Oligoastrocytoma pathophysiology: Difference between revisions

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Revision as of 19:01, 20 October 2015

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

Overview

Pathophysiology

Pathogenesis

Oligoastrocytomas are mixed tumors that arises from the proliferation of both oligodendrocytes and astrocytes.^[1]
Oligoastrocytomas are low-grade (grade II) tumors and anaplastic oligoastrocytomas are high-grade (grade III) tumors that occur in the brain.^[2]

Genetics

Development of oligoastrocytoma is the result of multiple genetic mutations.
Oligoastrocytomas are mixed tumors that have overlapping molecular genetics with both oligodendrogliomas and astrocytomas.^[3]
Genes associated with the pathogenesis of oligoastrocytoma and anaplastic oligoastrocytoma include:^[3]^[4]^[5]^[6]^[7]^[8]^[9]

IDH1
p53
EGFR
ATRX
EGFR
PTEN
MGMT
CIC
FUBP1

30-70% of oligoastrocytomas show loss of heterozygosity (LOH) 1p and 19q.^[3]

Gross Pathology

Oligoastrocytomas are commonly found in the supratentorial region.
Common intracranial sites associated with oligoastrocytoma include:^[10]^[11]^[12]^[3]
- Frontal lobe (most common)
- Temporal lobe
- Parietal lobe
- Occipital lobe
- Insula
- Diencephalon
- Spinal cord

Microscopic Pathology

On microscopic histopathological analysis, oligoastrocytoma is characterized by:^[13]^[14]^[15]^[16]^[17]

Highly cellular lesion composed of both oligodendroglial and astrocytic components
Two types of pattern: biphasic and diffuse
- Biphasic pattern demonstrates oligodendroglial and astrocytic differentiation, whereas diffuse pattern demonstrates intermingling of both the components
Oligodendrocytes
- Fried-egg shaped cells
- Composed of minigemistocytes
- Round nucleus
- Distinct cell borders
- Moderate-to-marked nuclear atypia with speckled "salt-and-pepper" chromatin pattern and perinuclear halo
- Focal microcalcification
Astrocytes
- Star-shaped cells
- Composed of gemistocytes
- Multinucleated giant cells
- Ovoid nucleus
- Nuclear atypia

On microscopic histopathological analysis, anaplastic oligoastrocytoma is characterized by:^[13]^[14]^[15]

Significant or brisk mitotic activity (≥ 6 mitoses per 10 high power field)
Marked cytologic and nuclear atypia
Necrosis
Apoptotic cells
Microvacular proliferation
- 'Glomeruloid' vessels or endothelial hyperplasia

Gallery

_{Biopsy specimen of an oligoastrocytoma (HE stain).^[18]}
File:===Immunohistochemistry===
File:===Gallery===
_{Histology of oligoastrocytoma cells demonstrating positivity to tumor marker GFAP.^[19]}
_{Histology of oligoastrocytoma cells demonstrating positivity to tumor marker Ki-67.^[20]}

References

↑ Introduction of oligodendroglioma and oligoastrocytoma. American Brain Tumor Association. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 16, 2015
↑ Mixed Gliomas. Canadian ?Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on#ixzz3okGrTzyi. Accessed on October 16, 2015
↑ ^3.0 ^3.1 ^3.2 ^3.3 Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J; et al. (2002). "Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets". Am J Pathol. 161 (1): 313–9. doi:10.1016/S0002-9440(10)64183-1. PMC 1850690. PMID 12107116.
↑ Sahm F, Reuss D, Koelsche C, Capper D, Schittenhelm J, Heim S; et al. (2014). "Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma". Acta Neuropathol. 128 (4): 551–9. doi:10.1007/s00401-014-1326-7. PMID 25143301.
↑ Viana-Pereira M, Lopes JM, Little S, Milanezi F, Basto D, Pardal F; et al. (2008). "Analysis of EGFR overexpression, EGFR gene amplification and the EGFRvIII mutation in Portuguese high-grade gliomas". Anticancer Res. 28 (2A): 913–20. PMID 18507036.
↑ Ermoian RP, Furniss CS, Lamborn KR, Basila D, Berger MS, Gottschalk AR; et al. (2002). "Dysregulation of PTEN and protein kinase B is associated with glioma histology and patient survival". Clin Cancer Res. 8 (5): 1100–6. PMID 12006525.
↑ van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG; et al. (2013). "MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951". Clin Cancer Res. 19 (19): 5513–22. doi:10.1158/1078-0432.CCR-13-1157. PMID 23948976.
↑ Jiao Y, Killela PJ, Reitman ZJ, Rasheed AB, Heaphy CM, de Wilde RF; et al. (2012). "Frequent ATRX, CIC, FUBP1 and IDH1 mutations refine the classification of malignant gliomas". Oncotarget. 3 (7): 709–22. PMC 3443254. PMID 22869205.
↑ Liang Y, Bollen AW, Nicholas MK, Gupta N (2005). "Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas". BMC Clin Pathol. 5: 6. doi:10.1186/1472-6890-5-6. PMC 1182359. PMID 16018821.
↑ Location of oligoastrocytoma. Dr. Bruno Di Muzio and Dr. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 19, 2015
↑ Shimizu T, Saito N, Aihara M, Kurihara H, Nakazato Y, Ueki K; et al. (2004). "Primary spinal oligoastrocytoma: a case report". Surg Neurol. 61 (1): 77–81, discussion 81. PMID 14706386.
↑ Oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015
↑ ^13.0 ^13.1 Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015
↑ ^14.0 ^14.1 Naugle DK, Duncan TD, Grice GP (2004). "Oligoastrocytoma". Radiographics. 24 (2): 598–600. doi:10.1148/rg.242035069. PMID 15026604.
↑ ^15.0 ^15.1 Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015
↑ Love, S.; Loius, D. & Ellison, D.W. (2008), Greenfield's neuropathology, 1 (8th ed.), Boca Raton, Florida: Hodder Arnold
↑ Histology of anaplastic oligoastrocytes. Dr. Frank Gaillard. Radiopaedia 2015. http://radiopaedia.org/cases/anaplastic-oligoastrocytoma. Accessed on October 19, 2015
↑ Classification and external sources of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015
↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC
↑ Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC

