1
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Satomi K, Ichimura K, Shibahara J. Decoding the DNA methylome of central nervous system tumors: An emerging modality for integrated diagnosis. Pathol Int 2024; 74:51-67. [PMID: 38224248 DOI: 10.1111/pin.13402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/16/2023] [Accepted: 12/18/2023] [Indexed: 01/16/2024]
Abstract
The definitive diagnosis and classification of individual cancers are crucial for patient care and cancer research. To achieve a robust diagnosis of central nervous system (CNS) tumors, a genotype-phenotype integrated diagnostic approach was introduced in recent versions of the World Health Organization classification, followed by the incorporation of a genome-wide DNA methylome-based classification. Microarray-based platforms are widely used to obtain DNA methylome data, and the German Cancer Research Center (Deutsches Krebsforschungszentrum [DKFZ]) has a webtool for a DNA methylation-based classifier (DKFZ classifier). Integration of DNA methylome will further enhance the precision of CNS tumor classification, especially in diagnostically challenging cases. However, in the clinical application of DNA methylome-based classification, challenges related to data interpretation persist, in addition to technical caveats, regulations, and limited accessibility. Dimensionality reduction (DMR) can complement integrated diagnosis by visualizing a profile and comparing it with other known samples. Therefore, DNA methylome-based classification is a highly useful research tool for auxiliary analysis in challenging diagnostic and rare disease cases, and for establishing novel tumor concepts. Decoding the DNA methylome, especially by DMR in addition to DKFZ classifier, emphasizes the capability of grasping the fundamental biological principles that provide new perspectives on CNS tumors.
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Affiliation(s)
- Kaishi Satomi
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Koichi Ichimura
- Department of Brain Disease Translational Research, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University Faculty of Medicine, Tokyo, Japan
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2
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Bertero L, Mangherini L, Ricci AA, Cassoni P, Sahm F. Molecular neuropathology: an essential and evolving toolbox for the diagnosis and clinical management of central nervous system tumors. Virchows Arch 2024; 484:181-194. [PMID: 37658995 PMCID: PMC10948579 DOI: 10.1007/s00428-023-03632-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/04/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Abstract
Molecular profiling has transformed the diagnostic workflow of CNS tumors during the last years. The latest WHO classification of CNS tumors (5th edition), published in 2021, pushed forward the integration between histopathological features and molecular hallmarks to achieve reproducible and clinically relevant diagnoses. To address these demands, pathologists have to appropriately deal with multiple molecular assays mainly including DNA methylation profiling and DNA/RNA next generation sequencing. Tumor classification by DNA methylation profiling is now a critical tool for many diagnostic tasks in neuropathology including the assessment of complex cases, to evaluate novel tumor types and to perform tumor subgrouping in hetereogenous entities like medulloblastoma or ependymoma. DNA/RNA NGS allow the detection of multiple molecular alterations including single nucleotide variations, small insertions/deletions (InDel), and gene fusions. These molecular markers can provide key insights for diagnosis, for example, if a tumor-specific mutation is detected, but also for treatment since targeted therapies are progressively entering the clinical practice. In the present review, a brief, but comprehensive overview of these tools will be provided, discussing their technical specifications, diagnostic value, and potential limitations. Moreover, the importance of molecular profiling will be shown in a representative series of CNS neoplasms including both the most frequent tumor types and other selected entities for which molecular characterization plays a critical role.
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Affiliation(s)
- Luca Bertero
- Pathology Unit, Department of Medical Sciences, University of Turin and Città Della Salute E Della Scienza University Hospital, Via Santena 7, 10126, Turin, Italy
| | - Luca Mangherini
- Pathology Unit, Department of Medical Sciences, University of Turin and Città Della Salute E Della Scienza University Hospital, Via Santena 7, 10126, Turin, Italy
| | - Alessia Andrea Ricci
- Pathology Unit, Department of Medical Sciences, University of Turin and Città Della Salute E Della Scienza University Hospital, Via Santena 7, 10126, Turin, Italy
| | - Paola Cassoni
- Pathology Unit, Department of Medical Sciences, University of Turin and Città Della Salute E Della Scienza University Hospital, Via Santena 7, 10126, Turin, Italy
| | - Felix Sahm
- Department of Neuropathology, Heidelberg University Hospital, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany.
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany.
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3
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Wongsurawat T, Jenjaroenpun P, Anekwiang P, Arigul T, Thongrattana W, Jamshidi‐Parsian A, Boysen G, Suriyaphol P, Suktitipat B, Srirabheebhat P, Cheunsuchon P, Tanboon J, Nookaew I, Sathornsumetee S. Exploiting nanopore sequencing for characterization and grading of IDH-mutant gliomas. Brain Pathol 2024; 34:e13203. [PMID: 37574201 PMCID: PMC10711254 DOI: 10.1111/bpa.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/28/2023] [Indexed: 08/15/2023] Open
Abstract
The 2021 WHO Classification of Central Nervous System Tumors recommended evaluation of cyclin-dependent kinase inhibitor 2A/B (CDKN2A/B) deletion in addition to codeletion of 1p/19q to characterize IDH-mutant gliomas. Here, we demonstrated the use of a nanopore-based copy-number variation sequencing (nCNV-seq) approach to simultaneously identify deletions of CDKN2A/B and 1p/19q. The nCNV-seq approach was initially evaluated on three distinct glioma cell lines and then applied to 19 IDH-mutant gliomas (8 astrocytomas and 11 oligodendrogliomas) from patients. The whole-arm 1p/19q codeletion was detected in all oligodendrogliomas with high concordance among nCNV-seq, FISH, DNA methylation profiling, and whole-genome sequencing. For the CDKN2A/B deletion, nCNV-seq detected the loss in both astrocytoma and oligodendroglioma, with strong correlation with the CNV profiles derived from whole-genome sequencing (Pearson correlation (r) = 0.95, P < 2.2 × 10-16 to r = 0.99, P < 2.2 × 10-16 ) and methylome profiling. Furthermore, nCNV-seq can differentiate between homozygous and hemizygous deletions of CDKN2A/B. Taken together, nCNV-seq holds promise as a new, alternative approach for a rapid and simultaneous detection of the molecular signatures of IDH-mutant gliomas without capital expenditure for a sequencer.
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Affiliation(s)
- Thidathip Wongsurawat
- Division of Medical Bioinformatics, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
- Department of Biomedical Informatics, College of MedicineUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Piroon Jenjaroenpun
- Division of Medical Bioinformatics, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
- Department of Biomedical Informatics, College of MedicineUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Panatna Anekwiang
- Department of Medicine (Neurology), Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Tantip Arigul
- Division of Medical Bioinformatics, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Wichayapat Thongrattana
- Division of Medical Bioinformatics, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Azemat Jamshidi‐Parsian
- Department of Radiation OncologyUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Gunnar Boysen
- Department of Environmental and Occupational HealthUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Prapat Suriyaphol
- Division of Medical Bioinformatics, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Bhoom Suktitipat
- Division of Medical Bioinformatics, Department of Research and Development, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
- Department of Biochemistry, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Prajak Srirabheebhat
- Department of Surgery (Neurosurgery), Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Pornsuk Cheunsuchon
- Department of Pathology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Jantima Tanboon
- Department of Pathology, Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
| | - Intawat Nookaew
- Department of Biomedical Informatics, College of MedicineUniversity of Arkansas for Medical SciencesLittle RockArkansasUSA
| | - Sith Sathornsumetee
- Department of Medicine (Neurology), Faculty of Medicine Siriraj HospitalMahidol UniversityBangkokThailand
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4
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Park YW, Vollmuth P, Foltyn-Dumitru M, Sahm F, Choi KS, Park JE, Ahn SS, Chang JH, Kim SH. The 2021 WHO Classification for Gliomas and Implications on Imaging Diagnosis: Part 3-Summary of Imaging Findings on Glioneuronal and Neuronal Tumors. J Magn Reson Imaging 2023; 58:1680-1702. [PMID: 37715567 DOI: 10.1002/jmri.29016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 09/17/2023] Open
Abstract
The fifth edition of the World Health Organization classification of central nervous system tumors published in 2021 reflects the current transitional state between traditional classification system based on histopathology and the state-of-the-art molecular diagnostics. This Part 3 Review focuses on the molecular diagnostics and imaging findings of glioneuronal and neuronal tumors. Histological and molecular features in glioneuronal and neuronal tumors often overlap with pediatric-type diffuse low-grade gliomas and circumscribed astrocytic gliomas (discussed in the Part 2 Review). Due to this overlap, in several tumor types of glioneuronal and neuronal tumors the diagnosis may be inconclusive with histopathology and genetic alterations, and imaging features may be helpful to distinguish difficult cases. Thus, it is crucial for radiologists to understand the underlying molecular diagnostics as well as imaging findings for application on clinical practice. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Yae Won Park
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Philipp Vollmuth
- Department of Neuroradiology, Heidelberg University College of Medicine, Heidelberg, Germany
| | - Martha Foltyn-Dumitru
- Department of Neuroradiology, Heidelberg University College of Medicine, Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Heidelberg University College of Medicine, Heidelberg, Germany
| | - Kyu Sung Choi
- Department of Radiology, Seoul National University Hospital, Seoul, Korea
| | - Ji Eun Park
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Soo Ahn
- Department of Radiology and Research Institute of Radiological Science and Center for Clinical Imaging Data Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hee Chang
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea
| | - Se Hoon Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
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5
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Yoda RA, Cimino PJ. Classification and Grading of Central Nervous System Tumors According to the World Health Organization 5th Edition. Semin Neurol 2023; 43:833-844. [PMID: 37949117 DOI: 10.1055/s-0043-1776793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
The World Health Organization (WHO) released the 5th edition of its classification of central nervous system (CNS) tumors in 2021. Advances in the landscape of molecular tumor pathophysiology prompted major revisions to the previous edition released in 2016, some of which were first introduced by the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy-Not Official WHO (cIMPACT-NOW). The 2021 classification system integrates newly gained molecular insights to guide changes in tumor taxonomy and nomenclature, introduces several new types of tumors, and expands the use of molecular testing for diagnosis and grading, with a particular impact on adult-type and pediatric-type gliomas, ependymomas, and embryonal tumors. These updates aim to promote clear and accurate diagnoses, yield more reliable prognostic information, and enable the selection of optimal therapies. Familiarity with these changes will be of great importance for clinicians involved in the management of CNS tumor patients.
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Affiliation(s)
- Rebecca A Yoda
- Division of Neuropathology, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| | - Patrick J Cimino
- Neuropathology Unit, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
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6
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Muench A, Teichmann D, Spille D, Kuzman P, Perez E, May SA, Mueller WC, Kombos T, Nazari-Dehkordi S, Onken J, Vajkoczy P, Ntoulias G, Bettencourt C, von Deimling A, Paulus W, Heppner FL, Koch A, Capper D, Kaul D, Thomas C, Schweizer L. A Novel Type of IDH-wildtype Glioma Characterized by Gliomatosis Cerebri-like Growth Pattern, TERT Promoter Mutation, and Distinct Epigenetic Profile. Am J Surg Pathol 2023; 47:1364-1375. [PMID: 37737691 DOI: 10.1097/pas.0000000000002118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Diffuse gliomas in adults encompass a heterogenous group of central nervous system neoplasms. In recent years, extensive (epi-)genomic profiling has identified several glioma subgroups characterized by distinct molecular characteristics, most importantly IDH1/2 and histone H3 mutations. A group of 16 diffuse gliomas classified as "adult-type diffuse high-grade glioma, IDH-wildtype, subtype F (HGG-F)" was identified by the DKFZ v12.5 Brain Tumor Classifier . Histopathologic characterization, exome sequencing, and review of clinical data was performed in all cases. Based on unsupervised t -distributed stochastic neighbor embedding and clustering analysis of genome-wide DNA methylation data, HGG-F shows distinct epigenetic profiles separate from established central nervous system tumors. Exome sequencing demonstrated frequent TERT promoter (12/15 cases), PIK3R1 (11/16), and TP53 mutations (5/16). Radiologic characteristics were reminiscent of gliomatosis cerebri in 9/14 cases (64%). Histopathologically, most cases were classified as diffuse gliomas (7/16, 44%) or were suspicious for the infiltration zone of a diffuse glioma (5/16, 31%). None of the cases demonstrated microvascular proliferation or necrosis. Outcome of 14 patients with follow-up data was better compared to IDH-wildtype glioblastomas with a median progression-free survival of 58 months and overall survival of 74 months (both P <0.0001). Our series represents a novel type of adult-type diffuse glioma with distinct molecular and clinical features. Importantly, we provide evidence that TERT promoter mutations in diffuse gliomas without further morphologic or molecular signs of high-grade glioma should be interpreted in the context of the clinicoradiologic presentation as well as epigenetic profile and may not be suitable as a standalone marker for glioblastoma, IDH-wildtype.
