Diffuse Gliomas for Nonneuropathologists: The New Integrated Molecular Diagnostics

Archives of Pathology & Laboratory Medicine
Sunhee C Lee

Abstract

Diffuse gliomas comprise the bulk of "brain cancer" in adults. The recent update to the 4th edition of the World Health Organization's classification of tumors of the central nervous system reflects an unprecedented change in the landscape of the diagnosis and management of diffuse gliomas that will affect all those involved in the management and care of patients. Of the recently discovered gene alterations, mutations in the Krebs cycle enzymes isocitrate dehydrogenases (IDHs) 1 and 2 have fundamentally changed the way the gliomas are understood and classified. Incorporating information on a few genetic parameters (IDH, ATRX and/or p53, and chromosome 1p19q codeletion), a relatively straightforward diagnostic algorithm has been generated with robust and reproducible results that correlate with patients' survival far better than relying on conventional histology alone. Evidence also supports the conclusion that the vast majority of diffuse gliomas without IDH mutations (IDH-wild-type astrocytomas) behave like IDH-wild-type glioblastomas ("molecular GBM"). Together, these changes reflect a big shift in the practice of diagnostic neuropathology in which tumor risk stratification aligns better with molecular information than histol...Continue Reading

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Citations

Jul 9, 2020·International Journal of Molecular Sciences·Susannah HallalKimberley Louise Alexander-Kaufman
Jul 29, 2020·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Gloria C ChiangIlhami Kovanlikaya
Jul 31, 2020·Journal of Clinical Pathology·Cassandra Bruce-Brand, Dhirendra Govender
Mar 5, 2021·Journal of Epilepsy Research·Lanisha D Fuller, Richard A Prayson
May 1, 2021·Cancers·Elisabete Cruz Da SilvaLaurence Choulier
Aug 11, 2021·Surgical Pathology Clinics·Jonathan C Slack, Alanna J Church

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