Advertisement

The Classification of Adult Gliomas

  • Kieren S. J. AllinsonEmail author
Chapter

Abstract

The current classification and grading of gliomas is based on the 2016 World Health Organisation (WHO) system. The WHO 2016 system is the first attempt to classify gliomas by integrating well-established molecular information with the histological features in order to arrive at an integrated diagnosis. The vast majority of adult gliomas grow in a diffuse manner, infiltrating grey and white matter and creating a tumour mass that is inseparable from the surrounding brain tissue and very difficult to surgically remove. When we talk about adult gliomas, we are generally talking about diffuse gliomas. Diffuse gliomas are broadly divided into astrocytoma and oligodendroglioma and graded as II, III or IV. How these are divided and classified into tumour grades and subtypes is explored further in this chapter.

Keywords

Glioma classification WHO grading Tumour necrosis Glioblastoma Gliomas 

References

  1. 1.
    Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol. 2016;131:803–20.CrossRefGoogle Scholar
  2. 2.
    Theeler BJ, Ellezam B, Sadighi ZS, Mehta V, Diep Tran M, Adesina AM, Bruner JM, Puduvalli VK. Adult pilocytic astrocytomas: clinical features and molecular analysis. Neuro Oncol. 2014;16(6):841–7.CrossRefGoogle Scholar
  3. 3.
    Ohgaki H, Kleihues P. Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol. 2005;64(6):479–89.  https://doi.org/10.1093/jnen/64.6.479.CrossRefPubMedGoogle Scholar
  4. 4.
    Modrek AS, Bayin NS, Placantonakis DG. Brain stem cells as the cell of origin in glioma. World J Stem Cells. 2014;6(1):43–52.  https://doi.org/10.4252/wjsc.v6.i1.43.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Reuss DE, Mamatjan Y, Schrimpf D, et al. IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO. Acta Neuropathol. 2015;129(6):867–73.  https://doi.org/10.1007/s00401-015-1438-8.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Sahm F, Reuss D, Koelsche C, Capper D, Schittenhelm J, Heim S, Jones DT, Pfister SM, Herold-Mende C, Wick W, Mueller W, Hartmann C, Paulus W, von Deimling A. Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma. Acta Neuropathol. 2014;128(4):551–9.  https://doi.org/10.1007/s00401-014-1326.CrossRefPubMedGoogle Scholar
  7. 7.
    Bourne D, Schiff D. Update on molecular findings, management and outcome in low-grade gliomas. Nat Rev Neurol. 2010;6:695–701.CrossRefGoogle Scholar
  8. 8.
    Cohen A, Holmen S, Colman H. IDH1 and IDH2 Mutations in Gliomas. Curr Neurol Neurosci Rep. 2013;13(5):345.  https://doi.org/10.1007/s11910-013-0345-4.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Leeper HE, Caron AA, Decker PA, Jenkins RB, Lachance DH, Giannini C. IDH mutation, 1p19q codeletion and ATRX loss in WHO grade II gliomas. Oncotarget. 2015;6(30):30295–305.CrossRefGoogle Scholar
  10. 10.
    Eckel-Passow JE, Lachance DH, Molinaro AM, Walsh KM, Decker PA, Sicotte H, et al. Glioma groups based on 1p/19q, IDH, and TERT promoter mutations in tumors. N Engl J Med. 2015;372(26):2499–508.  https://doi.org/10.1056/NEJMoa1407279.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hartmann C, Hentschel B, Wick W, Capper D, Felsberg J, Simon M, Von Deimling A. Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. Acta Neuropathol. 2010;120(6):707–18.  https://doi.org/10.1007/s00401-010-0781-z.CrossRefPubMedGoogle Scholar
  12. 12.
    van den Bent M, Brandes A, Taphoorn M, Kros J, Kouwenhoven M, Delattre J, Bernsen HJ, Frenay M, Tijssen C, Grisold W, Sipos L, Enting R, French P, Dinjens W, Vecht C, Allgeier A, Lacombe D, Gorlia T, Hoang-Xuan K. Adjuvant procarbazine, lomustine, and vincristine chemotherapy in newly diagnosed anaplastic oligodendroglioma: long-term follow-up of EORTC brain tumor group study 26951. J Clin Oncol. 2013;31(3):344.CrossRefGoogle Scholar
  13. 13.
    Hinrichs BH, Newman S, Appin CL, et al. Farewell to GBM-O: Genomic and transcriptomic profiling of glioblastoma with oligodendroglioma component reveals distinct molecular subgroups. Acta Neuropathol Commun. 2016;4:4.  https://doi.org/10.1186/s40478-015-0270-7.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Ostrom QT, Gittleman H, Liao P, Rouse C, Chen Y, Dowling J, Wolinsky Y, Kruchko C, Barnholtz-Sloan J. CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007–2011. Neuro Oncol. 2014;16(Suppl 4):iv1.CrossRefGoogle Scholar
  15. 15.
    Purkait S, Mallick S, Sharma V, et al. Prognostic stratification of GBMs using combinatorial assessment of IDH1 mutation, MGMT promoter methylation, and TERT mutation status: experience from a tertiary care center in India. Transl Oncol. 2016;9(4):371–6.  https://doi.org/10.1016/j.tranon.2016.06.005.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Nobusawa S, Watanabe T, Kleihues P, Ohgaki H. IDH1 mutations as molecular signature and predictive factor of secondary glioblastomas. Clin Cancer Res. 2009;15(19):6002–7.  https://doi.org/10.1158/1078-0432.CCR-09-0715.CrossRefPubMedGoogle Scholar
  17. 17.
    Schwartzentruber J, et al. Driver mutations in histone H3.3 and chromatin remodelling genes in paediatric glioblastoma. Nature. 2012;482:226–U119.CrossRefGoogle Scholar
  18. 18.
    Hegi ME, Diserens AC, Gorlia T, Hamou MF, De Tribolet N, Weller M, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med. 2005;352(10):997–1003.  https://doi.org/10.1056/NEJMoa043331.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Histopathology, Division BAddenbrooke’s Hospital, CUHFTCambridgeUK

Personalised recommendations