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Affiliation(s)
- Amos Muench
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main
| | | | | | - Peter Kuzman
- Institute of Neuropathology, University Hospital Leipzig, Leipzig
| | | | - Sven-Axel May
- Department of Neurosurgery, Klinikum Chemnitz, Chemnitz
| | - Wolf C Mueller
- Institute of Neuropathology, University Hospital Leipzig, Leipzig
| | | | | | | | | | - Georgios Ntoulias
- Department of Neurosurgery, Schlosspark-Klinik Charlottenburg, Berlin
| | - Conceição Bettencourt
- Queen Square Brain Bank, UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | - Werner Paulus
- Institute of Neuropathology, University Hospital Münster, Münster
| | - Frank L Heppner
- Departments of Neuropathology
- Cluster of Excellence, NeuroCure
- German Center for Neurodegenerative Diseases (DZNE)
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ)
| | - Arend Koch
- Departments of Neuropathology
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ)
| | - David Capper
- Departments of Neuropathology
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ)
| | - David Kaul
- Radiation Oncology and Radiotherapy, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
| | - Christian Thomas
- Institute of Neuropathology, University Hospital Münster, Münster
| | - Leonille Schweizer
- Edinger Institute, Institute of Neurology, University of Frankfurt am Main
- Frankfurt Cancer Institute (FCI), Frankfurt am Main
- Departments of Neuropathology
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ)
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, German Cancer Research Center (DKFZ), Heidelberg, Germany
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7
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Park JW, Lee K, Kim EE, Kim SI, Park SH. Brain Tumor Classification by Methylation Profile. J Korean Med Sci 2023; 38:e356. [PMID: 37935168 PMCID: PMC10627723 DOI: 10.3346/jkms.2023.38.e356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/12/2023] [Indexed: 11/09/2023] Open
Abstract
The goal of the methylation classifier in brain tumor classification is to accurately classify tumors based on their methylation profiles. Accurate brain tumor diagnosis is the first step for healthcare professionals to predict tumor prognosis and establish personalized treatment plans for patients. The methylation classifier can be used to perform classification on tumor samples with diagnostic difficulties due to ambiguous histology or mismatch between histopathology and molecular signatures, i.e., not otherwise specified (NOS) cases or not elsewhere classified (NEC) cases, aiding in pathological decision-making. Here, the authors elucidate upon the application of a methylation classifier as a tool to mitigate the inherent complexities associated with the pathological evaluation of brain tumors, even when pathologists are experts in histopathological diagnosis and have access to enough molecular genetic information. Also, it should be emphasized that methylome cannot classify all types of brain tumors, and it often produces erroneous matches even with high matching scores, so, excessive trust is prohibited. The primary issue is the considerable difficulty in obtaining reference data regarding the methylation profile of each type of brain tumor. This challenge is further amplified when dealing with recently identified novel types or subtypes of brain tumors, as such data are not readily accessible through open databases or authors of publications. An additional obstacle arises from the fact that methylation classifiers are primarily research-based, leading to the unavailability of charging patients. It is important to note that the application of methylation classifiers may require specialized laboratory techniques and expertise in DNA methylation analysis.
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Affiliation(s)
- Jin Woo Park
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Kwanghoon Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Eric Eunshik Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Seong-Ik Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
- Institute of Neuroscience, Seoul National University College of Medicine, Seoul, Korea.
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8
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van den Bent MJ, Geurts M, French PJ, Smits M, Capper D, Bromberg JEC, Chang SM. Primary brain tumours in adults. Lancet 2023; 402:1564-1579. [PMID: 37738997 DOI: 10.1016/s0140-6736(23)01054-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 05/06/2023] [Accepted: 05/16/2023] [Indexed: 09/24/2023]
Abstract
The most frequent adult-type primary CNS tumours are diffuse gliomas, but a large variety of rarer CNS tumour types exists. The classification of these tumours is increasingly based on molecular diagnostics, which is reflected in the extensive molecular foundation of the recent WHO 2021 classification of CNS tumours. Resection as extensive as is safely possible is the cornerstone of treatment in most gliomas, and is now also recommended early in the treatment of patients with radiological evidence of histologically low-grade tumours. For the adult-type diffuse glioma, standard of care is a combination of radiotherapy and chemotherapy. Although treatment with curative intent is not available, combined modality treatment has resulted in long-term survival (>10-20 years) for some patients with isocitrate dehydrogenase (IDH) mutant tumours. Other rarer tumours require tailored approaches, best delivered in specialised centres. Targeted treatments based on molecular alterations still only play a minor role in the treatment landscape of adult-type diffuse glioma, and today are mainly limited to patients with tumours with BRAFV600E (ie, Val600Glu) mutations. Immunotherapy for CNS tumours is still in its infancy, and so far, trials with checkpoint inhibitors and vaccination studies have not shown improvement in patient outcomes in glioblastoma. Current research is focused on improving our understanding of the immunosuppressive tumour environment, the molecular heterogeneity of tumours, and the role of tumour microtube network connections between cells in the tumour microenvironment. These factors all appear to play a role in treatment resistance, and indicate that novel approaches are needed to further improve outcomes of patients with CNS tumours.
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Affiliation(s)
- Martin J van den Bent
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Netherlands.
| | - Marjolein Geurts
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Netherlands
| | - Pim J French
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Netherlands
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Netherlands; Medical Delta, Delft, Netherlands
| | - David Capper
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; German Cancer Consortium, Berlin, Germany; German Cancer Research Center, Heidelberg, Germany
| | - Jacoline E C Bromberg
- Department of Neurology, Brain Tumor Center, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Netherlands
| | - Susan M Chang
- Brain Tumor Center, University of California San Francisco, San Francisco, CA, USA
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9
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Guerin JB, Kaufmann TJ, Eckel LJ, Morris JM, Vaubel RA, Giannini C, Johnson DR. A Radiologist's Guide to the 2021 WHO Central Nervous System Tumor Classification: Part 2-Newly Described and Revised Tumor Types. Radiology 2023; 307:e221885. [PMID: 37191486 DOI: 10.1148/radiol.221885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The fifth edition of the World Health Organization classification of tumors of the central nervous system (CNS), published in 2021, introduces major shifts in the classification of brain and spine tumors. These changes were necessitated by rapidly increasing knowledge of CNS tumor biology and therapies, much of which is based on molecular methods in tumor diagnosis. The growing complexity of CNS tumor genetics has required reorganization of tumor groups and acknowledgment of new tumor entities. For radiologists interpreting neuroimaging studies, proficiency with these updates is critical in providing excellent patient care. This review will focus on new or revised CNS tumor types and subtypes, beyond infiltrating glioma (described in part 1 of this series), with an emphasis on imaging features.
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Affiliation(s)
- Julie B Guerin
- From the Departments of Radiology (J.B.G., T.J.K., L.J.E., J.M.M., D.R.J.), Laboratory Medicine and Pathology (R.A.V., C.G.), and Neurology (D.R.J.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy (C.G.)
| | - Timothy J Kaufmann
- From the Departments of Radiology (J.B.G., T.J.K., L.J.E., J.M.M., D.R.J.), Laboratory Medicine and Pathology (R.A.V., C.G.), and Neurology (D.R.J.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy (C.G.)
| | - Laurence J Eckel
- From the Departments of Radiology (J.B.G., T.J.K., L.J.E., J.M.M., D.R.J.), Laboratory Medicine and Pathology (R.A.V., C.G.), and Neurology (D.R.J.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy (C.G.)
| | - Jonathan M Morris
- From the Departments of Radiology (J.B.G., T.J.K., L.J.E., J.M.M., D.R.J.), Laboratory Medicine and Pathology (R.A.V., C.G.), and Neurology (D.R.J.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy (C.G.)
| | - Rachael A Vaubel
- From the Departments of Radiology (J.B.G., T.J.K., L.J.E., J.M.M., D.R.J.), Laboratory Medicine and Pathology (R.A.V., C.G.), and Neurology (D.R.J.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy (C.G.)
| | - Caterina Giannini
- From the Departments of Radiology (J.B.G., T.J.K., L.J.E., J.M.M., D.R.J.), Laboratory Medicine and Pathology (R.A.V., C.G.), and Neurology (D.R.J.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy (C.G.)
| | - Derek R Johnson
- From the Departments of Radiology (J.B.G., T.J.K., L.J.E., J.M.M., D.R.J.), Laboratory Medicine and Pathology (R.A.V., C.G.), and Neurology (D.R.J.), Mayo Clinic, 200 First St SW, Rochester, MN 55905; and Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy (C.G.)
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10
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Saliba T, Boitsios G. Diffuse Leptomeningeal Glioneuronal Tumour. Cureus 2023; 15:e38404. [PMID: 37265882 PMCID: PMC10231907 DOI: 10.7759/cureus.38404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2023] [Indexed: 06/03/2023] Open
Abstract
Diffuse leptomeningeal glioneuronal tumours (DL-GNT) are rare, with an unknown incidence but fewer than 100 cases reported since 2012. The clinical presentation is non-specific, ranging from abdominal to neurological symptoms. Presently, definitive radiological criteria aren't established, but some features, such as nodules, characteristic extension patterns and post-contrast leptomeningeal enhancement, are found to be prominent. We present the case of a 14-year-old male with an advanced case of DL-GNT, with MRI showing all the features of what is currently thought to be the typical radiological presentation. The patient is currently undergoing treatment but remains severely handicapped by the disease.
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Affiliation(s)
- Tom Saliba
- Radiology, Hopital Universitaire Des Enfants Reine Fabiola, Brussels, BEL
- Radiology, Université Libre de Bruxelles, Brussels, BEL
| | - Grammatina Boitsios
- Pediatric Neuroradiologist, Hopital Universitaire Des Enfants Reine Fabiola, Brussels, BEL
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Sturm D, Capper D, Andreiuolo F, Gessi M, Kölsche C, Reinhardt A, Sievers P, Wefers AK, Ebrahimi A, Suwala AK, Gielen GH, Sill M, Schrimpf D, Stichel D, Hovestadt V, Daenekas B, Rode A, Hamelmann S, Previti C, Jäger N, Buchhalter I, Blattner-Johnson M, Jones BC, Warmuth-Metz M, Bison B, Grund K, Sutter C, Hirsch S, Dikow N, Hasselblatt M, Schüller U, Koch A, Gerber NU, White CL, Buntine MK, Kinross K, Algar EM, Hansford JR, Gottardo NG, Schuhmann MU, Thomale UW, Hernáiz Driever P, Gnekow A, Witt O, Müller HL, Calaminus G, Fleischhack G, Kordes U, Mynarek M, Rutkowski S, Frühwald MC, Kramm CM, von Deimling A, Pietsch T, Sahm F, Pfister SM, Jones DTW. Multiomic neuropathology improves diagnostic accuracy in pediatric neuro-oncology. Nat Med 2023; 29:917-926. [PMID: 36928815 PMCID: PMC10115638 DOI: 10.1038/s41591-023-02255-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 02/13/2023] [Indexed: 03/17/2023]
Abstract
The large diversity of central nervous system (CNS) tumor types in children and adolescents results in disparate patient outcomes and renders accurate diagnosis challenging. In this study, we prospectively integrated DNA methylation profiling and targeted gene panel sequencing with blinded neuropathological reference diagnostics for a population-based cohort of more than 1,200 newly diagnosed pediatric patients with CNS tumors, to assess their utility in routine neuropathology. We show that the multi-omic integration increased diagnostic accuracy in a substantial proportion of patients through annotation to a refining DNA methylation class (50%), detection of diagnostic or therapeutically relevant genetic alterations (47%) or identification of cancer predisposition syndromes (10%). Discrepant results by neuropathological WHO-based and DNA methylation-based classification (30%) were enriched in histological high-grade gliomas, implicating relevance for current clinical patient management in 5% of all patients. Follow-up (median 2.5 years) suggests improved survival for patients with histological high-grade gliomas displaying lower-grade molecular profiles. These results provide preliminary evidence of the utility of integrating multi-omics in neuropathology for pediatric neuro-oncology.
