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Histologic Classification of High-Grade Gliomas

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High-Grade Gliomas

Part of the book series: Current Clinical Oncology ((CCO))

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Abstract

High-grade gliomas (HGG), as a group, are the most common primary neoplasms of the central nervous system (CNS). Historically, and to a great extent currently, morphologic classification has and does dictate treatment. This chapter reviews the pathologic features and grading parameters for high-grade astrocytomas, oligodendrogliomas, mixed gliomas, and ependymomas. The histologic subtypes of glioblastoma multiforme and the affects of radiotherapy on gliomas will be discussed. The potential role for cell proliferation markers (Ki-67, MIB-1) in evaluating HGGs will be examined.

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References

  1. Cairncross JC, Ueki K, Zlatescu MC, et al. Specific genetic predictors of chemotherapeutic response and survial in patients with anaplastic oliogdendrogliomas. J Natl Cancer Inst 1998;90:1473–1479.

    Article  PubMed  CAS  Google Scholar 

  2. Ino Y, Zlatescu MC, Sasaki H, et al. Long survival and therapeutic responses in patients with histologically disparate high-grade gliomas demonstrating chromosome 1p loss. J Neurosurg 2000;92:983–990.

    PubMed  CAS  Google Scholar 

  3. Ino Y, Betensky RA, Zlatescu MC, et al. Molecular subtypes of anaplastic oligodendroglioma: Implications for patient management at diagnosis. Clin Cancer Res 2001;7:839–845.

    PubMed  CAS  Google Scholar 

  4. Reifenberger G, Louis DN. Oligodendroglioma: Toward molecular definitions in diagnostic neuro-oncology. J Neuropathol Exp Neurol 2003;62:111–126.

    PubMed  CAS  Google Scholar 

  5. Ringertz N. “eGrading”e of gliomas. Acta Pathol Microbiol Scand 1950;27:51–64.

    PubMed  CAS  Google Scholar 

  6. Burger PC, Vogel FS, Green SB, et al. Glioblastoma multiforme and anaplastic astrocytoma: pathologic criteria and prognostic implications. Cancer 1985;56:1106–1111.

    Article  PubMed  CAS  Google Scholar 

  7. Cavenee WK, Furnari FB, Nagane M, et al. Diffusely infiltrating astrocytomas. In: Kleihues P, Cavenee WK, eds. Tumours of the Nervous System. Lyon, France: IARC Press, 2000:10–21.

    Google Scholar 

  8. Krouwer HGJ, Davis RL, Silver P, et al. Gemistocytic astrocytomas: a reappraisal. JNeurosurg 1991;74:399–406.

    CAS  Google Scholar 

  9. Watanabe K, Tachibana O, Yonekawa Y, et al. Role of gemistocytes in astrocytoma progression. Lab Invest 1997;76:277–284.

    PubMed  CAS  Google Scholar 

  10. Hoshino T, Wilson CB, Ellis WG. Gemistocytic astrocytes in gliomas: an autoradiographic study. J Neuropathol Exp Neurol 1995;34:263–281.

    Google Scholar 

  11. Sreenan JJ, Prayson RA. Gliosarcoma: a study of 13 tumors, including p53 and CD34 immunohistochemistry. Arch Pathol Lab Med 1997;121:129–133.

    PubMed  CAS  Google Scholar 

  12. Morantz RA, Feigin I, Ransohoff J. Clinical and pathologic study of 24 cases of gliosarcoma. J Neurosurg 1976;45:398–408.

    PubMed  CAS  Google Scholar 

  13. Meis JM, Ho KL. Gliosarcoma: A histologic and immunohistochemical reaffirmation. Mod Pathol 1990;3:19–24.

    PubMed  CAS  Google Scholar 

  14. Perry JR, Ang LC, Bilbao JM, et al. Clinicopathologic features of primary and post-radiation cerebral gliosarcoma. Cancer 1995;75:2910–2918.

