Oligodendroglioma

Case contributed by Dr Ernest Lekgabe

Presentation

Presented with episodes of blurred vision.

Patient Data

Age: 50 years
Gender: Female
MRI
Extensive infiltrating left frontal tumor with imaging characteristics consistent with diffuse low grade glioma. No radiological evidence of high grade tumor.
Pathology

MICROSCOPIC DESCRIPTION:

Sections of brain tissue cores show a moderately cellular tumor composed of mildly pleomorphic cells containing round to oval, hyperchromatic, vesicular nuclei and inconspicuous nucleoli. Tumor cells demonstrate prominent perineuronal secondary structuring. No mitoses, necrosis or microvascular proliferation are seen.

IMMUNOHISTOCHEMISTRY:

  • GFAP Positive
  • Nogo A Negative
  • Nestin Positive (low)
  • IDH-1 R132H Positive (mutated)
  • ATRX Positive (non mutated)
  • MGMT Negative
  • p53 Negative
  • p16 Negative T
  • opoisomerase labeling index: Approximately 1-2%.

DIAGNOSIS:

IDH-1 mutant diffuse glioma, favoring astrocytoma (WHO Grade II). ( Morphologically tumor cells demonstrate astrocytic differentiation however the immunohistochemistry results show absent p53 staining and intact ATRX staining, therefore 1p19q molecular testing is recommended) FISH for chromosome 1p/19q deletion.

Results: Chromosome 1p/19q co-deletion detected by FISH.

FINAL DIAGNOSIS: Oligodendroglioma IDH mutant chromosome 1p/19q co-deleted (WHO Grade II).

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Case information

rID: 54574
Published: 5th Nov 2017
Last edited: 12th Feb 2019
Inclusion in quiz mode: Included

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