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Affiliation(s)
- Dominik Sturm
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology & Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - David Capper
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felipe Andreiuolo
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn, Bonn, Germany
- Laboratory of Neuropathology, Paulo Niemeyer State Brain Institute, Rio de Janeiro, Brazil
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Marco Gessi
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn, Bonn, Germany
| | - Christian Kölsche
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Philipp Sievers
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Annika K Wefers
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Azadeh Ebrahimi
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn, Bonn, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Abigail K Suwala
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Neurological Surgery, Helen Diller Research Center, University of California, San Francisco, San Francisco, CA, USA
| | - Gerrit H Gielen
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn, Bonn, Germany
| | - Martin Sill
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Daniel Schrimpf
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Damian Stichel
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Volker Hovestadt
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Bjarne Daenekas
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Agata Rode
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Stefan Hamelmann
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Christopher Previti
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Natalie Jäger
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Ivo Buchhalter
- Omics IT and Data Management Core Facility, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Mirjam Blattner-Johnson
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Barbara C Jones
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology & Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Monika Warmuth-Metz
- Department of Diagnostic and Interventional Neuroradiology, University Hospital of Würzburg, Würzburg, Germany
- Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, University Hospital Würzburg, since 2021 University Hospital Augsburg, Augsburg, Germany
| | - Brigitte Bison
- Neuroradiological Reference Center for the Pediatric Brain Tumor (HIT) Studies of the German Society of Pediatric Oncology and Hematology, University Hospital Würzburg, since 2021 University Hospital Augsburg, Augsburg, Germany
- Diagnostic and Interventional Neuroradiology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Kerstin Grund
- Institute of Human Genetics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christian Sutter
- Institute of Human Genetics, Heidelberg University Hospital, Heidelberg, Germany
| | - Steffen Hirsch
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
- Institute of Human Genetics, Heidelberg University Hospital, Heidelberg, Germany
| | - Nicola Dikow
- Institute of Human Genetics, Heidelberg University Hospital, Heidelberg, Germany
| | - Martin Hasselblatt
- Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Ulrich Schüller
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Paediatric Haematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
| | - Arend Koch
- Department of Neuropathology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nicolas U Gerber
- Department of Oncology, University Children's Hospital Zürich, Zürich, Switzerland
| | - Christine L White
- Genetics and Molecular Pathology Laboratory, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Molecular and Translational Science, Monash University, Melbourne, VIC, Australia
- Victorian Clinical Genetics Services, Parkville, VIC, Australia
| | - Molly K Buntine
- Genetics and Molecular Pathology Laboratory, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Molecular and Translational Science, Monash University, Melbourne, VIC, Australia
| | - Kathryn Kinross
- Australian and New Zealand Children's Haematology and Oncology Group (ANZCHOG), Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Elizabeth M Algar
- Genetics and Molecular Pathology Laboratory, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Molecular and Translational Science, Monash University, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Jordan R Hansford
- Women's and Children's Hospital, South Australia Health and Medical Research Institute, South Australia immunoGENomics Cancer Institute, University of Adelaide, Adelaide, SA, Australia
| | - Nicholas G Gottardo
- Department of Paediatric and Adolescent Oncology/Haematology, Perth Children's Hospital, Nedlands, WA, Australia
- Centre for Child Health Research, University of Western Australia, Nedlands, WA, Australia
- Brain Tumour Research Program, Telethon Kids Institute, Nedlands, WA, Australia
| | | | - Ulrich W Thomale
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Pablo Hernáiz Driever
- German HIT-LOGGIC Registry for low-grade glioma in children and adolescents, Department of Pediatric Oncology and Hematology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Astrid Gnekow
- Swabian Children's Cancer Center, Paediatric and Adolescent Medicine, Faculty of Medicine, University Augsburg, Augsburg, Germany
| | - Olaf Witt
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology & Immunology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Hermann L Müller
- Department of Pediatrics and Pediatric Hematology/Oncology, University Children's Hospital, Klinikum Oldenburg AöR, Oldenburg, Germany
| | - Gabriele Calaminus
- Department of Pediatric Hematology and Oncology, University Childrens' Hospital Muenster, Muenster, Germany
| | - Gudrun Fleischhack
- Pediatric Hematology and Oncology, Pediatrics III, University Children's Hospital of Essen, Essen, Germany
| | - Uwe Kordes
- Department of Paediatric Haematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Mynarek
- Department of Paediatric Haematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Rutkowski
- Department of Paediatric Haematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael C Frühwald
- Swabian Children's Cancer Center, Paediatric and Adolescent Medicine, Faculty of Medicine, University Augsburg, Augsburg, Germany
| | - Christof M Kramm
- Department of Child and Adolescent Health, Division of Pediatric Hematology and Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Torsten Pietsch
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn, Bonn, Germany
| | - Felix Sahm
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology & Immunology, Heidelberg University Hospital, Heidelberg, Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - David T W Jones
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.
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12
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Rigsby RK, Brahmbhatt P, Desai AB, Bathla G, Ebner BA, Gupta V, Vibhute P, Agarwal AK. Newly Recognized CNS Tumors in the 2021 World Health Organization Classification: Imaging Overview with Histopathologic and Genetic Correlation. AJNR Am J Neuroradiol 2023; 44:367-380. [PMID: 36997287 PMCID: PMC10084895 DOI: 10.3174/ajnr.a7827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/14/2022] [Indexed: 04/01/2023]
Abstract
In 2021, the World Health Organization released an updated classification of CNS tumors. This update reflects the growing understanding of the importance of genetic alterations related to tumor pathogenesis, prognosis, and potential targeted treatments and introduces 22 newly recognized tumor types. Herein, we review these 22 newly recognized entities and emphasize their imaging appearance with correlation to histologic and genetic features.
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Affiliation(s)
- R K Rigsby
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - P Brahmbhatt
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - A B Desai
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - G Bathla
- Department of Radiology (G.B.), Mayo Clinic, Rochester, Minnesota
| | - B A Ebner
- Department of Laboratory Medicine and Pathology (B.A.E.), Mayo Clinic, Rochester, Minnesota
| | - V Gupta
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - P Vibhute
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - A K Agarwal
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
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13
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Xu EX, Lu SY, Chen B, Ma XD, Sun EY. Manifestation of the malignant progression of glioma following initial intracerebral hemorrhage: A case report. World J Clin Cases 2023; 11:1576-1585. [PMID: 36926402 PMCID: PMC10011987 DOI: 10.12998/wjcc.v11.i7.1576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/03/2022] [Accepted: 02/16/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Intracranial hemorrhage is extremely rare during the initial stages of glioma. Here, we report a case of glioma with unclassified pathology and intracranial bleeding.
CASE SUMMARY After the second surgery for intracerebral hemorrhage, the patient experienced weakness in the left arm and leg, but could walk unassisted. One month after discharge, the weakness in the left limbs had exacerbated and the patient also suffered from headaches and dizziness. A third surgery was ineffective against the rapidly growing tumor. Intracerebral hemorrhage may be the initial symptom of glioma in some rare cases, and atypical perihematomal edema can be used for diagnosis during an emergency. Certain histological and molecular features seen in our case were similar to that of glioblastoma with a primitive neuronal component, which is termed diffuse glioneuronal tumor with features similar to oligodendroglioma and nuclear clusters (DGONC). The patient underwent three surgeries to remove the tumor. The first tumor resection had been performed when the patient was 14-years-old. Resection of the hemorrhage and bone disc decompression were performed when the patient was 39-years-old. One month after the last discharge, the patient underwent neuronavigation-assisted resection of the right frontotemporal parietal lesion plus extended flap decompression. On the 50th d after the third operation, computed tomography imaging showed rapid tumor growth accompanied by brain hernia. The patient was discharged and died 3 d later.
CONCLUSION Glioma can present as bleeding in the initial stage and should be considered in such a setting. We have reported a case of DGONC, which is a rare molecular subtype of glioma with a unique methylation profile.
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Affiliation(s)
- En-Xi Xu
- Department of Neurosurgery, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu Province, China
| | - Si-Yuan Lu
- Department of Radiology, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu Province, China
| | - Bo Chen
- Department of Neurosurgery, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu Province, China
| | - Xiao-Dong Ma
- Department of Anesthesia, The Affiliated People’s Hospital, Zhenjiang 212002, Jiangsu Province, China
| | - Er-Yi Sun
- Department of Neurosurgery, The Affiliated People’s Hospital of Jiangsu University, Zhenjiang 212002, Jiangsu Province, China
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Oztek MA, Noda SM, Romberg EK, Cole BL, Wright JN, Ishak GE, Perez FA. Changes to pediatric brain tumors in 2021 World Health Organization classification of tumors of the central nervous system. Pediatr Radiol 2023; 53:523-43. [PMID: 36348014 DOI: 10.1007/s00247-022-05546-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/12/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022]
Abstract
New tumor types are continuously being described with advances in molecular testing and genomic analysis resulting in better prognostics, new targeted therapy options and improved patient outcomes. As a result of these advances, pathological classification of tumors is periodically updated with new editions of the World Health Organization (WHO) Classification of Tumors books. In 2021, WHO Classification of Tumors of the Central Nervous System, 5th edition (CNS5), was published with major changes in pediatric brain tumors officially recognized including pediatric gliomas being separated from adult gliomas, ependymomas being categorized based on anatomical compartment and many new tumor types, most of them seen in children. Additional general changes, such as tumor grading now being done within tumor types rather than across entities and changes in definition of glioblastoma, are also relevant to pediatric neuro-oncology practice. The purpose of this manuscript is to highlight the major changes in pediatric brain tumors in CNS5 most relevant to radiologists. Additionally, brief descriptions of newly recognized entities will be presented with a focus on imaging findings.
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Crainic N, Furtner J, Pallud J, Bielle F, Lombardi G, Rudà R, Idbaih A. Rare Neuronal, Glial and Glioneuronal Tumours in Adults. Cancers (Basel) 2023; 15:cancers15041120. [PMID: 36831464 PMCID: PMC9954092 DOI: 10.3390/cancers15041120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Abstract
Rare glial, neuronal and glioneuronal tumours in adults form a heterogeneous group of rare, primary central nervous system tumours. These tumours, with a glial and/or neuronal component, are challenging in terms of diagnosis and therapeutic management. The novel classification of primary brain tumours published by the WHO in 2021 has significantly improved the diagnostic criteria of these entities. Indeed, diagnostic criteria are nowadays multimodal, including histological, immunohistochemical and molecular (i.e., genetic and methylomic). These integrated parameters have allowed the specification of already known tumours but also the identification of novel tumours for a better diagnosis.
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Affiliation(s)
- Nicolas Crainic
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neurologie 2, 75013 Paris, France
- Department of Neurology, University Hospital of Brest, 29200 Brest, France
- Correspondence: (N.C.); (A.I.)
| | - Julia Furtner
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
- Research Center of Medical Image Analysis and Artificial Intelligence (MIAAI), Danube Private University, 3500 Krems, Austria
| | - Johan Pallud
- Service de Neurochirurgie, GHU Paris Psychiatrie et Neurosciences, Hôpital Sainte-Anne, 75014 Paris, France
- Institute of Psychiatry and Neuroscience of Paris, IMABRAIN, INSERM U1266, Université de Paris, 75014 Paris, France
| | - Franck Bielle
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neuropathologie, 75013 Paris, France
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology-IRCCS, 35128 Padua, Italy
| | - Roberta Rudà
- Division of Neurology, Castelfranco Veneto and Treviso Hospitals, 31033 Treviso, Italy
- Department of Neuro-Oncology, University of Turin, 10126 Turin, Italy
| | - Ahmed Idbaih
- Sorbonne Université, Institut du Cerveau—Paris Brain Institute—ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Service de Neurologie 2, 75013 Paris, France
- Correspondence: (N.C.); (A.I.)
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Ahmad Z, Rahim S, Abdul-Ghafar J, Chundriger Q, Ud Din N. Events in CNS Tumor Pathology Post-2016 WHO CNS: cIMPACT-NOW Updates and Other Advancements: A Comprehensive Review Plus a Summary of the Salient Features of 2021 WHO CNS 5. Int J Gen Med 2023; 16:107-127. [PMID: 36644568 PMCID: PMC9833325 DOI: 10.2147/ijgm.s394872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction The 2016 World Health Organization Classification (WHO) of Tumors of the Central Nervous System (CNS) represented a major change. It recommended an "integrated diagnosis" comprising histologic and molecular information facilitating a more precise diagnosis of specific CNS tumors. Its goal was to provide greater diagnostic precision and reproducibility resulting in more clinical relevance and predictive value, ultimately leading to better patient care. Advances in molecular classification, mostly resulting from DNA methylation array profiling of CNS tumors, were occurring at a very rapid pace and required more rapid integration into clinical practice. Methods cIMPACT-NOW updates and other recent papers plus salient features of 2021 WHO CNS5 in this comprehensive write-up were reviewed. Results CNS tumor classification needs to be updated at a rapid pace and mechanisms put into place to guide diagnosticians and clinicians in the interim period if major changes in the classification of tumor types came to light. Recognizing the need to integrate these into clinical practice more rapidly and without inordinate delay, the International Society of Neuropathology (ISN) 2016 sponsored an initiative called cIMPACT-NOW. Discussion and/or Conclusion Goal of cIMPACT-NOW was to provide clarification regarding contentious issues arising in the wake of the 2016 WHO CNS update as well as report new advancements in molecular classification of CNS tumors and new tumor entities emerging as a result of these advancements. cIMPACT-NOW updates: It thus laid the foundation for the 5th edition of the WHO Classification of CNS tumors (2021 WHO CNS 5). We have discussed cIMPACT updates in detail in this review. In addition, molecular diagnostics including DNA methylation-based classification of CNS tumors and the practical use of molecular classification in the prognostication and treatment of CNS tumors is discussed. Finally, the salient features of the new CNS tumor classification are summarized.