    Article  PubMed  CAS  Google Scholar 

  15. Biernat W, Aguzzi A, Sure U, et al. Identical mutations of the p53 tumor suppressor gene in the gliomatous and the sarcomatous components of gliosarcomas suggest a common origin from glial cells. J Neuropathol Exp Neurol 1995;54:651–656.

    PubMed  CAS  Google Scholar 

  16. Boerman RH, Anderl K, Herath J, et al. The glial and mesenchymal elements of gliosarcomas share similar genetic alterations. J Neuropathol Exp Neurol 1996;55:973–981.

    PubMed  CAS  Google Scholar 

  17. Rosenblum MK, Erlandson RA, Budzilovich GN. The lipid-rich epithelioid glioblastoma. Am J Surg Pathol 1991;15:925–934.

    Article  PubMed  CAS  Google Scholar 

  18. Mueller W, Lass U, Herms J, et al. Clonal analysis in glioblastoma with epithelial differentiation. Brain Pathol 2001;11:39–43.

    Article  PubMed  CAS  Google Scholar 

  19. Burger PC. Cytologic composition of the untreated glioblastoma with implications for evaluation of needle biopsies. Cancer 1989;63:2014–2023.

    Article  PubMed  CAS  Google Scholar 

  20. Burger PC, Pearl DK, Aldape K, et al. Small cell architecture—a histological equivalent of EGFR amplification in glioblastoma multiforme? J Neuropathol Exp Neurol 2001;60:1099–1104.

    PubMed  CAS  Google Scholar 

  21. Oh D, Prayson RA. Evaluation of epithelioid and keratin markers in glioblastoma multiforme An immunohiostochemical study. Am J Clin Pathol 1999;123:917–920.

    CAS  Google Scholar 

  22. Katoh M, Toshimitsu A, Sugimoto S, et al. Immunohistochemical analysis of giant cell glioblastoma. Pathol Int 1995;45:275–282.

    PubMed  CAS  Google Scholar 

  23. Kornfeld M. Granular cell glioblastoma. A malignant granular cell neoplasm of astrocytic origin. J Neuropathol Exp Neurol 1986;45:447–462.

    Article  PubMed  CAS  Google Scholar 

  24. Melaragno MJ, Prayson RA, Murphy MA, et al. Anaplastic astrocytoma with granular cell differentiation: case report and review of the literature. Hum Pathol 1993;24:805–808.

    Article  PubMed  CAS  Google Scholar 

  25. Geddes JF, Thom M, Robinson SFD, et al. Granular cell change in astrocytic tumors. Am J Surg Pathol 1996;20:55–63.

    Article  PubMed  CAS  Google Scholar 

  26. Cohen BH, Packer RJ. Adverse neurologic effects of chemotherapy and radiation therapy. In: Berg BO, ed. Neurological Aspects of Pediatrics. Stoneham: Butterwork, 1992:567–594.

    Google Scholar 

  27. Caveness WF. Experimental observations: delayed necrosis in normal monkey brain. In: Gilbert HA, Kagen AR, eds. Radiation Damage to the Nervous System: A Delayed Therapeutic Hazard. New York, NY: Raven Press, 1992:1–38.

    Google Scholar 

  28. Burger PC, Mahaley Jr. MS, Dudka L, et al. The morphologic effects of radiation administered therapeutic ally for intracranial gliomas: a postmortem study of 25 cases. Cancer 1979;44:1256–1272.

    Article  PubMed  CAS  Google Scholar 

  29. Artigas J, Cervos-Navarro J, Iglesias JR, et al. Gliomatosis cerebri: clinical and histological findings. Clin Neuropathol 1985;4:135–148.

    PubMed  CAS  Google Scholar 

  30. Elshaikh MA, Stevens GH, Peereboom DM, et al. Gliomatosis cerebri. Treatment results with radiotherapy alone. Cancer 2002;95:2027–2031.

