Oligodendroglioma pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [16]Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[17]Sujit Routray, M.D. [18]

Overview

Oligodendroglioma arises from the tripotential glial precursor cells and not from the bipotential oligodendrocytes. Genes associated with the pathogenesis of oligodendroglioma include t[1;19][q10;p10], ATRX, NJDS, IDH1, IDH2, TERT promoter, H3 K27M (H3F3A, HIST1H3B/C), CIC, FUBP1, p53, Leu-7, TCF-12, TP53,MGMT, TP73, BRAF, EGFR, and PTEN. Common intracranial sites involved by oligodendroglioma include cerebral hemispheres, posterior fossa, and intramedullary spinal cord. On gross pathology, oligodendroglioma is characterized by a well-circumscribed, gelatinous, calcified, cystic, gray mass with focal hemorrhage which may expand a gyrus and remodel the skull. On microscopic histopathological analysis, oligodendroglioma is characterized by diffuse growthpattern of highly cellular lesion of monomorphic cells having rounded nucleus with atypia, speckled "salt-and-pepper" chromatin pattern and perinuclear haloresembling fried eggs, distinct cell borders, clear cytoplasm, abundant calcification and "chicken-wire" like vascularity pattern. Oligodendroglioma is demonstrated by positivity to tumor markers such as IDH1-R132H, MAP2, GFAP, S-100, SOX10, EMA, ATRX, Ki-67, NSE, synaptophysin, OLIG1, and OLIG2.

Pathophysiology

Pathogenesis

Genetics

Gross Pathology

Oligodendroglioma involving frontal lobe [1]
Mixed astrocytoma and oligodendroglioma [2]
Oligodendroglioma gross appearance [3]

Microscopic Pathology

On microscopic histopathological analysis, oligodendroglioma is characterized by:[20][60][61][62][63]

Oligodendroglioma HE stain [4]
Low power magnification of a Oligodendroglioma biopsy specimen showing discrete infiltration of the surrounding brain [5]
Oligodendroglioma HE stain [6]
Oligodendroglioma HE stain [7]
Oligodendroglioma HE stain [8]
GFAP immunohistochemistry in a histopathology specimen of oligodendroglioma grade II WHO [9]
High magnification micrograph of an oligodendroglioma showing the characteristic branching, small, chicken wire-like blood vessels and fried egg-like cells, with clear cytoplasm and well-defined cell borders. H&E stain. [10]
Low magnification micrograph of an oligodendroglioma showing the characteristic, small, branching, chicken wire-like blood vessels. H&E stain. [11]

Microscopic histopathological findings in anaplastic oligodendroglioma

On microscopic histopathological analysis, anaplastic oligodendroglioma, IDH mutant and 1p/19q codeleted, is characterized by:[60]

Brisk mitotic rate in anaplastic oligodendroglioma [12]
Vascularproliferation Source: Roger E McLendon, MD et al.
Histopathology of anaplastic oligodendroglioma (MAP2 staining) showing perinuclear immunoreactivity of tumor cells[13]
"Fried egg" appearance Source: John DeWitt, M.D., Ph.D.
Chicken wire vessels Source: John DeWitt, M.D., Ph.D.
"Fried egg" appearance Source: John DeWitt, M.D., Ph.D.
Infiltrating cortex Source: John DeWitt, M.D., Ph.D.
Histopathology of anaplastic oligodendroglioma (HE stain) showing minigemistocytes and mitoses among tumor cells with perinuclear halo.[14]
Histopathology of anaplastic oligodendroglioma (IDH1 R132H staining) showing immunoreactivity of tumor cells idicating presence of the isocitrate dehydrogenase 1 R132H mutation [15]

Immunohistochemistry

Oligodendroglioma is demonstrated by positivity to tumor markers such as:[68][69][20][7]

Oligodendroglioma stains negative for:

References

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