Oligoastrocytoma (IDH1 positive)

Case contributed by A.Prof Frank Gaillard

Presentation

Seizure

Patient Data

Age: young adult
Modality: MRI

Diffuse area of increased signal involving the precuneus on the left, with considerable cortical involvement. 

MRI 28 months later

Modality: MRI

Diffuse area of increased signal involving the precuneus on the left, with considerable cortical involvement has not changed over the preceding 28 months.

Case Discussion

The patient went on to have an eventual biopsy (after the second scan). 

Histology

MICROSCOPIC DESCRIPTION: The sections from all the specimens show features of moderately cellular glial tumour. There is a proliferation of predominantly neoplastic astrocytes of the fibrillary and protoplasmic types. They have round to elongated and hyperchromatic nuclei. A second minor population of neoplastic oligodendroglial cells is also present (about 10%). These
cells have round nuclei and perinuclear haloes. The tumour cells extend into the cortex with secondary structuring including perineuronal satellitosis and perivascular aggregation. Rare mitoses are seen (less than 5 per 10 high power fields). No microvascular proliferation or necrosis is present. The features are those of oligoastrocytoma. The tumour cells are p53 and IDH-1 positive. The neoplastic astrocytes are ATRX positive. The Ki-67 index is about 8%. They are MGMT negative.

DIAGNOSIS: Oligoastrocytoma (WHO Grade II). 

Discussion

This case illustrates the typical 'benign' biological behaviour of IDH1 positive low grade tumours. Note, 1p19q was not, but would now, be routinely performed in this case. 

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Case Information

rID: 43705
Case created: 22nd Mar 2016
Last edited: 22nd Mar 2016
Inclusion in quiz mode: Excluded

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