    Article  PubMed  Google Scholar 

  31. Herrlinger U, Felsberg J, Küker W, et al. Gliomatosis cerebri: Molecular pathology and clinical course. Ann Neurol 2002;53:390–399.

    Article  CAS  Google Scholar 

  32. Prayson RA, Morris HH. Anaplasticpleomorphicxanthoastrocytoma. Arch Pathol Lab Med 1998;122:1082–1086.

    PubMed  CAS  Google Scholar 

  33. Macaulay RJB, Jay V, Hoffman HJ, et al. Increased mitotic activity as a negative prognostic indicator in pleomorphic xanthoastrocytoma. J Neurosurg 1993;79:761–768.

    PubMed  CAS  Google Scholar 

  34. Giannini C, Scheithauer BW, Burger PC, et al. Pleomorphic xanthoastrocytoma. What do we really know about it. Cancer 1999;85:2033–2045.

    PubMed  CAS  Google Scholar 

  35. Tomlinson FH, Scheithauer BW, Hayostek CJ, et al. The significance of atypia and histologic malignancy in pilocytic astrocytoma of the cerebellum: a clinicopathologic and flow cytometric study. J Child Neurol 1994;9:301–310.

    PubMed  CAS  Google Scholar 

  36. Brat DJ, Hirose Y, Cohen KJ, et al. Astroblastoma: clinicopathologic features and chromosomal abnormalities defined by comparative genomic hybridization. Brain Pathol 2000;10:342–352.

    Article  PubMed  CAS  Google Scholar 

  37. Bonnin JM, Rubinstein LJ. Astroblastomas: A pathological study of 23 tumors, with a postoperative fellow-up in 13 patients. Neurosurgery 1989;25:6–13.

    Article  PubMed  CAS  Google Scholar 

  38. VandenBerg SR. Desmoplastic infantile ganglioglioma and desmoplastic cerebral astrocytoma of infancy. Brain Pathol 1993;3:275–281.

    PubMed  CAS  Google Scholar 

  39. Setty SN, Miller DC, Camras L, et al. Desmoplastic infantile astrocytoma with metastases at presentation. Mod Pathol 1997;10:945–995.

    PubMed  CAS  Google Scholar 

  40. Burger PC, Rawlings CE, Cox EB, et al. Clinicopathologic correlations in the oligodendroglioma. Cancer 1987;59:1345–1352.

    Article  PubMed  CAS  Google Scholar 

  41. Shaw EG, Scheithauer BW, O’eFallon JR, et al. Oligodendrogliomas: the Mayo Clinic experience. JNeurosurg 1992;76:428–434.

    CAS  Google Scholar 

  42. Daumas-Duport C, Varlet P, Tucker M-L, et al. Oligodendrogliomas part I: patterns of growth, histological diagnosis, clinical and imaging correlations: a study of 153 cases. J Neuro Oncol 1997;34:37–59.

    Article  CAS  Google Scholar 

  43. Kros JM, Troost D, van Eden CG, et al. Oligodendroglioma. A comparison of two grading systems. Cancer 1988;61:2251–2259.

    Article  PubMed  CAS  Google Scholar 

  44. Dehghani F, Schachenmayr W, Laun A, et al. Prognostic implication of histological, immunohistochemical and clinical features of oligodendrogliomas: a study of 89 cases. Acta Neuropathol 1998;95:493–504.

    Article  PubMed  CAS  Google Scholar 

  45. Mørk SJ, Halvorsen TB, Lindegaard K-F, et al. Oligodendroglioma: histologic evaluation and prognosis. J Neuropathol Exp Neurol 1986;45:65–78.

    PubMed  Google Scholar 

  46. Reifenberger G, Kros JM, Burger PC, et al. Oligodendroglioma and anaplastic oligodendroglioma. In: Kleihues P, Cavenee WK, eds. Tumours of the Nervous System. Lyon, France: IARC Press, 2000:56–64.