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Affiliation(s)
- Zubair Ahmad
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Shabina Rahim
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Jamshid Abdul-Ghafar
- Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan,Correspondence: Jamshid Abdul-Ghafar, Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan, Tel +93 792 827 287, Email
| | - Qurratulain Chundriger
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Nasir Ud Din
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Halfpenny AM, Wood MD. Review of the Recent Changes in the WHO Classification for Pediatric Brain and Spinal Cord Tumors. Pediatr Neurosurg 2023; 58:337-355. [PMID: 36617415 PMCID: PMC10664345 DOI: 10.1159/000528957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Periodic updates to the World Health Organization (WHO) classification system for central nervous system (CNS) tumors reflect advances in the pathological diagnosis, categorization, and molecular underpinnings of primary brain, spinal cord, and peripheral nerve tumors. The 5th edition of the WHO Classification of CNS Tumors was published in 2021. This review discusses the guiding principles of the revision, introduces the more common new diagnostic entities, and describes tumor classification and nomenclature changes that are relevant for pediatric neurological surgeons. SUMMARY Revisions to the WHO CNS tumor classification system introduced new diagnostic entities, restructured and renamed other entities with particular impact in the diffuse gliomas and CNS embryonal tumors, and expanded the requirements for incorporating both molecular and histological features of CNS tumors into a unified integrated diagnosis. Many of the new diagnostic entities occur at least occasionally in pediatric patients and will thus be encountered by pediatric neurosurgeons. New nomenclature impacts the terminology that is applied in communication between pathologists, surgeons, clinicians, and patients. Requirements for molecular information in tumor diagnosis are expected to refine diagnostic categories while also introducing practical considerations for intraoperative consultation, preliminary histological evaluation, and triaging of neurosurgical tissue samples for histology, molecular testing, and clinical trial requirements. KEY MESSAGES Pediatric brain tumor diagnosis and clinical management are a multidisciplinary effort that is rapidly advancing in the molecular era. Interdisciplinary collaboration is critical for providing the best care for pediatric CNS tumor patients. Pediatric neurosurgeons and their local neuropathologists and neuro-oncologists must work collaboratively to put the most current CNS tumor diagnostic guidelines into standard practice.
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Affiliation(s)
| | - Matthew D. Wood
- Department of Pathology and Laboratory Medicine, Oregon Health & Science University, Portland, Oregon, USA
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Viaene AN. Pediatric brain tumors: A neuropathologist's approach to the integrated diagnosis. Front Pediatr 2023; 11:1143363. [PMID: 36969278 PMCID: PMC10030595 DOI: 10.3389/fped.2023.1143363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/14/2023] [Indexed: 03/29/2023] Open
Abstract
The classification of tumors of the central nervous system (CNS) is a rapidly evolving field. While tumors were historically classified on the basis of morphology, the recent integration of molecular information has greatly refined this process. In some instances, molecular alterations provide significant prognostic implications beyond what can be ascertained by morphologic examination alone. Additionally, tumors may harbor molecular alterations that provide a therapeutic target. Pediatric CNS tumors, in particular, rely heavily on the integration of molecular data with histologic, clinical, and radiographic features to reach the most accurate diagnosis. This review aims to provide insight into a neuropathologist's approach to the clinical workup of pediatric brain tumors with an ultimate goal of reaching an integrated diagnosis that provides the most accurate classification and informs prognosis and therapy selection. The primary focus will center on how histology and molecular findings are used in combination with clinical and radiographic information to reach a final, integrated diagnosis.
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Affiliation(s)
- Angela N. Viaene
- Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Correspondence: Angela N. Viaene
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19
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Galbraith K, Vasudevaraja V, Serrano J, Shen G, Tran I, Abdallat N, Wen M, Patel S, Movahed-Ezazi M, Faustin A, Spino-Keeton M, Roberts LG, Maloku E, Drexler SA, Liechty BL, Pisapia D, Krasnozhen-Ratush O, Rosenblum M, Shroff S, Boué DR, Davidson C, Mao Q, Suchi M, North P, Hopp A, Segura A, Jarzembowski JA, Parsons L, Johnson MD, Mobley B, Samore W, McGuone D, Gopal PP, Canoll PD, Horbinski C, Fullmer JM, Farooqi MS, Gokden M, Wadhwani NR, Richardson TE, Umphlett M, Tsankova NM, DeWitt JC, Sen C, Placantonakis DG, Pacione D, Wisoff JH, Teresa Hidalgo E, Harter D, William CM, Cordova C, Kurz SC, Barbaro M, Orringer DA, Karajannis MA, Sulman EP, Gardner SL, Zagzag D, Tsirigos A, Allen JC, Golfinos JG, Snuderl M. Clinical utility of whole-genome DNA methylation profiling as a primary molecular diagnostic assay for central nervous system tumors-A prospective study and guidelines for clinical testing. Neurooncol Adv 2023; 5:vdad076. [PMID: 37476329 PMCID: PMC10355794 DOI: 10.1093/noajnl/vdad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
Background Central nervous system (CNS) cancer is the 10th leading cause of cancer-associated deaths for adults, but the leading cause in pediatric patients and young adults. The variety and complexity of histologic subtypes can lead to diagnostic errors. DNA methylation is an epigenetic modification that provides a tumor type-specific signature that can be used for diagnosis. Methods We performed a prospective study using DNA methylation analysis as a primary diagnostic method for 1921 brain tumors. All tumors received a pathology diagnosis and profiling by whole genome DNA methylation, followed by next-generation DNA and RNA sequencing. Results were stratified by concordance between DNA methylation and histopathology, establishing diagnostic utility. Results Of the 1602 cases with a World Health Organization histologic diagnosis, DNA methylation identified a diagnostic mismatch in 225 cases (14%), 78 cases (5%) did not classify with any class, and in an additional 110 (7%) cases DNA methylation confirmed the diagnosis and provided prognostic information. Of 319 cases carrying 195 different descriptive histologic diagnoses, DNA methylation provided a definitive diagnosis in 273 (86%) cases, separated them into 55 methylation classes, and changed the grading in 58 (18%) cases. Conclusions DNA methylation analysis is a robust method to diagnose primary CNS tumors, improving diagnostic accuracy, decreasing diagnostic errors and inconclusive diagnoses, and providing prognostic subclassification. This study provides a framework for inclusion of DNA methylation profiling as a primary molecular diagnostic test into professional guidelines for CNS tumors. The benefits include increased diagnostic accuracy, improved patient management, and refinements in clinical trial design.
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Affiliation(s)
- Kristyn Galbraith
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Varshini Vasudevaraja
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Jonathan Serrano
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Guomiao Shen
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Ivy Tran
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Nancy Abdallat
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Mandisa Wen
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Seema Patel
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Misha Movahed-Ezazi
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Arline Faustin
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Marissa Spino-Keeton
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Leah Geiser Roberts
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Ekrem Maloku
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Steven A Drexler
- Department of Pathology and Laboratory Medicine, NYU, Mineola, New York, USA
- Current affiliations: Department of Pathology, Mount Sinai South Nassau Hospital, Oceanside, New York, USA
| | - Benjamin L Liechty
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College - New York Presbyterian Hospital, New York, New York, USA
| | - David Pisapia
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College - New York Presbyterian Hospital, New York, New York, USA
| | - Olga Krasnozhen-Ratush
- Department of Pathology and Laboratory Medicine, Baystate Health, Springfield, Massachusetts, USA
| | - Marc Rosenblum
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Seema Shroff
- Department of Pathology and Laboratory Medicine, AdventHealth Orlando, Orlando, Florida, USA
| | - Daniel R Boué
- Department of Pathology and Laboratory Medicine, Nationwide Children’s Hospital, and the Ohio State University, Columbus, Ohio, USA
| | | | - Qinwen Mao
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
| | - Mariko Suchi
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Paula North
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Annette Segura
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jason A Jarzembowski
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lauren Parsons
- Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mahlon D Johnson
- Department of Pathology, University of Rochester School of Medicine, New York, USA
| | - Bret Mobley
- Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Wesley Samore
- Department of Pathology, Advocate Aurora Health, Chicago, Illinois, USA
| | - Declan McGuone
- Department of Pathology, Yale University School of Medicine, Connecticut, USA
| | - Pallavi P Gopal
- Department of Pathology, Yale University School of Medicine, Connecticut, USA
| | - Peter D Canoll
- Department of Pathology and Cell Biology, Columbia University Irving Medical Center, New York, USA
| | - Craig Horbinski
- Departments of Pathology and Neurosurgery, Feinberg School of Medicine, Northwestern University, Illinois, USA
| | - Joseph M Fullmer
- Department of Pathology, Beaumont Hospital, Royal Oak, Michigan, USA
| | - Midhat S Farooqi
- Department of Pathology and Laboratory Medicine, Children’s Mercy Kansas City, Kansas City, Missouri, USA
| | - Murat Gokden
- Department of Pathology, University of Arkansas and Arkansas Children’s Hospital, Little Rock, Arkansas, USA
| | - Nitin R Wadhwani
- Department of Pathology and Laboratory Medicine, Ann and Robert H. Lurie Children’s Hospital of Chicago, Illinois, USA
| | - Timothy E Richardson
- Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Melissa Umphlett
- Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nadejda M Tsankova
- Department of Pathology and Laboratory Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - John C DeWitt
- Department of Pathology, University of Vermont Medical Center
| | - Chandra Sen
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | | | - Donato Pacione
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | - Jeffrey H Wisoff
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | | | - David Harter
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | - Christopher M William
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
| | - Christine Cordova
- Department of Neuro-oncology, NYU Langone, New York, New York, USA
- Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, OH
| | - Sylvia C Kurz
- Department of Neuro-oncology, NYU Langone, New York, New York, USA
- Department of Interdisciplinary Neuro-Oncology, Comprehensive Cancer Center, University of Tuebingen, Tübingen, Germany
| | - Marissa Barbaro
- Department of Neuro-oncology, NYU Langone, New York, New York, USA
| | | | - Matthias A Karajannis
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Erik P Sulman
- Department of Radiation Oncology, NYU Langone, New York, New York, USA
| | | | - David Zagzag
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | | | - Jeffrey C Allen
- Department of Pediatrics, NYU Langone, New York, New York, USA
| | - John G Golfinos
- Department of Neurosurgery, NYU Langone, New York, New York, USA
| | - Matija Snuderl
- Department of Pathology, NYU Langone Health, New York, Department of Pathology, NYU Langone, New York, USA
- Laura and Isaac Perlmutter Cancer Center, New York, New York, USA
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20
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Jesus-Ribeiro J, Rebelo O, Ribeiro IP, Pires LM, Melo JD, Sales F, Santana I, Freire A, Melo JB. The landscape of common genetic drivers and DNA methylation in low-grade (epilepsy-associated) neuroepithelial tumors: A review. Neuropathology 2022; 42:467-482. [PMID: 35844095 DOI: 10.1111/neup.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/05/2022] [Accepted: 06/05/2022] [Indexed: 12/15/2022]
Abstract
Low-grade neuroepithelial tumors (LNETs) represent an important group of central nervous system neoplasms, some of which may be associated to epilepsy. The concept of long-term epilepsy-associated tumors (LEATs) includes a heterogenous group of low-grade, cortically based tumors, associated to drug-resistant epilepsy, often requiring surgical treatment. LEATs entities can sometimes be poorly discriminated by histological features, precluding a confident classification in the absence of additional diagnostic tools. This study aimed to provide an updated review on the genomic findings and DNA methylation profiling advances in LNETs, including histological entities of LEATs. A comprehensive search strategy was conducted on PubMed, Embase, and Web of Science Core Collection. High-quality peer-reviewed original manuscripts and review articles with full-text in English, published between 2003 and 2022, were included. Results were screened based on titles and abstracts to determine suitability for inclusion, and when addressed the topic of the review was screened by full-text reading. Data extraction was performed through a qualitative content analysis approach. Most LNETs appear to be driven mainly by a single genomic abnormality and respective affected signaling pathway, including BRAF p.V600E mutations in ganglioglioma, FGFR1 abnormalities in dysembryoplastic neuroepithelial tumor, MYB alterations in angiocentric glioma, BRAF fusions in pilocytic astrocytoma, PRKCA fusions in papillary glioneuronal tumor, between others. However, these molecular alterations are not exclusive, with some overlap amongst different tumor histologies. Also, clustering analysis of DNA methylation profiles allowed the identification of biologically similar molecular groups that sometimes transcend conventional histopathological classification. The exciting developments on the molecular basis of these tumors reinforce the importance of an integrative histopathological and (epi)genetic classification, which can be translated into precision medicine approaches.
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Affiliation(s)
- Joana Jesus-Ribeiro
- Neurology Department, Centro Hospitalar de Leiria, Leiria, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Olinda Rebelo
- Neuropathology Laboratory, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ilda Patrícia Ribeiro
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Laboratory of Cytogenetics and Genomics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Luís Miguel Pires
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Laboratory of Cytogenetics and Genomics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - João Daniel Melo
- Internal Medicine Department, CUF Coimbra Hospital, Coimbra, Portugal
| | - Francisco Sales
- Epilepsy and Sleep Monitoring Unit, Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - António Freire
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Neurology Department, Coimbra Luz Hospital, Coimbra, Portugal
| | - Joana Barbosa Melo
- Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.,Laboratory of Cytogenetics and Genomics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
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21
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Barresi V, Gianno F, Marucci G. Newly recognised Tumour Types in Glioneuronal tumours according to the 5th edition of the CNS WHO Classification. Pathologica 2022; 114:447-454. [PMID: 36534423 PMCID: PMC9763980 DOI: 10.32074/1591-951x-819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 10/26/2022] [Indexed: 12/24/2022] Open
Abstract
Glioneuronal tumours (GNT) are uncommon neoplasms, characterised by glial and neuronal differentiation. In the 5th edition of the World Health Organization (WHO) Classification, they are grouped under the heading "Glioneuronal and neuronal tumours", which comprises fourteen different tumours, among which the diffuse glioneuronal tumour with oligodendroglioma-like cells and nuclear clusters (DGONC), myxoyd glioneuronal tumour (MGT) and multinodular and vacuolating neuronal tumour (MNVNT) are new types. MGT and MNVNT are classified WHO grade 1 and may be recognised and diagnosed by peculiar clinical-pathological features. DGONC was not assigned a WHO grade and was only provisionally included among GNT, due to the possibility that it rather represents an embryonal tumour type or subtype. Although the histopathological characteristics may be useful for its identification, the specific methylation profile is an essential diagnostic criterion for DGONC.
