Anaplastic oligodendroglioma NOS

Discussion:

The patient went on to have surgery. 

Histology

This is a high-grade mixed oligoastrocytoma that shows necrosis; which should be classified as glioblastoma with oligodendroglial component, although it might have a better prognosis than standard glioblastoma.

The previous material was reviewed and it shows low-grade oligodendroglioma.

Immunohistochemistry:
GFAP+, P53+ strongly, KI-67 high (over 25%)

Final diagnosis:  Glioblastoma with oligodendroglial component, WHO grade IV.

NoteUnder the current (2016) WHO classification of CNS tumors, this tumor is not easily classified. If the original tumor was indeed an oligodendroglioma (IDH mutant, 1p19q co-deleted) then this is now an anaplastic oligodendroglioma and not a glioblastoma.

As molecular status is unavailable this is best thought of as an oligodendroglioma NOS progressing to an anaplastic oligodendroglioma NOS.

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