    Google Scholar 

  47. Hart MN, Petito CK, Earle KM. Mixed gliomas. Cancer 1974;33:134–140.

    Article  PubMed  CAS  Google Scholar 

  48. Beckmann MJ, Prayson RA. A clinicopathologic study of 30 cases of oligoastrocytoma including p53 immunohistochemistry. Pathology 1997;29:159–164.

    Article  PubMed  CAS  Google Scholar 

  49. Jask-lsky D, Zawirski M, Papierz W et al. Mixed gliomas: their clinical course and results of surgery. Zentralbl Neurochir 1987;48:120–123.

    Google Scholar 

  50. Shaw EG, Scheithauer BW, O’eFallon JR, et al. Mixed oligoastrocytomas: a survival and prognostic factor and analysis. Neurosurgery 1994;34:577–582.

    Article  PubMed  CAS  Google Scholar 

  51. Reifenberger G, Kros JM, Burger PC, et al. Oligoastrocytoma and anaplastic oligoastrocytoma. In: Kleihues P, Cavenee WK, eds. Tumours of the Nervous System. Lyon, France: IARC Press, 2000:65–69.

    Google Scholar 

  52. Smith JS, Perry A, Borell TJ, et al. Alterations of chromosome arms 1p and 19q as predictors of survival in oligodendrogliomas, astrocytomas, and mixed oligoastrocytomas. J Clin Oncol 2000;18:636–645.

    PubMed  CAS  Google Scholar 

  53. Wiestler OD, Schiffer D, Coons SW, et al. Ependymoma and anaplastic ependymoma. In: Kleihues P, Cavenee WK, eds. Tumours of the Nervous System. Lyon, France: IARC Press, 2000:72–77.

    Google Scholar 

  54. Afra D, Muller W, Slowik F, Wilcke O, Budka H, Turoczy L. Supratentorial lobar ependymomas: reports on the grading and survival periods in 80 cases, including 46 recurrences. Acta Neurochir (Wein) 1983;69:243–251.

    Article  CAS  Google Scholar 

  55. Ernestus R-I, Wilcke O, Schröder R. Supratentorial ependymomas in childhood: clinicopathological findings and prognosis. Acta Neurochir (Wien) 1991;111:96–102.

    Article  CAS  Google Scholar 

  56. Mørk SJ, Løken AC. Ependymoma: a follow-up study of 101 cases. Cancer 1977;40:907–915.

    Article  PubMed  Google Scholar 

  57. Lyons MK, Kelly PJ. Posterior fossa ependymomas: report of 30 cases and review of the literature. Neurosurgery 1991;28:659–665.

    Article  PubMed  CAS  Google Scholar 

  58. Rawlings III CE, Giangaspero F, Burger PC, et al. Ependymomas: a clinicopathologic study. Surg Neurol 1988;29:271–281.

    Article  PubMed  Google Scholar 

  59. Figarella-Branger D, Gambarelli D, Dollo C, et al. Infratentorial ependymomas of childhood: correlation between histological features, immunohistological phenotype, silver nucleolar organizer region staining values and post-operative survival in 16 cases. Acta Neuropathol (Berl) 1991;82:208–216.

    Article  CAS  Google Scholar 

  60. Prayson RA. Cyclin D1 and MIB-1 immunohistochemistry in ependymomas: a study of 41 cases. Am J Clin Pathol 1998;110:629–634.

    PubMed  CAS  Google Scholar 

  61. Paulus W, Peiffer J. Intratumoral histologic heterogeneity of gliomas: a quantitative study. Cancer 1989;64:442–447.

    Article  PubMed  CAS  Google Scholar 

  62. Coons SW, Johnson PC. Regional heterogeneity in the proliferative activity of human gliomas as measured by Ki-67 labeling index. J Neuropathol Exp Neurol 1993;52:609–618.

    PubMed  CAS  Google Scholar 

  63. Brainard JA, Prayson RA, Barnett GH. Frozen section evaluation of stereotactic brain biopsies: diagnostic yield at the stereotactic target position in 188 cases. Arch Pathol Lab Med 1997;121:481–484.