Template:WikiDoc Sources

[pathogenesis-1] Introduction of oligodendroglioma and oligoastrocytoma. American Brain Tumor Association. http://www.abta.org/secure/oligodendrioma-oligo.pdf. Accessed on October 16, 2015

[pathogenesis2-2] Mixed Gliomas. Canadian ?Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/brain-spinal/brain-and-spinal-tumours/mixed-glioma/?region=on#ixzz3okGrTzyi. Accessed on October 16, 2015

[pmid12107116-3] 3.0 ^3.1 ^3.2 ^3.3 Mueller W, Hartmann C, Hoffmann A, Lanksch W, Kiwit J, Tonn J; et al. (2002). "Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets". Am J Pathol. 161 (1): 313–9. doi:10.1016/S0002-9440(10)64183-1. PMC 1850690. PMID 12107116.

[pmid25143301-4] Sahm F, Reuss D, Koelsche C, Capper D, Schittenhelm J, Heim S; et al. (2014). "Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma". Acta Neuropathol. 128 (4): 551–9. doi:10.1007/s00401-014-1326-7. PMID 25143301.

[pmid18507036-5] Viana-Pereira M, Lopes JM, Little S, Milanezi F, Basto D, Pardal F; et al. (2008). "Analysis of EGFR overexpression, EGFR gene amplification and the EGFRvIII mutation in Portuguese high-grade gliomas". Anticancer Res. 28 (2A): 913–20. PMID 18507036.

[pmid12006525-6] Ermoian RP, Furniss CS, Lamborn KR, Basila D, Berger MS, Gottschalk AR; et al. (2002). "Dysregulation of PTEN and protein kinase B is associated with glioma histology and patient survival". Clin Cancer Res. 8 (5): 1100–6. PMID 12006525.

[pmid23948976-7] van den Bent MJ, Erdem-Eraslan L, Idbaih A, de Rooi J, Eilers PH, Spliet WG; et al. (2013). "MGMT-STP27 methylation status as predictive marker for response to PCV in anaplastic Oligodendrogliomas and Oligoastrocytomas. A report from EORTC study 26951". Clin Cancer Res. 19 (19): 5513–22. doi:10.1158/1078-0432.CCR-13-1157. PMID 23948976.

[pmid22869205-8] Jiao Y, Killela PJ, Reitman ZJ, Rasheed AB, Heaphy CM, de Wilde RF; et al. (2012). "Frequent ATRX, CIC, FUBP1 and IDH1 mutations refine the classification of malignant gliomas". Oncotarget. 3 (7): 709–22. PMC 3443254. PMID 22869205.

[pmid16018821-9] Liang Y, Bollen AW, Nicholas MK, Gupta N (2005). "Id4 and FABP7 are preferentially expressed in cells with astrocytic features in oligodendrogliomas and oligoastrocytomas". BMC Clin Pathol. 5: 6. doi:10.1186/1472-6890-5-6. PMC 1182359. PMID 16018821.

[locOA-10] Location of oligoastrocytoma. Dr. Bruno Di Muzio and Dr. Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 19, 2015

[pmid14706386-11] Shimizu T, Saito N, Aihara M, Kurihara H, Nakazato Y, Ueki K; et al. (2004). "Primary spinal oligoastrocytoma: a case report". Surg Neurol. 61 (1): 77–81, discussion 81. PMID 14706386.

[wikigross-12] Oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015

[patho1-13] 13.0 ^13.1 Pathology of oligoastrocytoma. Dr Bruno Di Muzio and Dr Frank Gaillard et al. Radiopaedia 2015. http://radiopaedia.org/articles/oligoastrocytoma. Accessed on October 16, 2015

[pmid15026604-14] 14.0 ^14.1 Naugle DK, Duncan TD, Grice GP (2004). "Oligoastrocytoma". Radiographics. 24 (2): 598–600. doi:10.1148/rg.242035069. PMID 15026604.

[pathowiki-15] 15.0 ^15.1 Pathology of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 16, 2015

[bookneuropathologyoligoastro-16] Love, S.; Loius, D. & Ellison, D.W. (2008), Greenfield's neuropathology, 1 (8th ed.), Boca Raton, Florida: Hodder Arnold

[histoOA-17] Histology of anaplastic oligoastrocytes. Dr. Frank Gaillard. Radiopaedia 2015. http://radiopaedia.org/cases/anaplastic-oligoastrocytoma. Accessed on October 19, 2015

[microwikiOA1-18] Classification and external sources of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015

[ihc1OA-19] Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC

[ihc02OA-20] Image courtesy of Dr. Frank Gaillard. Radiopaedia (original file here). Creative Commons BY-SA-NC

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@@ Line 62: / Line 62: @@
 *Microvacular proliferation
 **'Glomeruloid' vessels or endothelial [[hyperplasia]]
-<br>
 ====Gallery====
+<gallery>
+Image:Oligoastrocytoma histology HE stain.jpg|<sub>Biopsy specimen of an oligoastrocytoma (HE stain).<ref name=microwikiOA1>Classification and external sources of oligoastrocytoma. Wikipedia 2015. https://en.wikipedia.org/wiki/Oligoastrocytoma. Accessed on October 20, 2015</ref></sub>
 ===Immunohistochemistry===