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Affiliation(s)
- Valeria Barresi
- Department of Diagnostics and Public Health, University of Verona, Italy
| | - Francesca Gianno
- Department of Radiologic, Oncologic and Anatomo Pathological Sciences, University Sapienza of Rome, Italy
| | - Gianluca Marucci
- Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy,Correspondence Gianluca Marucci Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133, Milan, Italy Tel.: 02-23942260; Fax: 02-23942101 E-mail:
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22
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Muacevic A, Adler JR, Santellán-Hernández JO, Calderón-Garcidueñas AL, Romero-Luna G, Monjarás-Romo G, Torres-Ríos JA, Mejía-Pérez SI. A Patient With Epilepsy, Ganglioglioma, and Oligodendroglioma With Anaplastic Foci in the Same Left Frontoparietal Lesion: A Case Report. Cureus 2022; 14:e31323. [PMID: 36514634 PMCID: PMC9737647 DOI: 10.7759/cureus.31323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2022] [Indexed: 11/11/2022] Open
Abstract
Gangliogliomas are central nervous system (CNS) tumors with a neuronal and glial component considered grade 1 according to the World Health Organization (WHO) classification. On the other hand, oligodendrogliomas are diffuse infiltrating gliomas (CNS WHO grade 2 or 3) characterized by both an isocitrate dehydrogenase mutation and 1p/19q co-deletion. There have been some cases with the coexistence of these two tumors. Here, we present the case of a low-growing left frontoparietal brain tumor with a definite diagnosis of ganglioglioma (CNS WHO grade 1) and oligodendroglioma (CNS WHO grade 2) with areas of anaplastic oligodendroglioma (CNS WHO grade 3) in a patient with long-standing epilepsy.
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23
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Benesch M, Perwein T, Apfaltrer G, Langer T, Neumann A, Brecht IB, Schuhmann MU, Cario H, Frühwald MC, Vollert K, van Buiren M, Deng MY, Seitz A, Haberler C, Mynarek M, Kramm C, Sahm F, Robe PA, Dankbaar JW, Hoff KV, Warmuth-Metz M, Bison B. MR Imaging and Clinical Characteristics of Diffuse Glioneuronal Tumor with Oligodendroglioma-like Features and Nuclear Clusters. AJNR Am J Neuroradiol 2022; 43:1523-1529. [PMID: 36137663 PMCID: PMC9575520 DOI: 10.3174/ajnr.a7647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/28/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Diffuse glioneuronal tumor with oligodendroglioma-like features and nuclear clusters (DGONC) is a new, molecularly defined glioneuronal CNS tumor type. The objective of the present study was to describe MR imaging and clinical characteristics of patients with DGONC. MATERIALS AND METHODS Preoperative MR images of 9 patients with DGONC (median age at diagnosis, 9.9 years; range, 4.2-21.8 years) were reviewed. RESULTS All tumors were located superficially in the frontal/temporal lobes and sharply delineated, displaying little mass effect. Near the circle of Willis, the tumors encompassed the arteries. All except one demonstrated characteristics of low-to-intermediate aggressiveness with high-to-intermediate T2WI and ADC signals and bone remodeling. Most tumors (n = 7) showed a homogeneous ground-glass aspect on T2-weighted and FLAIR images. On the basis of the original histopathologic diagnosis, 6 patients received postsurgical chemo-/radiotherapy, 2 were irradiated after surgery, and 1 patient underwent tumor resection only. At a median follow-up of 61 months (range, 10-154 months), 6 patients were alive in a first complete remission and 2 with stable disease 10 and 21 months after diagnosis. The only patient with progressive disease was lost to follow-up. Five-year overall and event-free survival was 100% and 86±13%, respectively. CONCLUSIONS This case series presents radiomorphologic characteristics highly predictive of DGONC that contrast with the typical aspects of the original histopathologic diagnoses. This presentation underlines the definition of DGONC as a separate entity, from a clinical perspective. Complete resection may be favorable for long-term disease control in patients with DGONC. The efficacy of nonsurgical treatment modalities should be evaluated in larger series.
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Affiliation(s)
- M Benesch
- From the Division of Pediatric Hematology and Oncology (M.B., T.P.), Department of Pediatrics and Adolescent Medicine
| | - T Perwein
- From the Division of Pediatric Hematology and Oncology (M.B., T.P.), Department of Pediatrics and Adolescent Medicine
| | - G Apfaltrer
- Division of Pediatric Radiology (G.A.), Department of Radiology, Medical University Graz, Graz, Austria
| | - T Langer
- Departments of Pediatrics (T.L.)
| | - A Neumann
- Neuroradiology (A.N.), University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - I B Brecht
- Pediatric Hematology and Oncology (I.B.B.), Children's Hospital
| | - M U Schuhmann
- Division of Pediatric Neurosurgery (M.U.S.), Department of Neurosurgery, Eberhard-Karls University Tübingen, Tübingen, Germany
| | - H Cario
- Department of Pediatrics and Adolescent Medicine (H.C.), Ulm University Medical Center, Ulm, Germany
| | | | - K Vollert
- Pediatric and Adolescent Medicine and Departments of Diagnostic and Interventional Radiology and Neuroradiology (K.V., B.B.), University Medical Center Augsburg, Augsburg, Germany
| | - M van Buiren
- Department of Pediatric Hematology and Oncology (M.v.B.), Center for Pediatrics, Medical Center-University of Freiburg, Freiburg, Germany
| | - M Y Deng
- Hopp Children's Cancer Center Heidelberg (M.Y.D., F.S.)
| | - A Seitz
- German Cancer Research Center and Department of Neuroradiology (A.S.)
| | - C Haberler
- Division of Neuropathology and Neurochemistry (C.H.), Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Mynarek
- Department of Pediatric Hematology and Oncology (M.M.)
- Mildred Scheel Cancer Career Center (M.M.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Kramm
- Division of Pediatric Hematology and Oncology (C.K.), University Medical Center Göttingen, Göttingen, Germany
| | - F Sahm
- Hopp Children's Cancer Center Heidelberg (M.Y.D., F.S.)
- Department of Neuropathology (F.S.), Institute of Pathology
- Clinical Cooperation Unit Neuropathology (F.S.), German Cancer Consortium, German Cancer Research Center, Heidelberg University Hospital, Heidelberg, Germany
| | - P A Robe
- Department of Neurology and Neurosurgery (P.A.R.)
| | - J W Dankbaar
- Department of Radiology (J.W.D.), University Medical Center Utrecht, Utrecht, the Netherlands
| | - K V Hoff
- Department of Pediatric Oncology and Hematology (K.V.H.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - M Warmuth-Metz
- Institute of Diagnostic and Interventional Neuroradiology (M.W.-M.), University Hospital Würzburg, Würzburg, Germany
| | - B Bison
- Pediatric and Adolescent Medicine and Departments of Diagnostic and Interventional Radiology and Neuroradiology (K.V., B.B.), University Medical Center Augsburg, Augsburg, Germany
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24
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Kalawi AZ, Malicki DM, Abdullaev Z, Pratt DW, Quezado M, Aldape K, Elster JD, Paul MR, Khanna PC, Levy ML, Crawford JR. The role of methylation profiling in histologically diagnosed neurocytoma: a case series. J Neurooncol 2022; 159:725-733. [PMID: 35994156 PMCID: PMC9477906 DOI: 10.1007/s11060-022-04117-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 08/16/2022] [Indexed: 11/28/2022]
Abstract
Purpose To highlight the clinical, neuroradiographic, neuropathologic, and molecular features of histologically identified neurocytoma in a pediatric cohort and highlight the evolving use methylation profiling in providing diagnostic clarity in difficult to diagnosis pediatric brain tumors. Methods Five consecutive children (ages 9–13, 2 girls 3 boys) were histologically diagnosed with neurocytoma at Rady Children’s Hospital San Diego from 2012 to 2018. Clinical and molecular features were analyzed with regards to treatment course and outcome. Results Presenting symptoms included seizures (n = 2), syncope (n = 1), headache (n = 2), visual disturbances (n = 2) and emesis (n = 2). Tumor location included intraventricular (n = 2), intraventricular with parenchymal spread (n = 1), and extraventricular (n = 2). Magnetic resonance imaging demonstrated reduced diffusivity (2/5), signal abnormality on susceptibility-weighted sequences (3/5), and varying degrees of contrast enhancement (4/5). All patients underwent surgical resection alone. Recurrence occurred in four children that were treated with surgery (4/4), adjuvant radiation (2/4), and chemoradiation (1/4). Neuropathologic features included positivity for GFAP (4/5), synaptophysin (4/5), NSE (2/2), NeuN (4/4), and variable Ki-67 (< 1% to 15%). Next generation sequencing (3/5) and microarray (3/5) collectively were abnormal in four of five tumors. Methylation profiling was successfully performed on four of five samples which led to modification of diagnosis in two patients and the others were either unclassifiable or confirmatory with the histologic diagnosis. Mean time to follow up was 77 months (range 44–112 months). Mean progression free survival and overall survival were 24 months (range 6 to 52 months) and 100% respectively. Conclusion Neurocytomas are a rare clinical entity that warrants further investigation into molecular and pathologic prognosticating features. Methylation profiling may aid in differentiation of neurocytoma from other difficult to diagnose tumors who share similar histologic features.
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Affiliation(s)
- Adam Z Kalawi
- Division of Child Neurology, Department of Neurosciences, University of California, San Diego, CA, USA.
- Rady Children's Hospital, San Diego, CA, USA.
| | - Denise M Malicki
- Rady Children's Hospital, San Diego, CA, USA
- Department of Pathology, University of California, San Diego, CA, USA
| | - Zied Abdullaev
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
| | - Drew W Pratt
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Martha Quezado
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
| | - Kenneth Aldape
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD, USA
| | - Jennifer D Elster
- Rady Children's Hospital, San Diego, CA, USA
- Division of Hematology Oncology, Department of Pediatrics, University of California, San Diego, CA, USA
| | - Megan R Paul
- Rady Children's Hospital, San Diego, CA, USA
- Division of Hematology Oncology, Department of Pediatrics, University of California, San Diego, CA, USA
| | - Paritosh C Khanna
- Rady Children's Hospital, San Diego, CA, USA
- Department of Radiology, University of California, San Diego, CA, USA
| | - Michael L Levy
- Rady Children's Hospital, San Diego, CA, USA
- Division of Pediatric Neurosurgery, Department of Neurosurgery, University of California, San Diego, CA, USA
| | - John R Crawford
- Division of Child Neurology, Department of Neurosciences, University of California, San Diego, CA, USA
- Rady Children's Hospital, San Diego, CA, USA
- Division of Hematology Oncology, Department of Pediatrics, University of California, San Diego, CA, USA
- Division of Child Neurology, Children's Hospital of Orange County, Orange, CA, USA
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25
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Rudà R, Capper D, Waldman AD, Pallud J, Minniti G, Kaley TJ, Bouffet E, Tabatabai G, Aronica E, Jakola AS, Pfister SM, Schiff D, Lassman AB, Solomon DA, Soffietti R, Weller M, Preusser M, Idbaih A, Wen PY, van den Bent MJ. EANO - EURACAN - SNO Guidelines on circumscribed astrocytic gliomas, glioneuronal, and neuronal tumors. Neuro Oncol 2022; 24:2015-2034. [PMID: 35908833 PMCID: PMC9713532 DOI: 10.1093/neuonc/noac188] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
In the new WHO 2021 Classification of CNS Tumors the chapter "Circumscribed astrocytic gliomas, glioneuronal and neuronal tumors" encompasses several different rare tumor entities, which occur more frequently in children, adolescents, and young adults. The Task Force has reviewed the evidence of diagnostic and therapeutic interventions, which is low particularly for adult patients, and draw recommendations accordingly. Tumor diagnosis, based on WHO 2021, is primarily performed using conventional histological techniques; however, a molecular workup is important for differential diagnosis, in particular, DNA methylation profiling for the definitive classification of histologically unresolved cases. Molecular factors are increasing of prognostic and predictive importance. MRI finding are non-specific, but for some tumors are characteristic and suggestive. Gross total resection, when feasible, is the most important treatment in terms of prolonging survival and achieving long-term seizure control. Conformal radiotherapy should be considered in grade 3 and incompletely resected grade 2 tumors. In recurrent tumors reoperation and radiotherapy, including stereotactic radiotherapy, can be useful. Targeted therapies may be used in selected patients: BRAF and MEK inhibitors in pilocytic astrocytomas, pleomorphic xanthoastrocytomas, and gangliogliomas when BRAF altered, and mTOR inhibitor everolimus in subependymal giant cells astrocytomas. Sequencing to identify molecular targets is advocated for diagnostic clarification and to direct potential targeted therapies.
