Oligodendroglioma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Sujit Routray, M.D. [3]

Overview

According to the old 2007 WHO classification of the central nervous system tumors, oligodendrogliomas were divided into five subtypes: oligodendroglioma (OII), anaplastic oligodendroglioma (OIII), oligoastrocytoma (OAII), anaplastic oligoastrocytoma (OAIII), and glioblastoma with oligodendroglioma component (GBMo). But the new 2016 edition of WHO classification of gliomas is based not only on histopathologic appearance but also on well-established molecular parameters, and oligodendroglial tumors are now more narrowly defined by molecular diagnostics to include only those diffuse gliomas having both a mutation in isocitrate dehydrogenase type 1 (IDH1) or type 2 (IDH2) and codeletion of chromosomes 1p and 19q. This new pattern of classification divides oligodendrogliomas into grade II tumors including oligodendroglioma IDH-mutant and 1p/19q-codeleted, oligodendroglioma NOS, oligoastrocytoma NOS, and grade III tumors including anaplasticoligodendroglioma IDH-mutant and 1p/19q-codeleted, anaplastic oligodendroglioma NOS, and anaplastic oligoastrocytoma NOS.

Classification

2016 World Health Organization (WHO) classification of diffuse astrocytic and oligodendroglial tumors
Tumor classification Tumor grade Defining* or characteristic molecular genetic features
Astrocytic tumors
Diffuse astrocytoma, IDH-mutant II IDH1/2 mutation*, TP53 mutation, ATRX mutation
Diffuse astrocytoma, IDH-wildtype II No IDH1/2 mutation
Anaplastic astrocytoma, IDH-mutant III IDH1/2 mutation*, TP53 mutation, ATRX mutation
Anaplastic astrocytoma, IDH-wildtype III No IDH1/2 mutation
Glioblastoma, IDH-mutant IV IDH1/2 mutation*, TP53 mutation, ATRX mutation
Glioblastoma, IDH-wildtype IV No IDH1/2 mutation, TERT promoter mutations
Glioblastoma, NOS IV Genetic testing not done or inconclusive
Midline diffuse glioma, H3 K27M-mutant IV H3 K27M mutation*
Oligodendroglial tumors
Oligodendroglioma, IDH-mutant and 1p/19q-codeleted II IDH1/2 mutation*, 1p/19q-codeletion*, no ATRX mutation, TERT promoter mutations
Oligodendroglioma, NOS II Genetic testing not done or inconclusive
Oligoastrocytoma, NOS II Genetic testing not done or inconclusive
Anaplastic oligodendroglioma, IDH-mutant and 1p/19q-codeleted III IDH1/2 mutation*, 1p/19q-codeletion*, no ATRX mutation, TERT promoter mutations
Anaplastic oligodendroglioma, NOS III Genetic testing not done or inconclusive
Anaplastic oligoastrocytoma, NOS III Genetic testing not done or inconclusive

IDH: isocitrate dehydrogenase; NOS: not otherwise specified

Data from: WHO classification of tumors of the central nervous system, revised 4th ed, Louis DN, Ohgaki H, Wiestler OD, Cavenee WK (Eds), IARC, Lyon 2016

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
WHO grade II
 
 
 
 
WHO grade III
 
 
 
WHO grade IV
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

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