Anaplastic oligodendroglioma

Case contributed by RMH Neuropathology

Presentation

Not available.

Patient Data

Age: 17
Gender: Male
MRI

MRI Brain (2008)

Multifocal regions of cortical and subcortical T2/FLAIR hyperintensity are unchanged, and consistent with gliomatosis cerebri.

No new enhancing lesion identified.

MRI

MRI Brain (2015)

Multifocal regions of cortical and subcortical T2/FLAIR hyperintensity are unchanged, and consistent with gliomatosis cerebri.

There is a superior right parietal heterogeneous lesion measuring 47 x 39 mm, with a central cystic area surrounded by calcifications and hemosiderin products foci. 

No new enhancing lesion identified.

Pathology

MICROSCOPIC DESCRIPTION:

1&2. The sections show fragments of a moderately hypercellular glial tumour. This consists predominantly of moderately pleomorphic oligodendroglial cells arranged in diffuse sheets. These are admixed with a population of reactive astrocytes. Moderate numbers of gliofibrillary ligodendrocytes are also seen. Moderate numbers of mitotic figures are identified (4/10 HPF). There is also microvascular proliferation with multilayering of atypical cells around vessel lumena. No necrosis is seen.

IMMUNOHISTOCHEMISTRY:

GFAP positive in reactive astrocytes and gliofibrillary oligodendrocytes; negative in tumlur

oligodendrocytes. 

NogoA positive in tumour oligodendrocytes. 

ATRX positive (not mutated)

IDH-1 R132H positive (mutated)

MGMT negative (likely methylated)

p53 negative in tumour oligodendrocytes

Topoisomerase labelling index: Approximately 10%

The features are of anaplastic oligodendroglioma (WHO grade III).

DIAGNOSIS: 1&2. Right frontoparietal tumour: Anaplastic oligodendroglioma (WHO Grade III).

Case Discussion

Oligodendrogliomas are intracranial tumours that account for 5-25% of all gliomas and 5-10% of all primary intracranial neoplasms. 

Anaplastic oligodendrogliomas make up 20-50% of them. Increased cellular density, mitotic activity, microvascular proliferation and necrosis.  Nuclear anaplasia is also common.

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Case information

rID: 37667
Case created: 17th Jun 2015
Last edited: 7th Sep 2015
Inclusion in quiz mode: Included

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