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Hoeberigs MC, Beckervordersandforth JC, de Bruyn G, Klinkenberg S, Schijns OEMG. A teenage girl with drug-resistant epilepsy and a hippocampal angiocentric neuroepithelial tumor (ANET) - illustrative case of 7T MRI in clinical practice. Seizure 2024; 121:152-155. [PMID: 39181014 DOI: 10.1016/j.seizure.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/14/2024] [Accepted: 08/05/2024] [Indexed: 08/27/2024] Open
Affiliation(s)
- M Christianne Hoeberigs
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands; Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht-Heeze, the Netherlands.
| | | | - G de Bruyn
- Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht-Heeze, the Netherlands
| | - S Klinkenberg
- Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht-Heeze, the Netherlands; Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - O E M G Schijns
- Academic Center for Epileptology, Maastricht University Medical Center and Kempenhaeghe, Maastricht-Heeze, the Netherlands; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands; Mental Health and Neuroscience Research Institute (MHeNS), Maastricht University, Maastricht, the Netherlands
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2
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Li T, Aihemaitiniyazi A, Zhang H, Wei D, Hu Y, Guan Y, Zhou J, Qi X, Wang M, Wu B, Zhu M, Zhang L, Luan G, Liu C. Clinical characteristics and detection of MYB-QKI fusions in patients with angiocentric glioma. Neurol Sci 2024:10.1007/s10072-024-07721-3. [PMID: 39098857 DOI: 10.1007/s10072-024-07721-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Accepted: 07/29/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE Angiocentric glioma (AG), a benign tumor identified within the last two decades, was officially included in the 2007 WHO Classification of Tumors of the Central Nervous System, WHO grade I. The tumor is relatively rare, with only approximately 100 cases reported. We aim to complement the characteristics and long-term prognosis of AG, as well as to detect MYB-QKI fusions. METHODS The characteristics of all cases collected between 1 March 2009 and 1 March 2023 at the Beijing Sanbo Brain Hospital, Capital Medical University, were summarized and analyzed. Additionally, all fourteen patients were tested for MYB-QKI fusions. RESULTS AG more predominantly occurs in adolescents (median age 16.5-year-old), and commonly presents with drug-resistant epilepsy. AG is frequently localized in the supratentorial regions and only one patient is in the brainstem. Brain parenchyma atrophy, and stalk-like signs can observe in imaging. Pathologically, tumor cells are perivascular pseudorosettes, presenting immunoreactivity for GFAP, S-100, Vimentin, "dot-like" staining for EMA, and low proliferative activity. Focal cortex dysplasia was observed in four patients. Twelve of fourteen (85.7%) patients were found with MYB-QKI fusions. Completely surgical resection typically has a satisfactory prognosis with long-term follow-up. CONCLUSION AG is a rare benign tumor with a favorable prognosis after complete resection, characterized by refractory epilepsy, frequently occurring in adolescents. MYB-QKI fusions were detected in most AG patients, as a good defining genetic alteration pathologically. The potential presence of focal cortical dysplasia (FCD) may affect the prognosis of epilepsy.
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Affiliation(s)
- Tiemin Li
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Adilijiang Aihemaitiniyazi
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Huawei Zhang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Da Wei
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Yue Hu
- Department of Neurosurgery, Aviation General Hospital, China Medical University, Beijing, 100012, China
| | - Yuguang Guan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Jian Zhou
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Xueling Qi
- Department of Pathology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China
| | - Mengyang Wang
- Department of Neurology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China
| | - Bin Wu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Mingwang Zhu
- Department of Radiology, Sanbo Brain Hospital, Capital Medical University, Beijing, 100093, China
| | - Linpeng Zhang
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China
| | - Guoming Luan
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China.
| | - Changqing Liu
- Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, No. 50, Yikesong, Xiangshan, Haidian District, Beijing, 100093, China.
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China.