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Affiliation(s)
- Roberta Rudà
- Corresponding Author: Roberta Rudà, Department of Neurology, Castelfranco Veneto/Treviso Hospital and Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy ()
| | - David Capper
- Department of Neuropathology, Charité Universitätsmedizin Berlin, Berlin and German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Adam D Waldman
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh and Department of Brain Science, Imperial College London, United Kingdom
| | - Johan Pallud
- Department of Neurosurgery, GHU-Paris Psychiatrie et Neurosciences, Hôpital Sainte Anne, Paris, France
| | - Giuseppe Minniti
- Radiation Oncology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy and IRCCS Neuromed (IS), Italy
| | - Thomas J Kaley
- Department of Neurology, Brain Tumor Service, Memorial Sloan Kettering Cancer Center, New York, US
| | - Eric Bouffet
- Division of Paediatric Oncology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - Ghazaleh Tabatabai
- Department of Neurology & Neurooncology, University of Tübingen, German Cancer Consortium (DKTK), DKFZ partner site Tübingen, Germany
| | - Eleonora Aronica
- Department of (Neuro)Pathology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam and Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands
| | - Asgeir S Jakola
- Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden. Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden
| | - Stefan M Pfister
- Hopp Children´s Cancer Center Heidelberg (KiTZ), Division of Pediatric Neuro-oncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), and Department of Pediatric Oncology, Hematology and Immunology, University Hospital Heidelberg, Heidelberg, Germany
| | - David Schiff
- Department of Neurology, Division of Neuro-Oncology, University of Virginia, Charlottesville, US
| | - Andrew B Lassman
- Division of Neuro-Oncology, Department of Neurology and the Herbert Irving Comprehensive Cancer Center, Columbia University Vagelos College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, US
| | - David A Solomon
- Department of Pathology, University of California, San Francisco, CA, US
| | - Riccardo Soffietti
- Division of Neuro-Oncology, Department of Neuroscience, University and City of Health and Science Hospital, Turin, Italy
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
| | - Matthias Preusser
- Department of Medicine I, Division of Oncology, Medical University of Vienna, Vienna, Austria
| | - Ahmed Idbaih
- Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France
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26
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Mcnamara C, Mankad K, Thust S, Dixon L, Limback-stanic C, D’arco F, Jacques TS, Löbel U. 2021 WHO classification of tumours of the central nervous system: a review for the neuroradiologist. Neuroradiology. [DOI: 10.1007/s00234-022-03008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
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Osborn AG, Louis DN, Poussaint TY, Linscott LL, Salzman KL. The 2021 World Health Organization Classification of Tumors of the Central Nervous System: What Neuroradiologists Need to Know. AJNR Am J Neuroradiol 2022; 43:928-937. [PMID: 35710121 DOI: 10.3174/ajnr.a7462] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022]
Abstract
Neuroradiologists play a key role in brain tumor diagnosis and management. Staying current with the latest classification systems and diagnostic markers is important to provide optimal patient care. Publication of the 2016 World Health Organization Classification of Tumors of the Central Nervous System introduced a paradigm shift in the diagnosis of CNS neoplasms. For the first time, both histologic features and genetic alterations were incorporated into the diagnostic framework, classifying and grading brain tumors. The newly published 2021 World Health Organization Classification of Tumors of the Central Nervous System, May 2021, 5th edition, has added even more molecular features and updated pathologic diagnoses. We present, summarize, and illustrate the most salient aspects of the new 5th edition. We have selected the key "must know" topics for practicing neuroradiologists.
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Affiliation(s)
- A G Osborn
- From the Department of Radiology and Imaging Sciences (A.G.O., K.L.S.), University of Utah School of Medicine, Salt Lake City, Utah
| | - D N Louis
- Department of Pathology (D.N.L.), Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - T Y Poussaint
- Department of Radiology (T.Y.P.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - L L Linscott
- Intermountain Pediatric Imaging (L.L.L.), Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah
| | - K L Salzman
- From the Department of Radiology and Imaging Sciences (A.G.O., K.L.S.), University of Utah School of Medicine, Salt Lake City, Utah
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28
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Koelsche C, von Deimling A. Methylation classifiers: brain tumors, sarcomas and what's next. Genes Chromosomes Cancer 2022; 61:346-355. [PMID: 35388566 DOI: 10.1002/gcc.23041] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 11/09/2022] Open
Abstract
Tumor classification has evolved over the last decades with technical progress contributing much to our current concepts. Among diagnostic hallmark novelties were immunostaining, Fluorescence in situ hybridization, Sanger sequencing followed by massive parallel DNA sequencing and recently, epigenetic analyses have entered the stage. Although each of these techniques was revolutionary and, in some way, also disruptive in certain diagnostic fields, it took years to decades for broad implementation into standard pathological-diagnostic algorithms. In contrast, DNA methylation profiling has been accepted in short time as a game changer with lasting impact on brain tumor classification and with potential for classification of other tumor types. This review provides a brief introduction in DNA methylation-based tumor classification. We present why DNA methylation signatures are attractive diagnostic biomarkers, discuss present achievements and future aims and explain the integration of methylation-based classifiers in diagnostic procedure. Finally, we provide an outlook on the challenges and opportunities associated with DNA methylation-based tumor profiling. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Christian Koelsche
- Department of General Pathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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29
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Bale TA, Rosenblum MK. The 2021 WHO Classification of Tumors of the Central Nervous System: An update on pediatric low-grade gliomas and glioneuronal tumors. Brain Pathol 2022; 32:e13060. [PMID: 35218102 PMCID: PMC9245930 DOI: 10.1111/bpa.13060] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 12/13/2022] Open
Abstract
The 2021 5th edition of the WHO Classification of Tumors of the Central Nervous System reflects the discovery of genetic alterations underlying many central nervous system (CNS) neoplasms. Insights gained from technologic advances and novel applications in molecular diagnostics, including next‐generation sequencing and DNA methylation‐based profiling, coupled with the recognition of clinicopathologic correlates, have prompted substantial changes to CNS tumor classification; this is particularly true for pediatric low‐grade gliomas and glioneuronal tumors (pLGG/GNTs). The 2021 WHO now classifies gliomas, glioneuronal tumors and neuronal tumors into 6 families, three of which encompass pLGG/LGNTs: “Pediatric type diffuse low‐grade gliomas,” “circumscribed astrocytic gliomas,” and “glioneuronal and neuronal tumors.” Among these are six newly recognized tumor types: “diffuse astrocytoma, MYB or MYBL1‐altered”; “polymorphous low grade neuroepithelial tumor of the young (PLNTY)”; “diffuse low‐grade glioma‐MAPK altered”; “Diffuse glioneuronal tumor with oligodendroglioma‐like features and nuclear clusters (DGONC)”; “myxoid glioneuronal tumor (MGT)”; and “multinodular and vacuolating neuronal tumor (MVNT).” We review these newly recognized entities in the context of general changes to the WHO schema, discuss implications of the new classification for treatment of pLGG/LGNT, and consider strategies for molecular testing and interpretation.
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Affiliation(s)
- Tejus A Bale
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Marc K Rosenblum
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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30
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Pfister SM, Reyes-Múgica M, Chan JKC, Hasle H, Lazar AJ, Rossi S, Ferrari A, Jarzembowski JA, Pritchard-Jones K, Hill DA, Jacques TS, Wesseling P, López Terrada DH, von Deimling A, Kratz CP, Cree IA, Alaggio R. A Summary of the Inaugural WHO Classification of Pediatric Tumors: Transitioning from the Optical into the Molecular Era. Cancer Discov 2022; 12:331-355. [PMID: 34921008 PMCID: PMC9401511 DOI: 10.1158/2159-8290.cd-21-1094] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/28/2021] [Accepted: 11/18/2021] [Indexed: 01/07/2023]
Abstract
Pediatric tumors are uncommon, yet are the leading cause of cancer-related death in childhood. Tumor types, molecular characteristics, and pathogenesis are unique, often originating from a single genetic driver event. The specific diagnostic challenges of childhood tumors led to the development of the first World Health Organization (WHO) Classification of Pediatric Tumors. The classification is rooted in a multilayered approach, incorporating morphology, IHC, and molecular characteristics. The volume is organized according to organ sites and provides a single, state-of-the-art compendium of pediatric tumor types. A special emphasis was placed on "blastomas," which variably recapitulate the morphologic maturation of organs from which they originate. SIGNIFICANCE: In this review, we briefly summarize the main features and updates of each chapter of the inaugural WHO Classification of Pediatric Tumors, including its rapid transition from a mostly microscopic into a molecularly driven classification systematically taking recent discoveries in pediatric tumor genomics into account.
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Affiliation(s)
- Stefan M Pfister
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
- Department of Pediatric Hematology and Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Miguel Reyes-Múgica
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Division of Pediatric Pathology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - John K C Chan
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong, SAR China
| | - Henrik Hasle
- Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Alexander J Lazar
- Departments of Pathology & Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sabrina Rossi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Jason A Jarzembowski
- Department of Pathology, Children's Wisconsin and Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Kathy Pritchard-Jones
- Developmental Biology and Cancer Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
| | - D Ashley Hill
- Department of Pathology, Children's National Hospital, Genomics and Precision Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Thomas S Jacques
- Developmental Biology and Cancer Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Pieter Wesseling
- Laboratory for Childhood Cancer Pathology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
- Department of Pathology, Amsterdam University Medical Centers/VUmc, Amsterdam, the Netherlands
| | - Dolores H López Terrada
- Department of Pathology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Christian P Kratz
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Germany
| | - Ian A Cree
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Rita Alaggio
- Pathology Unit, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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31
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Lim SD, Kim SI, Park JW, Won JK, Kim SK, Phi JH, Chung CK, Choi SH, Yun H, Park SH. Emerging glioneuronal and neuronal tumors: case-based review. Brain Tumor Pathol 2022; 39:65-78. [PMID: 35048219 DOI: 10.1007/s10014-021-00420-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022]
Abstract
Glioneuronal and neuronal tumors (GNTs) are rare heterogeneous central nervous system tumors characterized by slow growth and favorable outcomes, but are often associated with diagnostic difficulties. A thorough analysis of three rare and recently recognized GNTs was performed in the context of clinicopathological features and molecular genetic characterization. The current spinal diffuse leptomeningeal glioneuronal tumor (DLGNT) was characterized with oligodendroglioma-like tumor with chromosome 1p/19q codeletion without IDH mutations and KIAA1549:BRAF fusion. The current occipital multinodular and vacuolating neuronal tumor (MVNT) was characteristic of the variable-sized vague nodules consisted of gangliocytic tumor cells with intracytoplasmic and pericellular vacuolation and the next-generation sequencing (NGS) revealed MAP2K1 p.Q56_V60del. A diffuse glioneuronal tumor with oligodendroglioma-like features and nuclear clusters (DGONC) of the amygdala was characterized by oligodendroglia-like cells and nuclear clusters, and monosomy 14. From the current cases and literature review, we found that DLGNT commonly occurs in the spinal cord and can make mass and more commonly have KIAA1549:BRAF fusion; MVNT is a neoplasm rather than malformation and MAP2K1 deletion is one of the hallmarks of this tumor; although DGONC may require a methylation profile, we can reach a diagnosis through its unique histology, monosomy 14, and exclusion diagnosis without a methylation profile.
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Affiliation(s)
- So Dug Lim
- Department of Pathology, KonKuk University School of Medicine, Seoul, 05029, Republic of Korea
| | - Seong Ik Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Jin Woo Park
- Department of Pathology, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Jae Kyung Won
- Department of Pathology, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Seung-Ki Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Ji Hoon Phi
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Chun-Kee Chung
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Seung-Hong Choi
- Department of Radiology, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Hongseok Yun
- Department of Genomic Medicine, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea
| | - Sung-Hye Park
- Department of Pathology, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea. .,Institute of Neuroscience, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea.
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Abstract
Neuropathological examination of the temporal lobe provides a better understanding and management of a wide spectrum of diseases. We focused on inflammatory diseases, epilepsy, and neurodegenerative diseases, and highlighted how the temporal lobe is particularly involved in those conditions. Although all these diseases are not specific or restricted to the temporal lobe, the temporal lobe is a key structure to understand their pathophysiology. The main histological lesions, immunohistochemical markers, and molecular alterations relevant for the neuropathological diagnostic reasoning are presented in relation to epidemiology, clinical presentation, and radiological findings. The inflammatory diseases section addressed infectious encephalitides and auto-immune encephalitides. The epilepsy section addressed (i) susceptibility of the temporal lobe to epileptogenesis, (ii) epilepsy-associated hippocampal sclerosis, (iii) malformations of cortical development, (iv) changes secondary to epilepsy, (v) long-term epilepsy-associated tumors, (vi) vascular malformations, and (vii) the absence of histological lesion in some epilepsy surgery samples. The neurodegenerative diseases section addressed (i) Alzheimer's disease, (ii) the spectrum of frontotemporal lobar degeneration, (iii) limbic-predominant age-related TDP-43 encephalopathy, and (iv) α-synucleinopathies. Finally, inflammatory diseases, epilepsy, and neurodegenerative diseases are considered as interdependent as some pathophysiological processes cross the boundaries of this classification.