    PubMed  CAS  Google Scholar 

  64. Mittler MA, Walters BC, Stopa EG. Observer reliability in histological grading of astrocytoma stereotactic biopsies. J Neurosurg 1996;85:1091–1094.

    PubMed  CAS  Google Scholar 

  65. Prayson RA, Agamanolis DP, Cohen ML, et al. Intraobserver reproducibility among neuropathologists and surgical pathologists in fibrillary astrocytoma grading. J Neurol Sci 2000;175:33–39.

    Article  PubMed  CAS  Google Scholar 

  66. Giannini C, Scheithauer BW, Weaver AL, et al. Oligodendrogliomas: Reproducibility and prognostic value of histologic diagnosis and grading. J Neuropathol Exp Neurol 2001;60:248–262.

    PubMed  CAS  Google Scholar 

  67. Coons SW, Johnson PC, Scheithauer BW, et al. Improving diagnostic accuracy and interobserver concordance in the classification and grading of primary gliomas. Cancer 1997;79:1381–1393.

    Article  PubMed  CAS  Google Scholar 

  68. Prayson RA. Cell proliferation and tumors of the central nervous system, Part II: Radiolabeling, cytometric, and immunohistochemical techniques. J Neuropathol Exp Neurol 2002;61:663–672.

    PubMed  Google Scholar 

  69. Giannini C, Scheithauer BW, Burger PC, et al. Cellular proliferation in pilocytic and diffuse astrocytomas. J Neuropathol Exp Neurol 1999;58:46–53.

    Article  PubMed  CAS  Google Scholar 

  70. Wakimoto H, Aoy agi M, Nakayama T, et al. Prognostic significance of Ki-67 labeling indices obtained using MIB-1 monoclonal antibody in patients with supratentorial astrocytomas. Cancer 1996;77:373–380.

    Article  PubMed  CAS  Google Scholar 

  71. Hsu DW, Louis DN. Efird JT, et al. Use of MIB-1 (Ki-67) immunoreactivity in differentiating grade II and grade III gliomas. J Neuropathol Exp Neurol 1997;56:857–865.

    PubMed  CAS  Google Scholar 

  72. Montine TJ, Vandersteenhoven J, Aguzzi A, et al. Prognostic significance of Ki-67 proliferation index in supratentorial fibrillary astrocytic neoplasms. Neurosurgery 1994;34:674–679.

    Article  PubMed  CAS  Google Scholar 

  73. Prayson RA, Mohan DS, Song P, et al. Clinicopathologic study of forty-four histologically pure supratentorial oligodendrogliomas. Ann Diagn Pathol 2000;4:218–227.

    Article  PubMed  CAS  Google Scholar 

  74. Kros JM, Hop WCJ, Godschalk JJCJ, et al. Prognostic value of the proliferation-related antigen Ki-67 in oligodendrogliomas. Cancer 1996;78:1107–1113.

    Article  PubMed  CAS  Google Scholar 

  75. Coons SW, Johnson PC, Pearl DK. The prognostic significance of Ki-67 labeling indices for oligodendrogliomas. Neurosurgery 1997;41:878–885.

    Article  PubMed  CAS  Google Scholar 

  76. Prayson RA. Clinicopathologic study of 61 patients with ependymoma including MIB-1 immunohistochemistry. Ann Diagn Pathol 1999;3:11–18.

    Article  PubMed  CAS  Google Scholar 

  77. Schröder R, Ploner C, Ernestus R-I. The growth potential of ependymomas with varying grades of malignancy measured by the Ki-67 labeling index and mitotic index. Neurosurg Rev 1993;16:145–150.

    Article  PubMed  Google Scholar 

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Prayson, R.A. (2007). Histologic Classification of High-Grade Gliomas. In: Barnett, G.H. (eds) High-Grade Gliomas. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59745-185-7_1

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  • DOI: https://doi.org/10.1007/978-1-59745-185-7_1

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