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Brain Tumor Pathology

Michael W Ruff, Adip G Bhargav, Aditya Raghunathan
Extraneural glioblastoma metastases are exceedingly rare, though previously described in the literature. Activating mutations in the BRAF kinase gene (V600E) are present in a minority of glioblastoma patients. Here, we describe a case of systemic metastases of a clonal subpopulation of BRAF V600E mutated glioblastoma in a patient previously treated with surgery, radiation, temozolomide and bevacizumab. The patient presented with a subacute cervical myelopathy during adjuvant treatment. He underwent emergent surgical decompression of an epidural spine metastasis...
May 9, 2018: Brain Tumor Pathology
Naoko Inoshita, Hiroshi Nishioka
The fourth edition of the World Health Organization classification of endocrine tumors has been recently published. There are two critical changes to the classification for pituitary adenomas in this edition. One is that the term "atypical adenoma," which was characterized based on highly proliferative properties to predict adenomas that carry a poor prognosis, was completely eliminated due to the lack of definitive evidence. The other change is the introduction of more precise cell lineage-based classification of pituitary adenoma that is defined based on lineage-specific transcription factors and hormones produced...
April 23, 2018: Brain Tumor Pathology
Valeria Barresi, Simona Lionti, Samuel Caliri, Maria Caffo
Atypical meningiomas are diagnosed in the presence of: (1) three or more of the following minor atypical criteria: increased cellularity, small cells with a high nuclear/cytoplasmic ratio, prominent nucleoli, sheeting, and foci of spontaneous or geographic necrosis; (2) mitotic count ≥ 4 mitoses per 10 HPF (high mitotic index); (3) brain invasion. The 5-year disease-free survival (DFS) is around 50%. Due to their heterogeneous behavior, the post-surgical treatment of atypical meningiomas is controversial...
April 18, 2018: Brain Tumor Pathology
Masayuki Kanamori, Masamitsu Maekawa, Ichiyo Shibahara, Ryuta Saito, Masashi Chonan, Miki Shimada, Yukihiko Sonoda, Toshihiro Kumabe, Mika Watanabe, Nariyasu Mano, Teiji Tominaga
The 2016 World Health Organization classification of tumors of the central nervous system was recently revised. Mutations in the isocitrate dehydrogenase 1 (IDH1) and IDH2 genes and chromosome 1p/19q codeletion are especially important for both the integrated diagnosis and the determination of surgical strategy. To establish a method for intraoperative molecular diagnosis, a simple, rapid method was developed for the measurement of 2-hydroxyglutarate (2-HG), a specific oncometabolite formed in the presence of IDH gene mutation, using liquid chromatography/electrospray ionization tandem mass spectrometry (LC/ESI-MS/MS)...
April 18, 2018: Brain Tumor Pathology
Takumi Kajitani, Masayuki Kanamori, Ryuta Saito, Yuko Watanabe, Hiroyoshi Suzuki, Mika Watanabe, Shigeo Kure, Teiji Tominaga
Radiation therapy is sometimes performed to control intracranial acute lymphoblastic leukemia (ALL), but may lead to radiation-induced malignant glioma. The clinical, radiological, histological, and molecular findings are described of three cases of radiation-induced glioblastoma after the treatment for ALL. They received radiation therapy at age 6-8 years. The latency from radiation therapy to the onset of radiation-induced glioblastoma was 5-10 years. Magnetic resonance imaging demonstrated diffuse lesions with multiple small enhanced lesions in all cases...
April 17, 2018: Brain Tumor Pathology
David N Louis
No abstract text is available yet for this article.
April 17, 2018: Brain Tumor Pathology
Yojiro Akagi, Koji Yoshimoto, Nobuhiro Hata, Daisuke Kuga, Ryusuke Hatae, Takeo Amemiya, Yuhei Sangatsuda, Satoshi O Suzuki, Toru Iwaki, Masahiro Mizoguchi, Koji Iihara
In this study, we reclassified 400 consecutive glioma cases including pediatric cases, using the revised 2016 WHO classification with samples collected from the Kyushu University Brain Tumor Bank. The IDH1/2, H3F3A, key genetic markers in the 2016 classification, were analyzed using high-resolution melting, with DNA extracted from frozen tissues. The 1p/19q codeletions were evaluated using a microsatellite-based loss of heterozygosity analysis, with 18 markers, to detect loss of the entire chromosome arm. In the integrated diagnosis, 29 oligodendroglioma cases and 28 anaplastic oligodendroglioma cases were diagnosed as "IDH-mutant and 1p/19q-codeleted," while 2 oligodendroglioma cases and 5 anaplastic oligodendroglioma cases were diagnosed as not otherwise specified (NOS)...