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Wagner MW, Jabehdar Maralani P, Bennett J, Nobre L, Lim-Fat MJ, Dirks P, Laughlin S, Tabori U, Ramaswamy V, Hawkins C, Ertl-Wagner BB. Brain Tumor Imaging in Adolescents and Young Adults: 2021 WHO Updates for Molecular-based Tumor Types. Radiology 2024; 310:e230777. [PMID: 38349246 DOI: 10.1148/radiol.230777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Published in 2021, the fifth edition of the World Health Organization (WHO) classification of tumors of the central nervous system (CNS) introduced new molecular criteria for tumor types that commonly occur in either pediatric or adult age groups. Adolescents and young adults (AYAs) are at the intersection of adult and pediatric care, and both pediatric-type and adult-type CNS tumors occur at that age. Mortality rates for AYAs with CNS tumors have increased by 0.6% per year for males and 1% per year for females from 2007 to 2016. To best serve patients, it is crucial that both pediatric and adult radiologists who interpret neuroimages are familiar with the various pediatric- and adult-type brain tumors and their typical imaging morphologic characteristics. Gliomas account for approximately 80% of all malignant CNS tumors in the AYA age group, with the most common types observed being diffuse astrocytic and glioneuronal tumors. Ependymomas and medulloblastomas also occur in the AYA population but are seen less frequently. Importantly, biologic behavior and progression of distinct molecular subgroups of brain tumors differ across ages. This review discusses newly added or revised gliomas in the fifth edition of the CNS WHO classification, as well as other CNS tumor types common in the AYA population.
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Affiliation(s)
- Matthias W Wagner
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Pejman Jabehdar Maralani
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Julie Bennett
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Liana Nobre
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Mary Jane Lim-Fat
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Peter Dirks
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Suzanne Laughlin
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Uri Tabori
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Vijay Ramaswamy
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Cynthia Hawkins
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
| | - Birgit B Ertl-Wagner
- From the Division of Neuroradiology, Department of Diagnostic Imaging (M.W.W., S.L., B.B.E.W.), Division of Hematology/Oncology (J.B., L.N., U.T., V.R.), Department of Paediatric Laboratory Medicine, Division of Pathology (C.H.), Division of Neurosurgery (P.D.), and Division of Pediatric Neuroradiology (M.W.W.), The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8; Neurosciences & Mental Health Research Program, SickKids Research Institute, Toronto, Canada (M.W.W., B.B.E.W.); Department of Medical Imaging, University of Toronto, Toronto, Canada (M.W.W., P.J.M., B.B.E.W.); Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany (M.W.W.); Divisions of Neuroradiology (P.J.M.) and Neurooncology (M.J.L.F.), Sunnybrook Health Science Centre, Toronto, Canada; and Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada (J.B.)
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Yano Y, Matsuda R, Okada F, Takeda M, Maeoka R, Nakgawa I. Awake Surgery for Angiocentric Glioma in the Eloquent Area in an Adolescent: A Case Report. Brain Tumor Res Treat 2024; 12:75-79. [PMID: 38317492 PMCID: PMC10864135 DOI: 10.14791/btrt.2023.0044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 02/07/2024] Open
Abstract
Angiocentric glioma (AG) is an extremely rare tumor that often develops in adolescents. Awake surgery for AG occurring in the eloquent area has not been reported to date. We report a case involving a right-handed 15-year-old boy with AG. He presented with a first-time generalized tonic-clonic seizure and was rushed to the local hospital. CT of the head indicated a left frontal low-density mass with no calcification. He was subsequently referred to our hospital. Comparison with a CT scan obtained two years prior due to mild head trauma indicated that the lesion showed a trend toward enlargement. The lesion was located in the anterior and lateral portions of the primary motor cortex, and MRI showed homogenous hypointensity on T1-weighted and hyperintensity on T2-weighted images. Contrast-enhanced MRI showed a linear contrast effect. The patient underwent awake surgery with successful intraoperative brain mapping and total resection, and brain function was preserved. Pathological analysis revealed AG. He returned to his normal life and has shown no recurrence without additional treatment for 2 years. Thus, awake surgery for complete tumor resection while preserving brain function is effective and safe even in adolescents with AGs.
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Affiliation(s)
- Yuma Yano
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan
- Department of Neurosurgery, Ohnishi Neurologic Center, Akashi, Japan
| | - Ryosuke Matsuda
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan.
