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Diffuse glioma is a term used to encompass a variety of poorly marginated infiltrating tumors of the central nervous system, which histologically appear similar to glial cells, specifically astrocytes and oligodendrocytes. These range in biological behavior from very indolent to extremely aggressive and this is reflected in grading that ranges from grade 1 to grade 4.
Importantly, the term diffuse glioma does not include circumscribed astrocytic tumors (e.g. pilocytic astrocytoma, subependymal giant cell astrocytoma, pleomorphic xanthoastrocytoma etc...) nor tumors with admixed neuronal elements (e.g. ganglioglioma) although there is overlap particularly with the latter.
Increasingly the classification relies on molecular markers rather than histology.
- adult-type diffuse gliomas
- pediatric-type diffuse low-grade gliomas
- pediatric-type diffuse high-grade gliomas