March 22, 2018: Brain Tumor Pathology
Akane Yamamichi, Fumiharu Ohka, Kosuke Aoki, Hiromichi Suzuki, Akira Kato, Masaki Hirano, Kazuya Motomura, Kuniaki Tanahashi, Lushun Chalise, Sachi Maeda, Toshihiko Wakabayashi, Yukinari Kato, Atsushi Natsume
The IDH-mutant and 1p/19q co-deletion (1p19q codel) provides significant diagnostic and prognostic value in lower-grade gliomas. As ATRX mutation and 1p19q codel are mutually exclusive, ATRX immunohistochemistry (IHC) may substitute for 1p19q codel, but this has not been comprehensively examined. In the current study, we performed ATRX-IHC in 78 gliomas whose ATRX statuses were comprehensively determined by whole exome sequencing. Among the 60 IHC-positive and 18 IHC-negative cases, 86.7 and 77.8% were ATRX-wildtype and ATRX-mutant, respectively...
March 17, 2018: Brain Tumor Pathology
Makoto Shibuya
The fourth edition of the World Health Organization classification of endocrine tumors (EN-WHO2017) was released in 2017. In this new edition, changes in the classification of non-neuroendocrine tumors are proposed particularly in tumors arising in the posterior pituitary. These tumors are a distinct group of low-grade neoplasms of the sellar region that express thyroid transcription factor-1, and include pituicytoma, granular cell tumor of the sellar region, spindle cell oncocytoma, and sellar ependymoma. This short review focuses on the classification of posterior pituitary tumors newly proposed in EN-WHO2017, and controversies in their pathological differential diagnosis are discussed based on recent cases...
April 2018: Brain Tumor Pathology
Heidi V N Küsters-Vandevelde, Menno R Germans, Roy Rabbie, Mamunur Rashid, Roel Ten Broek, Willeke A M Blokx, Clemens F M Prinsen, David J Adams, Mark Ter Laan
No abstract text is available yet for this article.
April 2018: Brain Tumor Pathology
Toshihiko Iuchi, Takahiro Sugiyama, Miki Ohira, Hajime Kageyama, Sana Yokoi, Tsukasa Sakaida, Yuzo Hasegawa, Taiki Setoguchi, Makiko Itami
In this study, we retrospectively compared the prognostic value of the 2016 WHO classification with the former classification in 387 patients with glioma treated at our institution. According to the new classification, diagnoses included oligodendroglioma with isocitrate dehydrogenase (IDH) mutation and 1p/19q co-deletion (5.4%), anaplastic oligodendroglioma with IDH mutation and 1p/19q co-deletion (3.4%), diffuse astrocytoma IDH-mutated (3.9%), anaplastic astrocytoma IDH-mutated (2.8%), glioblastoma IDH-mutated (7...
April 2018: Brain Tumor Pathology
Masaki Hirano, Fumiharu Ohka, Sachi Maeda, Lushun Chalise, Akane Yamamichi, Kosuke Aoki, Akira Kato, Kuniaki Tanahashi, Kazuya Motomura, Yusuke Nishimura, Masahito Hara, Keiko Shinjo, Yutaka Kondo, Toshihiko Wakabayashi, Atsushi Natsume
Detection of mutations in the isocitrate dehydrogenase 1 (IDH1) gene is useful for accurate diagnosis of lower grade gliomas, as described in the 2016 World Health Organization classification of tumors of the central nervous system. Conventional analysis tools, including Sanger DNA sequencing and immunohistochemistry, might fail to detect a small fraction of mutant IDH1 owing to their limited sensitivity. Considering that lower grade gliomas are infiltrative in nature, a highly sensitive detection assay for IDH1 mutation is required for their accurate diagnosis...
April 2018: Brain Tumor Pathology
Kurt A Grahnke, Daniel M Heiferman, Ewa Borys, Edward Melian, Kevin P Barton, Rimas V Lukas, Nawal Shaikh, John P Leonetti, Douglas E Anderson
No abstract text is available yet for this article.
January 13, 2018: Brain Tumor Pathology
Hiroshi Nishioka, Naoko Inoshita
WHO classification of pituitary adenomas was revised in 2017. The two major and significant changes are discussed. (1) The new classification focuses on adenohypophysial-cell lineage for the designation of adenomas, and thus, assessment of pituitary transcription factors is recommended. Its appropriate use has a complementary role in obtaining an accurate diagnosis, particularly in hormone-negative adenomas. Subclassification of nonfunctioning adenomas was revised accordingly and, consequently, null cell adenomas became quite rare...
