Tumor Neuropathology
Tumor Neuropathology
What You'll Learn
- The adult diffuse gliomas under WHO CNS5 — how IDH, 1p/19q, and molecular grade define astrocytoma vs oligodendroglioma vs glioblastoma
- Circumscribed, glioneuronal, ependymal and embryonal tumors and their signature histology
- Meningeal, nerve-sheath and sellar tumors
- The key other tumors — CNS lymphoma, metastases, hemangioblastoma
The neuropathology view — histology, IHC and molecular markers per tumor. For the clinical picture (epidemiology, presentation, imaging, grading, prognosis, treatment and complications) see Neuro-Oncology.
What You'll Learn
| Tumor | Histology | Molecular / grade |
|---|---|---|
| Astrocytoma, IDH-mutant | Infiltrating fibrillary astrocytes; grade by mitoses/MVP/necrosis | IDH1/2 mut, ATRX loss, p53; CDKN2A/B homozygous deletion → grade 4 |
| Oligodendroglioma, IDH-mutant & 1p/19q-codeleted | “Fried-egg” clear halos, chicken-wire capillaries, microcalcification | IDH mut + whole-arm 1p/19q codeletion (defining); TERT; grade 2/3 |
| Glioblastoma, IDH-wildtype | Pleomorphic astrocytic tumor with pseudopalisading necrosis and/or microvascular proliferation | IDH-wt plus ≥1 of: TERT promoter mut, EGFR amplification, +7/−10 (= grade 4 even without necrosis/MVP) |
What You'll Learn
| Tumor | Histology | Marker / clue |
|---|---|---|
| Pilocytic astrocytoma (grade 1) | Biphasic compact/loose; Rosenthal fibers + eosinophilic granular bodies; piloid cells | KIAA1549::BRAF fusion; cerebellum, child |
| Pleomorphic xanthoastrocytoma | Pleomorphic + lipidized (xanthomatous) cells, EGBs, reticulin network | BRAF V600E; superficial temporal, young; CD34 |
| Diffuse midline glioma, H3 K27-altered (grade 4) | Infiltrating; pons/thalamus/cord of children | H3 K27M (or EZHIP overexpression / EGFR-altered); loss of H3K27me3 |
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