| | - Fumi Okada
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan
| | - Maiko Takeda
- Department of Diagnostic Pathology, Nara Medical University, Kashihara, Japan
| | - Ryosuke Maeoka
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan
| | - Ichiro Nakgawa
- Department of Neurosurgery, Nara Medical University, Kashihara, Japan
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Rosemberg S. Long-term epilepsy associated-tumors (LEATs): what is new? ARQUIVOS DE NEURO-PSIQUIATRIA 2023; 81:1146-1151. [PMID: 38157880 PMCID: PMC10756815 DOI: 10.1055/s-0043-1777730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Abstract
Long-term epilepsy-associated tumors (LEATs) include a series of neoplasms that commonly occur in children, adolescents, or young adults, have an astrocytic or glioneuronal lineage, are histologically benign (WHO grade1) with a neocortical localization predominantly situated in the temporal lobes. Clinically, chronic refractory epilepsy is usually the unique symptom. Gangliogliomas (GG) and dysembryoplastic neuroepithelial tumors (DNT) are the most common representative entities besides pilocytic astrocytomas (PA) and angiocentric gliomas (AG). Recent molecular studies have defined new clinicopathological entities, which are recognized by the WHO 2021 classification of brain tumors. Some of them such as diffuse astrocytoma MIB or MYBL1 altered, polymorphous low-grade neuroepithelial tumor of the young (PLNTY), and multilocular and vacuolating neuronal tumor (MVNT) are currently considered LEATs. The relationship between LEATs and epilepsy is still a matter of debate, and there is a general agreement about the beneficial effects of an early neurosurgical intervention on the clinical outcome.
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Affiliation(s)
- Sergio Rosemberg
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Patologia, São Paulo SP, Brazil.
- Santa Casa de São Paulo, Faculdade de Ciências Médicas, São Paulo SP, Brazil.
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Yamano A, Yanaka K, Onuma K, Nakamura K, Takahashi N, Kohzuki H, Sakamoto N, Matsuda M, Ishikawa E. Significance of perilesional T1 hyperintense areas in the differential diagnosis of primary adult-type diffuse glioma: A case report. Radiol Case Rep 2023; 18:3448-3452. [PMID: 37502482 PMCID: PMC10369393 DOI: 10.1016/j.radcr.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/08/2023] [Indexed: 07/29/2023] Open
Abstract
Perilesional T1 hyperintensity on magnetic resonance imaging (MRI) of intra-axial brain masses is an unusual feature of the perilesional area, characteristic of cavernous malformations (CMs) and metastatic brain tumors (METs). Here, we report a case of primary diffuse glioma with a perilesional T1 hyperintense area (HIA) on MRI. A 61-year-old woman with transient aphasia visited our hospital. Radiological examination revealed an intra-axial mass with acute/subacute hemorrhaging and calcification in the left frontal lobe. It was presumed to be a CM because of the perilesional T1 HIA. Gross total resection of the tumor was performed, and the pathological diagnosis was anaplastic oligodendroglioma, not otherwise specified by World Health Organization 2016 classification. Histopathological findings in the perilesional T1 HIA indicated hemorrhage involvement in the surrounding white matter. No recurrence appeared after radio-chemotherapy. Perilesional T1 HIAs, characteristic of CMs and METs, are also seen in primary diffuse gliomas. Therefore, caution should be taken when using this sign for the differential diagnosis of intracranial masses.
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Affiliation(s)
- Akinari Yamano
- Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Kiyoyuki Yanaka
- Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan
| | - Kuniyuki Onuma
- Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan
| | - Kazuhiro Nakamura
- Department of Neurosurgery, Tsukuba Memorial Hospital, Tsukuba, Ibaraki, Japan
| | - Nobuyuki Takahashi
- Department of Radiology, Tsukuba Memorial Hospital, Tsukuba City, Ibaraki, Japan
| | - Hidehiro Kohzuki
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Noriaki Sakamoto
- Department of Pathology, Faculty of Medicine, University of Tsukuba, Tsukuba City, Ibaraki, Japan
| | - Masahide Matsuda
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
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Reisz Z, Radics BL, Nemes P, Laxton R, Kaizer L, Gabor KM, Novak T, Barzo P, Al-Sarraj S, Bodi I. Case Report: Brainstem angiocentric glioma presenting in a toddler child-diagnostic and therapeutic challenges. Pathol Oncol Res 2023; 29:1611231. [PMID: 37362245 PMCID: PMC10287963 DOI: 10.3389/pore.2023.1611231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023]
Abstract
Introduction: Angiocentric gliomas (AG) in brainstem location are exceedingly rare and might cause differential diagnostic problems and uncertainty regarding the best therapeutic approach. Hereby, we describe the clinicopathological findings in a brainstem AG presenting in a toddler child and review the literature. Case report: A 2-year-old boy presented with 5 weeks history of gait disturbances, frequent falls, left-sided torticollis and swallowing problems. MRI head showed a T2-hyperintense, partly exophytic mass lesion centred in the pontomedullary region, raising the possibility of diffuse midline glioma. The exophytic component was partially resected by suboccipital craniotomy, leaving intact the infiltrative component. Ventriculoperitoneal shunt was implanted due to postoperative hydrocephalus. Histological examination revealed a moderately cellular tumour consisted of bland glial cells infiltrating the brain parenchyma and radially arranged around the blood vessels. By immunohistochemistry, the tumour strongly expressed S100 and GFAP in addition to intense nestin positivity, while OLIG2 was negative in the perivascular tumour cells. DNA methylation array profiled the tumour as "methylation class diffuse astrocytoma, MYB or MYBL1-altered subtype B (infratentorial)" and an in-frame MYB::QKI fusion was identified by RNA sequencing, confirming the diagnosis of angiocentric glioma. The patient has been initially treated with angiogenesis inhibitor and mTOR inhibitor, and now he is receiving palliative vinblastine. He is clinically stable on 9 months follow-up. Conclusion: Brainstem AG may cause a diagnostic problem, and the surgical and oncological management is challenging due to unresectability and lack of response to conventional chemo-radiation. In the future, genetically-tailored therapies might improve the prognosis.