January 9, 2018: Brain Tumor Pathology
Nobuaki Funata, Sumihito Nobusawa, Satoshi Nakata, Tatsuya Yamazaki, Kazuhiko Takabagake, Tsukasa Koike, Tatsuya Maegawa, Ryoji Yamada, Nobusada Shinoura, Yutaka Mine
Diffuse midline glioma, H3 K27M mutant, is newly recognized as a distinct category, which usually arises in the brain stem, thalamus or spinal cord of children, and young adults. The oncogenic H3 K27M mutation involves H3.3 (encoded by H3F3A) or H3.1 (encoded by HIST1H3B/HIST1H3C), and the incidence of each mutation differs among the primary sites. Recently, several papers have reported that cerebellar high-grade gliomas in both children and adults also harbor H3 K27 mutation. With the exception of one pediatric case, all of the cases carried the mutation in H3...
January 2018: Brain Tumor Pathology
Jintao He, Xiang Li, Wanchun Zhu, Yaxiong Yu, Jian Gong
Glioma is the most common intracranial malignant tumor. Low-grade gliomas (LGG) occupy almost 80% in all of the gliomas. The prognosis of LGG in children is much better than in adult, however, the molecular mechanism is still unclear. In our investigation, it was first found that the level of soluble IL1RAP (sIL1RAP) was significantly higher in the LGG from children than that from adult. We also revealed that sIL1RAP could induce the apoptosis of U251. In cells with overexpression of sIL-1RAP, the cell proliferation promoted by IL-1 was significantly inhibited...
January 2018: Brain Tumor Pathology
Takamune Achiha, Hideyuki Arita, Naoki Kagawa, Tsuyoshi Murase, Jun-Ichiro Ikeda, Eiichi Morii, Yonehiro Kanemura, Yasunori Fujimoto, Haruhiko Kishima
Enchondromatosis is a rare skeletal disorder characterized by the development of multiple enchondromas, which can also manifest non-cartilage tumors including gliomas. Here, we describe a genetic analysis of a low-grade glioma that developed in an enchondromatosis case. A 32-year-old man with a long history of enchondromatosis developed a left frontal tumor. The histopathological findings of his surgical specimen revealed characteristics of a low-grade glioma with an IDH1 c.395G>A (R132H) mutation and 1p/19q codeletion, which led to a definitive diagnosis of oligodendroglioma...
January 2018: Brain Tumor Pathology
Ichiyo Shibahara, Yukihiko Sonoda, Hiroyoshi Suzuki, Akifumi Mayama, Masayuki Kanamori, Ryuta Saito, Yasuhiro Suzuki, Shoji Mashiyama, Hiroshi Uenohara, Mika Watanabe, Toshihiro Kumabe, Teiji Tominaga
Pilocytic astrocytomas and low-grade gliomas are more common compared with glioblastomas in patients with neurofibromatosis 1 (NF1). A recent genome-wide analysis has shown frequent NF1 gene alterations in the mesenchymal subtype of a glioblastoma; however, little is known about clinicopathological features of glioblastomas in NF1 patients (NF1 glioblastomas). We analyzed four NF1 glioblastomas. Radiographical and intraoperative findings showed well-circumscribed tumors from surrounding brain. Pathological analysis presented a paucity of processes with an eosinophilic cytoplasm, bizarre nuclei, xanthomatous-like appearance, multinucleated giant cells, and histiocytoid appearance...
January 2018: Brain Tumor Pathology
Shumpei Onishi, Fumiyuki Yamasaki, Yoshiko Nakano, Takeshi Takayasu, Vishwa Jeet Amatya, Manish Kolakshyapati, Yukio Takeshima, Takanori Hirose, Koichi Ichimura, Kazuhiko Sugiyama, Kaoru Kurisu
No abstract text is available yet for this article.
January 2018: Brain Tumor Pathology
Lawrance K Chung, Panayiotis E Pelargos, Ann M Chan, Joanna V Demos, Carlito Lagman, John P Sheppard, Thien Nguyen, Yu-Ling Chang, Seyed A Hojat, Robert M Prins, Linda M Liau, Leia Nghiemphu, Albert Lai, Timothy F Cloughesy, William H Yong, Lynn K Gordon, Madhuri Wadehra, Isaac Yang
Epithelial membrane protein-2 (EMP2) expression is noted in many human cancers. We evaluated EMP2 as a biomarker in gliomas. A large tissue microarray of lower grade glioma (WHO grades II-III, n = 19 patients) and glioblastoma (GBM) (WHO grade IV, n = 50 patients) was stained for EMP2. EMP2 expression was dichotomized to low or high expression scores and correlated with clinical data. The mean EMP2 expression was 1.68 in lower grade gliomas versus 2.20 in GBMs (P = 0.01). The percentage of samples with high EMP2 expression was greater in GBMs than lower grade gliomas (90...
January 2018: Brain Tumor Pathology
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