving understanding of genomic alterations across the spectrum of CNS tumors highlights the importance of utilizing traditional histological and immunohistochemical approaches to first establish as accurate a diagnosis as po...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: M Adelita Vizcaino Aditya Raghunathan Source Type: research

Liquid biopsy in CNS tumors: Current status & amp; future perspectives
Indian J Pathol Microbiol. 2022 May;65(Supplement):S111-S121. doi: 10.4103/ijpm.ijpm_1058_21.ABSTRACTPrecise classification of central nervous system (CNS) malignancies is vital for the treatment and prognostication. Identification of noninvasive markers can be of importance to guide treatment decisions and in monitoring treatment response. CNS tumors are classified based on morphology with an essential complement of molecular changes, including mutations, amplifications, and methylation. Neuroimaging is the mainstay for initial diagnosis and monitoring tumor response with obvious limitations of imprecise tumor typing and ...
Source: Indian Journal of Pathology and Microbiology - May 13, 2022 Category: Pathology Authors: Nuzhat Husain Adil Husain Sridhar Mishra Pallavi Srivastava Source Type: research