Neuropathology and Molecular Genetics of Diffusely Infiltrating Cerebral Gliomas
Diffusely infiltrating gliomas (astrocytic gliomas, oligodendrogliomas and oligoastrocytomas) are the most common primary brain tumors in adults. Despite impressive advances in structural and metabolic neuroimaging of brain tumors, definite classification and grading of these tumors is still based on the microscopic assessment of neurosurgically removed tumor specimens. Here, we summarize the most important neuropathological features of the different types of diffusely infiltrating gliomas based on the recently refined World Health Organization (WHO) classification of tumors of the nervous system. In addition, we report on the current state of the art concerning the molecular genetic aberrations associated with the development and progression of diffusely infiltrating gliomas. The clinical significance of the molecular genetic analysis of gliomas is exemplified by the loss of alleles on the short arm of chromosome 1 in anaplastic oligodendrogliomas, which represents a novel, molecular indicator of response to chemotherapy and prognosis. In the near future, further molecular aberrations of potential clinical significance will be identified and molecular diagnostics will become a routine adjunct method, which may provide valuable prognostic information and guide the individual treatment.
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