1 / 38

Case 3

2010 년 10 월 가을학술대회 신경병리 연구회. Case 3. 울산대학교 의과대학 서울아산병원 병리과 김선아. Clinical history. 65/M Personality change, headache, gait disturbance for one month Admitted for seizure with loss of consciousness. Summary of histology. Oligodendroglioma , anaplastic Suspicious astrocytoma component

kenyon-mccarty
Download Presentation

Case 3

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 2010년 10월 가을학술대회 신경병리 연구회 Case 3 울산대학교 의과대학 서울아산병원 병리과 김선아

  2. Clinical history • 65/M • Personality change, headache, gait disturbance for one month • Admitted for seizure with loss of consciousness

  3. Summary of histology • Oligodendroglioma, anaplastic • Suspicious astrocytoma component • Dysplastic ganglion cells

  4. Synaptophysin • Anaplasticoligoastrocytoma • Ganlgioglioma

  5. Synaptophysin

  6. Synaptophysin Anaplasticoligoastrocytoma Ganlgioglioma

  7. Neu N Anaplasticoligoastrocytoma Ganlgioglioma Adjacent normal brain

  8. Ki-67 Anaplasticoligoastrocytoma Ganlgioglioma

  9. GFAP Analplasticoligoastrocytoma Ganlgioglioma

  10. 1p19q deletion - Chromosome 1p/19q is stable: 1p (0/2) & 19q (0/2) D1S508 D19S412 D1S186 D1S2734 D19S219 ----------------------------------------------------------- No NoNo N/A No ----------------------------------------------------------- The LOH patterns were identical between oligoastrocytoma component and ganglioglioma component

  11. Oral mucosa Ganglioglioma Anaplasticoligoastro-cytoma Oral mucosa Ganglioglioma Anaplasticoligoastro-cytoma

  12. What do we call this tumor? • Anaplasticoligoastrocytoma with ganglioglioma-like maturation • Ganglioglioma with anaplasticoligoastrocytic component • Composite tumor of anaplasticoligoastocytoma and ganglioglioma

  13. Oligodendroglioma with neurocytic differentiation • Oligodendroglioma may contain neoplastic cells that express synaptophysin and/or neurofilatments (Vajtai et al. Oligodendroglioma with neurocytic differentiation and characteristic loss of heterozygosity on chromosomes 1p and 19q, Acta Neuropathol (2005) 110: 520–522) • Neurocytic differentiation has also been demonstrated by ultrastructural level (Vyberg et al. Neuronal features of oligodendrogliomas—an ultrastructural and immunohistochemical study, Histopathology 2007, 50, 887–896) • The neuronal phenotype is usually not evident by routine histology alone

  14. Anaplasticganglioglioma • Glioal component of ganglioglioma may resemble fibrillaryastrocytoma, oligodendroglioma or pilocyticastrocytoma • Malignant change almost invariably involves the glial component

  15. Synaptophysin Neurofilament

  16. Differences from ganglioglioma • No eosinophilic granular body • No CD34-positive cells • Less prominent perivascular lymphocytic infiltration • Older age (median 44y) • No history of chronic seizure disorder • Neuroimaging : characteristic findings of diffuse gliomas in three cases (infiltrative growth, significant mass effect, involvement of corpus callosum)

  17. Deletion of 1p and/or 19q • 80~90% of oligodendroglioma • Less frequently in anaplasticoligodendroglioma • 30~40% of oligoastrocytoma

More Related