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Affiliation(s)
- Susana Boluda
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France
| | - Danielle Seilhean
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France
| | - Franck Bielle
- Sorbonne Université, INSERM, CNRS, UMR S 1127, Paris Brain Institute, ICM, Paris, France; Neuropathology Department, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, AP-HP, Paris, France.
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33
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Jabari S, Kobow K, Pieper T, Hartlieb T, Kudernatsch M, Polster T, Bien CG, Kalbhenn T, Simon M, Hamer H, Rössler K, Feucht M, Mühlebner A, Najm I, Peixoto-Santos JE, Gil-Nagel A, Delgado RT, Aledo-Serrano A, Hou Y, Coras R, von Deimling A, Blümcke I. DNA methylation-based classification of malformations of cortical development in the human brain. Acta Neuropathol 2022; 143:93-104. [PMID: 34797422 PMCID: PMC8732912 DOI: 10.1007/s00401-021-02386-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/26/2021] [Accepted: 11/15/2021] [Indexed: 12/16/2022]
Abstract
Malformations of cortical development (MCD) comprise a broad spectrum of structural brain lesions frequently associated with epilepsy. Disease definition and diagnosis remain challenging and are often prone to arbitrary judgment. Molecular classification of histopathological entities may help rationalize the diagnostic process. We present a retrospective, multi-center analysis of genome-wide DNA methylation from human brain specimens obtained from epilepsy surgery using EPIC 850 K BeadChip arrays. A total of 308 samples were included in the study. In the reference cohort, 239 formalin-fixed and paraffin-embedded (FFPE) tissue samples were histopathologically classified as MCD, including 12 major subtype pathologies. They were compared to 15 FFPE samples from surgical non-MCD cortices and 11 FFPE samples from post-mortem non-epilepsy controls. We applied three different statistical approaches to decipher the DNA methylation pattern of histopathological MCD entities, i.e., pairwise comparison, machine learning, and deep learning algorithms. Our deep learning model, which represented a shallow neuronal network, achieved the highest level of accuracy. A test cohort of 43 independent surgical samples from different epilepsy centers was used to test the precision of our DNA methylation-based MCD classifier. All samples from the test cohort were accurately assigned to their disease classes by the algorithm. These data demonstrate DNA methylation-based MCD classification suitability across major histopathological entities amenable to epilepsy surgery and age groups and will help establish an integrated diagnostic classification scheme for epilepsy-associated MCD.
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Affiliation(s)
- Samir Jabari
- Department of Neuropathology, Affiliated Partner of the ERN EpiCARE, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Katja Kobow
- Department of Neuropathology, Affiliated Partner of the ERN EpiCARE, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Tom Pieper
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Vogtareuth, Germany
| | - Till Hartlieb
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Vogtareuth, Germany
- Research Institute, Rehabilitation, Transition, Palliation", PMU Salzburg, Salzburg, Austria
| | - Manfred Kudernatsch
- Center for Neurosurgery and Epilepsy Surgery, Schön Klinik Vogtareuth, Vogtareuth, Germany
- Research Institute, Rehabilitation, Transition, Palliation", PMU Salzburg, Salzburg, Austria
| | - Tilman Polster
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Thilo Kalbhenn
- Department of Neurosurgery - Epilepsy Surgery, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Bielefeld University, Bielefeld, Germany
| | - Matthias Simon
- Department of Neurosurgery - Epilepsy Surgery, Evangelisches Klinikum Bethel, Universitätsklinikum OWL, Bielefeld University, Bielefeld, Germany
| | - Hajo Hamer
- Department of Neurology, Epilepsy Center, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Karl Rössler
- Department of Neurosurgery, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
- Department of Neurosurgery, Medical University Vienna, Vienna, Austria
| | - Martha Feucht
- Department of Pediatrics and Adolescent Medicine, Affiliated Partner of the ERN EpiCARE, Medical University Vienna, Vienna, Austria
| | - Angelika Mühlebner
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of (Neuro) Pathology, Amsterdam UMC, Location AMC, Amsterdam, The Netherlands
| | - Imad Najm
- Charles Shor Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
- Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
| | | | | | | | | | - Yanghao Hou
- Department of Neuropathology, German Cancer Research Center (DKFZ), Universitätsklinikum Heidelberg, and CCU Neuropathology, Heidelberg, Germany
- Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Roland Coras
- Department of Neuropathology, Affiliated Partner of the ERN EpiCARE, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Andreas von Deimling
- Department of Neuropathology, German Cancer Research Center (DKFZ), Universitätsklinikum Heidelberg, and CCU Neuropathology, Heidelberg, Germany
| | - Ingmar Blümcke
- Department of Neuropathology, Affiliated Partner of the ERN EpiCARE, Universitätsklinikum Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Figarella-Branger D, Appay R, Metais A, Tauziède-Espariat A, Colin C, Rousseau A, Varlet P. [The 2021 WHO classification of tumours of the central nervous system]. Ann Pathol 2021; 42:367-382. [PMID: 34865882 DOI: 10.1016/j.annpat.2021.11.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
Abstract
Rapid technical advances in molecular biology allowed for the identification of key genetic alterations in central nervous system (CNS) tumors. Our ever-expanding knowledge of brain tumor genetics and the development of new technologies, such as DNA-methylation profiling, required an update of the 2016 fourth edition of the WHO classification of CNS tumors. Updates were regularly published by the Consortium to Inform Molecular Practical Approaches to CNS Tumor Taxonomy-Not Official WHO (c-IMPACT-NOW) until the publication of the fifth edition of the WHO classification of CNS tumors in 2021. In that edition, new types and subtypes are introduced and criteria for histo-molecular diagnostic and grading are refined, especially for diffuse gliomas. The definition of a broad category "diffuse glioma, pediatric subtype" (low or high grade) is a major improvement of the classification. Moreover, the nomenclature was simplified and aligned with that of other blue books. The 2021 edition truly advances the role of molecular diagnostics in CNS tumor classification. Methyloma profiling may become a cornerstone of CNS tumor diagnostic. The new WHO classification will lead to better management of brain tumor patients.
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Affiliation(s)
- Dominique Figarella-Branger
- Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France; APHM, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France.
| | - Romain Appay
- Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France; APHM, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
| | - Alice Metais
- Service de neuropathologie, GHU Paris psychiatrie et neurosciences, hôpital Sainte-Anne, Paris université, Paris, France
| | - Arnault Tauziède-Espariat
- Service de neuropathologie, GHU Paris psychiatrie et neurosciences, hôpital Sainte-Anne, Paris université, Paris, France
| | - Carole Colin
- Aix-Marseille Univ, CNRS, INP, Inst Neurophysiopathol, Marseille, France
| | - Audrey Rousseau
- Département de pathologie, CHU d'Angers, Angers, France; CRCINA université de Nantes, université d'Angers, Angers, France
| | - Pascale Varlet
- Service de neuropathologie, GHU Paris psychiatrie et neurosciences, hôpital Sainte-Anne, Paris université, Paris, France
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35
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Schmid S, Solomon DA, Perez E, Thieme A, Kleinschmidt-DeMasters BK, Giannini C, Reinhardt A, Asa SL, Mete O, Stichel D, Siewert C, Dittmayer C, Hasselblatt M, Paulus W, Nagel C, Harter PN, Schittenhelm J, Honegger J, Rushing E, Coras R, Pfister SM, Buslei R, Koch A, Perry A, Jones DTW, von Deimling A, Capper D, Lopes MB. Genetic and epigenetic characterization of posterior pituitary tumors. Acta Neuropathol 2021; 142:1025-43. [PMID: 34661724 DOI: 10.1007/s00401-021-02377-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 12/12/2022]
Abstract
Pituicytoma (PITUI), granular cell tumor (GCT), and spindle cell oncocytoma (SCO) are rare tumors of the posterior pituitary. Histologically, they may be challenging to distinguish and have been proposed to represent a histological spectrum of a single entity. We performed targeted next-generation sequencing, DNA methylation profiling, and copy number analysis on 47 tumors (14 PITUI; 12 GCT; 21 SCO) to investigate molecular features and explore possibilities of clinically meaningful tumor subclassification. We detected two main epigenomic subgroups by unsupervised clustering of DNA methylation data, though the overall methylation differences were subtle. The largest group (n = 23) contained most PITUIs and a subset of SCOs and was enriched for pathogenic mutations within genes in the MAPK/PI3K pathways (12/17 [71%] of sequenced tumors: FGFR1 (3), HRAS (3), BRAF (2), NF1 (2), CBL (1), MAP2K2 (1), PTEN (1)) and two with accompanying TERT promoter mutation. The second group (n = 16) contained most GCTs and a subset of SCOs, all of which mostly lacked identifiable genetic drivers. Outcome analysis demonstrated that the presence of chromosomal imbalances was significantly associated with reduced progression-free survival especially within the combined PITUI and SCO group (p = 0.031). In summary, we observed only subtle DNA methylation differences between posterior pituitary tumors, indicating that these tumors may be best classified as subtypes of a single entity. Nevertheless, our data indicate differences in mutation patterns and clinical outcome. For a clinically meaningful subclassification, we propose a combined histo-molecular approach into three subtypes: one subtype is defined by granular cell histology, scarcity of identifiable oncogenic mutations, and favorable outcome. The other two subtypes have either SCO or PITUI histology but are segregated by chromosomal copy number profile into a favorable group (no copy number changes) and a less favorable group (copy number imbalances present). Both of the latter groups have recurrent MAPK/PI3K genetic alterations that represent potential therapeutic targets.
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36
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McLendon RE, Yachnis AT, Miller CR, Ng HK. Central Nervous System Tumor Classification: An Update on the Integration of Tumor Genetics. Hematol Oncol Clin North Am 2022; 36:1-21. [PMID: 34763992 DOI: 10.1016/j.hoc.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In 2016, the World Health Organization Classification of CNS Tumors introduced molecular abnormalities that refined tumor diagnoses. Around this time, the introduction of large scale genetic mutational analyses quickly advanced our knowledge of recurrent abnormalities in disease. In 2017, the C-IMPACT group was established to render expert consensus opinions regarding the application of molecular findings into central nervous system tumor diagnoses. C-IMPACT have presented their recommendations in 7 peer-reviewed publications; this article details those recommendations that are expected to be incorporated into the upcoming fifth edition of the World Health Organization classification.
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Abstract
Recent years have witnessed a shift to more objective and biologically-driven methods for central nervous system (CNS) tumor classification. The 2016 world health organization (WHO) classification update ("blue book") introduced molecular diagnostic criteria into the definitions of specific entities as a response to the plethora of evidence that key molecular alterations define distinct tumor types and are clinically meaningful. While in the past such diagnostic alterations included specific mutations, copy number changes, or gene fusions, the emergence of DNA methylation arrays in recent years has similarly resulted in improved diagnostic precision, increased reliability, and has provided an effective framework for the discovery of new tumor types. In many instances, there is an intimate relationship between these mutations/fusions and DNA methylation signatures. The adoption of methylation data into neuro-oncology nosology has been greatly aided by the availability of technology compatible with clinical diagnostics, along with the development of a freely accessible machine learning-based classifier. In this review, we highlight the utility of DNA methylation profiling in CNS tumor classification with a focus on recently described novel and rare tumor types, as well as its contribution to refining existing types.
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Affiliation(s)
- Drew Pratt
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Kenneth Aldape
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
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Kobow K, Baulac S, von Deimling A, Lee JH. Molecular diagnostics in drug-resistant focal epilepsy define new disease entities. Brain Pathol 2021; 31:e12963. [PMID: 34196984 PMCID: PMC8412082 DOI: 10.1111/bpa.12963] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/31/2021] [Indexed: 01/16/2023] Open
Abstract
Structural brain lesions, including the broad range of malformations of cortical development (MCD) and glioneuronal tumors, are among the most common causes of drug-resistant focal epilepsy. Epilepsy surgery can provide a curative treatment option in respective patients. The currently available pre-surgical multi-modal diagnostic armamentarium includes high- and ultra-high resolution magnetic resonance imaging (MRI) and intracerebral EEG to identify a focal structural brain lesion as epilepsy underlying etiology. However, specificity and accuracy in diagnosing the type of lesion have proven to be limited. Moreover, the diagnostic process does not stop with the decision for surgery. The neuropathological diagnosis remains the gold standard for disease classification and patient stratification, but is particularly complex with high inter-observer variability. Here, the identification of lesion-specific mosaic variants together with epigenetic profiling of lesional brain tissue became new tools to more reliably identify disease entities. In this review, we will discuss how the paradigm shifts from histopathology toward an integrated diagnostic approach in cancer and the more recent development of the DNA methylation-based brain tumor classifier have started to influence epilepsy diagnostics. Some examples will be highlighted showing how the diagnosis and our mechanistic understanding of difficult to classify structural brain lesions associated with focal epilepsy has improved with molecular genetic data being considered in decision making.
