Oligodendroglioma NOS

Case contributed by A.Prof Frank Gaillard

Presentation

Adult patient presenting with a seizure.

CT brain

Modality: CT

CT demonstrates an ill-defined region of positive mass effect with calcifications. 

MRI brain

Modality: MRI

MRI confirms the abnormality. which is high T2 and intermediate T1 in signal, with little contrast enhancement. MR perfusion demonstrates significantly increased CBV (area 'under' the purple curve) compared to the other side. 

Case Discussion

The patient went on to have a biopsy of the mass. 

Histology

Microscopic Description: 

Sections show a neoplasm comprised predominantly of small round cells demonstrating a minimal degree of pleomorphism and frequent perinuclear halos. No mitotic figures are evident. There is no endothelial proliferation and no necrosis is evident. Toluidine blue-stained plastic sections of the glutaraldehyde-fixed tissue show no additional findings.

Immunohistochemistry shows that scattered cells are positive for glial fibrillary acidic protein (GFAP). The lesion shows a uniform distribution of MIB-1 positive cells. No p53-positive cells were seen.

FINAL DIAGNOSIS:  This stereotactic brain biopsy shows histological features of a low-grade oligodendroglial tumour. Thus, the features are consistent with an oligodendroglioma.

Note: This case predates the recent (2016) revision WHO classification of CNS tumours, and thus molecular markers (IDH mutation and 1p19q co-deletion) are not available. As such, this tumour would now be classified as an oligodendroglioma NOS.

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Case Information

rID: 5309
Case created: 2nd Jan 2009
Last edited: 20th May 2017
Inclusion in quiz mode: Included

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