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Affiliation(s)
- Katja Kobow
- Department of NeuropathologyUniversitätsklinikum ErlangenFriedrich‐Alexander‐University of Erlangen‐Nürnberg (FAU)ErlangenGermany
| | - Stéphanie Baulac
- Institut du Cerveau—Paris Brain Institute—ICMInsermCNRSSorbonne UniversitéParisFrance
| | - Andreas von Deimling
- Department of NeuropathologyUniversitätsklinikum HeidelbergHeidelbergGermany
- CCU NeuropathologyGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Jeong Ho Lee
- Graduate School of Medical Science and EngineeringKAISTDaejeonKorea
- SoVarGen, IncDaejeonRepublic of Korea
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39
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von Hoff K, Haberler C, Schmitt-Hoffner F, Schepke E, de Rojas T, Jacobs S, Zapotocky M, Sumerauer D, Perek-Polnik M, Dufour C, van Vuurden D, Slavc I, Gojo J, Pickles JC, Gerber NU, Massimino M, Gil-da-Costa MJ, Garami M, Kumirova E, Sehested A, Scheie D, Cruz O, Moreno L, Cho J, Zeller B, Bovenschen N, Grotzer M, Alderete D, Snuderl M, Zheludkova O, Golanov A, Okonechnikov K, Mynarek M, Juhnke BO, Rutkowski S, Schüller U, Pizer B, Zezschwitz BV, Kwiecien R, Wechsung M, Konietschke F, Hwang EI, Sturm D, Pfister SM, von Deimling A, Rushing EJ, Ryzhova M, Hauser P, Łastowska M, Wesseling P, Giangaspero F, Hawkins C, Figarella-Branger D, Eberhart C, Burger P, Gessi M, Korshunov A, Jacques TS, Capper D, Pietsch T, Kool M. Therapeutic implications of improved molecular diagnostics for rare CNS-embryonal tumor entities: results of an international, retrospective study. Neuro Oncol 2021; 23:1597-1611. [PMID: 34077956 DOI: 10.1093/neuonc/noab136] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Only few data are available on treatment-associated behavior of distinct rare CNS-embryonal tumor entities previously treated as "CNS-primitive neuroectodermal tumors" (CNS-PNET). Respective data on specific entities, including CNS neuroblastoma, FOXR2 activated (CNS NB-FOXR2), and embryonal tumor with multi-layered rosettes (ETMR) are needed for development of differentiated treatment strategies. METHODS Within this retrospective, international study, tumor samples of clinically well-annotated patients with the original diagnosis of CNS-PNET were analyzed using DNA methylation arrays (n=307). Additional cases (n=66) with DNA methylation pattern of CNS NB-FOXR2 were included irrespective of initial histological diagnosis. Pooled clinical data (n=292) were descriptively analyzed. RESULTS DNA methylation profiling of "CNS-PNET" classified 58(19%) cases as ETMR, 57(19%) as HGG, 36(12%) as CNS NB-FOXR2, and 89(29%) cases were classified into 18 other entities. Sixty-seven (22%) cases did not show DNA methylation patterns similar to established CNS tumor reference classes. Best treatment results were achieved for CNS NB-FOXR2 patients (5-year PFS: 63%±7%, OS: 85%±5%, n=63), with 35/42 progression-free survivors after upfront craniospinal irradiation (CSI) and chemotherapy. The worst outcome was seen for ETMR and HGG patients with 5-year PFS of 18%±6% and 22%±7%, and 5-year OS of 24%±6% and 25%±7%, respectively. CONCLUSION The historically reported poor outcome of CNS-PNET patients becomes highly variable when tumors are molecularly classified based on DNA methylation profiling. Patients with CNS NB-FOXR2 responded well to current treatments and a standard-risk-CSI based regimen may be prospectively evaluated. The poor outcome of ETMR across applied treatment strategies substantiates the necessity for evaluation of novel treatments.
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Affiliation(s)
- Katja von Hoff
- Department of Pediatric Oncology and Hematology, Charité University Medicine, Berlin, Germany
| | - Christine Haberler
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, Austria
| | - Felix Schmitt-Hoffner
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Faculty of Biosciences, Heidelberg University, Heidelberg, Germany
| | - Elizabeth Schepke
- The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Teresa de Rojas
- Pediatric OncoGenomics Unit, Children's University Hospital Niño Jesús, Madrid, Spain
| | - Sandra Jacobs
- Department of Pediatrics, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Michal Zapotocky
- Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - David Sumerauer
- Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marta Perek-Polnik
- Department of Oncology, The Children's Memorial Health Institute, University of Warsaw, Warsaw, Poland
| | - Christelle Dufour
- Gustave Roussy Cancer Center, Department of Pediatric and Adolescent Oncology, Villejuif, France.,Paris-Saclay University, INSERM, Molecular predictors and New targets in Oncology, Villejuif, France
| | | | - Irene Slavc
- Department of Pediatrics and Adolescent Medicine and Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Johannes Gojo
- Department of Pediatrics and Adolescent Medicine and Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Jessica C Pickles
- Developmental Biology and Cancer Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Nicolas U Gerber
- Department of Oncology, University Children's Hospital, Zurich, Switzerland
| | - Maura Massimino
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale die Tumori, Milan, Italy
| | | | - Miklos Garami
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Ella Kumirova
- Department of Neuro-Oncology, Dmitry Rogachev National Medical Research Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Astrid Sehested
- Department of Pediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark
| | - David Scheie
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Frederik Vs vej 11, 2100 Copenhagen, Denmark
| | - Ofelia Cruz
- Pediatric Oncology Department. Hospital Sant Joan de Deu. Barcelona, Spain
| | - Lucas Moreno
- Paediatric Haematology & Oncology Division, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Jaeho Cho
- Dept. of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea
| | - Bernward Zeller
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Niels Bovenschen
- Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Michael Grotzer
- Department of Oncology, University Children's Hospital, Zurich, Switzerland
| | - Daniel Alderete
- Service of Hematology/Oncology, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Matija Snuderl
- Department of Pathology, NYU Langone Health and School of Medicine, New York, NY, USA
| | - Olga Zheludkova
- Department of Neurooncology, Russian Scientific Center of Radiology, Moscow, Russia
| | - Andrey Golanov
- Department of Neuroradiology, Burdenko Neurosurgical Institute, Moscow, Russia
| | - Konstantin Okonechnikov
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Martin Mynarek
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - B Ole Juhnke
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - Stefan Rutkowski
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - Ulrich Schüller
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg.,Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
| | - Barry Pizer
- Institute of Translational Research, University of Liverpool, UK
| | - Barbara V Zezschwitz
- Department of Pediatric Oncology and Hematology, Charité University Medicine, Berlin, Germany
| | - Robert Kwiecien
- Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany
| | - Maximilian Wechsung
- Institute of Biometry and Clinical Epidemiology, Charité University Medicine and Berlin Institute of Health, Berlin, Germany
| | - Frank Konietschke
- Institute of Biometry and Clinical Epidemiology, Charité University Medicine and Berlin Institute of Health, Berlin, Germany
| | - Eugene I Hwang
- Department of Pediatric Hematology-Oncology, Center for Cancer and Immunology Research and Neuroscience Research, Children's National Medical Center, Washington DC, USA
| | - Dominik Sturm
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Pediatric Glioma Research, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology & Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan M Pfister
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Department of Pediatric Oncology, Hematology & Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Elisabeth J Rushing
- Institute of Neuropathology, University Medical Center Zurich, Zurich, Switzerland
| | - Marina Ryzhova
- Department of Neuropathology, Burdenko Neurosurgical Institute, Moscow, Russia
| | - Peter Hauser
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Maria Łastowska
- Department of Pathomorphology, Children's Memorial Health Institute, Warsaw, Poland
| | - Pieter Wesseling
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.,Amsterdam University Medical Center / VUmc, Amsterdam, The Netherlands
| | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomopathological Sciences, Sapienza University of Rome, Rome, Italy.,IRCCS Neuromed, Pozzilli (IS), Italy
| | - Cynthia Hawkins
- Division of Pathology, The Hospital for Sick Children, Toronto, Canada
| | - Dominique Figarella-Branger
- Aix-Marseille Univ, APHM, CNRS, INP, Inst Neurophysiopathol, CHU Timone, Service d'Anatomie Pathologique et de Neuropathologie, Marseille, France
| | - Charles Eberhart
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Peter Burger
- Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Marco Gessi
- Neuropathology Unit, Division of Pathology, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica S.Cuore, Rome, Italy
| | - Andrey Korshunov
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tom S Jacques
- Department of Histopathology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - David Capper
- Department of Neuropathology, Charité University Medicine, and Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK), partner site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Torsten Pietsch
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn, DZNE German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Marcel Kool
- Hopp Children´s Cancer Center (KiTZ), Heidelberg, Germany.,Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg, Germany.,Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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Dai Y, Zhang Y, Hao M, Zhu R. LINC00665 functions as a competitive endogenous RNA to regulate AGTR1 expression by sponging miR‑34a‑5p in glioma. Oncol Rep 2021; 45:1202-1212. [PMID: 33650673 PMCID: PMC7859982 DOI: 10.3892/or.2021.7949] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 08/21/2020] [Indexed: 12/22/2022] Open
Abstract
Glioma is the most aggressive tumor of the central nervous system. Long non-coding RNAs (lncRNAs) may be involved in modulating tumor generation. The present study analyzed an lncRNA microarray of glioma and selected long intergenic non-protein coding RNA 665 (LINC00665) as the research object. The mode of expression and biological function of LINC00665 in glioma were assessed using lncRNA microarray and RT-qPCR analyses. Gain-of-function assays and/or loss-of-function assays were implemented to explore the role of LINC00665 in the progression of glioma. Dual-luciferase reporter and RNA immunoprecipitation assays explored the downstream molecular mechanism of LINC00665. The function of the molecular pathway in progression of glioma was analyzed using rescue assays. High expression of LINC00665 was marked in glioma tissues and cells, which correlated with an unsatisfactory prognosis. Upregulation of LINC00665 significantly promoted the proliferation and invasion of glioma cells. LINC00665 acted as a competing endogenous RNA by sponging miR-34a-5p to upregulate angiotensin II receptor type 1 (AGTR1). LINC00665 promoted the progression of glioma by acting as a competitive endogenous RNA to competitively bind to miR-34a-5p and mediate AGTR1 expression.
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Affiliation(s)
- Yongyue Dai
- Department of Pathophysiology, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China
| | - Yucheng Zhang
- Department of General Surgery, Wenzhou Hospital Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang 325000, P.R. China
| | - Maolin Hao
- Department of Pathophysiology, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China
| | - Renwu Zhu
- Department of General Surgery, Wenzhou Hospital Integrated Traditional Chinese and Western Medicine, Wenzhou, Zhejiang 325000, P.R. China
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41
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Pickles JC, Mankad K, Aizpurua M, Paine SM, Bridges LR, Carceller F, Szychot E, Walker M, Fairchild AR, Mistry T, Ogunbiyi O, Rolland A, Stone TJ, Dryden C, Addy D, Garimberti E, Chalker J, Sahm F, Jones DT, Hargrave D, Jacques TS. A case series of Diffuse Glioneuronal Tumours with Oligodendroglioma-like features and Nuclear Clusters (DGONC). Neuropathol Appl Neurobiol 2021; 47:464-467. [PMID: 33325069 PMCID: PMC8048648 DOI: 10.1111/nan.12680] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Jessica C Pickles
- Developmental Biology and Cancer (DBC) Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Kshitij Mankad
- Department of Radiology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Miren Aizpurua
- Department of Clinical, Neuropathology King's College Hospital NHS Foundation Trust, London, UK
| | - Simon Ml Paine
- Queen's Medical Centre Campus, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Leslie R Bridges
- Department of Neuropathology, St George's Hospital NHS Trust, London, UK
| | - Fernando Carceller
- Children and Young People's Unit, The Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Elwira Szychot
- Children and Young People's Unit, The Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Mark Walker
- Cellular Pathology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Amy R Fairchild
- Developmental Biology and Cancer (DBC) Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Talisa Mistry
- Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Olumide Ogunbiyi
- Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Alice Rolland
- Département de Neurochirurgie, Centre Hospitalier Universitaire Montpellier, France
| | - Thomas J Stone
- Developmental Biology and Cancer (DBC) Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Carryl Dryden
- Specialist Integrated Haematology and Malignancy Diagnostic Service-Acquired Genomics, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Dilys Addy
- Specialist Integrated Haematology and Malignancy Diagnostic Service-Acquired Genomics, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Elisa Garimberti
- Specialist Integrated Haematology and Malignancy Diagnostic Service-Acquired Genomics, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Jane Chalker
- Specialist Integrated Haematology and Malignancy Diagnostic Service-Acquired Genomics, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Felix Sahm
- Hopp Children's Cancer Center Heidelberg (KiTZ, University Hospital Heidelberg, Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK, German Cancer Research Center (DKFZ, Heidelberg, Germany
| | - David Tw Jones
- Hopp Children's Cancer Center Heidelberg (KiTZ, University Hospital Heidelberg, Heidelberg, Germany.,Pediatric Glioma Research Group, German Cancer Research Center (DKFZ, Heidelberg, Germany
| | - Darren Hargrave
- Developmental Biology and Cancer (DBC) Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Paediatric Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Thomas S Jacques
- Developmental Biology and Cancer (DBC) Research & Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
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