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Affiliation(s)
- Zita Reisz
- Department of Clinical Neuropathology, King’s College Hospital, London, United Kingdom
| | | | - Peter Nemes
- Department of Neurosurgery, University of Szeged, Szeged, Hungary
| | - Ross Laxton
- Department of Clinical Neuropathology, King’s College Hospital, London, United Kingdom
| | - Laszlo Kaizer
- Department of Pathology, University of Szeged, Szeged, Hungary
| | - Krisztina Mita Gabor
- Department of Pediatrics and Pediatric Healthcare Center, University of Szeged, Szeged, Hungary
| | - Timea Novak
- Department of Radiology, University of Szeged, Szeged, Hungary
| | - Pal Barzo
- Department of Neurosurgery, University of Szeged, Szeged, Hungary
| | - Safa Al-Sarraj
- Department of Clinical Neuropathology, King’s College Hospital, London, United Kingdom
| | - Istvan Bodi
- Department of Clinical Neuropathology, King’s College Hospital, London, United Kingdom
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8
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Wu PB, Filley AC, Miller ML, Bruce JN. Benign Glioma. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1405:31-71. [PMID: 37452934 DOI: 10.1007/978-3-031-23705-8_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
Benign glioma broadly refers to a heterogeneous group of slow-growing glial tumors with low proliferative rates and a more indolent clinical course. These tumors may also be described as "low-grade" glioma (LGG) and are classified as WHO grade I or II lesions according to the Classification of Tumors of the Central Nervous System (CNS) (Louis et al. in Acta Neuropathol 114:97-109, 2007). Advances in molecular genetics have improved understanding of glioma tumorigenesis, leading to the identification of common mutation profiles with significant treatment and prognostic implications. The most recent WHO 2016 classification system has introduced several notable changes in the way that gliomas are diagnosed, with a new emphasis on molecular features as key factors in differentiation (Wesseling and Capper in Neuropathol Appl Neurobiol 44:139-150, 2018). Benign gliomas have a predilection for younger patients and are among the most frequently diagnosed tumors in children and young adults (Ostrom et al. in Neuro Oncol 22:iv1-iv96, 2020). These tumors can be separated into two clinically distinct subgroups. The first group is of focal, well-circumscribed lesions that notably are not associated with an increased risk of malignant transformation. Primarily diagnosed in pediatric patients, these WHO grade I tumors may be cured with surgical resection alone (Sturm et al. in J Clin Oncol 35:2370-2377, 2017). Recurrence rates are low, and the prognosis for these patients is excellent (Ostrom et al. in Neuro Oncol 22:iv1-iv96, 2020). Diffuse gliomas are WHO grade II lesions with a more infiltrative pattern of growth and high propensity for recurrence. These tumors are primarily diagnosed in young adult patients, and classically present with seizures (Pallud et al. Brain 137:449-462, 2014). The term "benign" is a misnomer in many cases, as the natural history of these tumors is with malignant transformation and recurrence as grade III or grade IV tumors (Jooma et al. in J Neurosurg 14:356-363, 2019). For all LGG, surgery with maximal safe resection is the treatment of choice for both primary and recurrent tumors. The goal of surgery should be for gross total resection (GTR), as complete tumor removal is associated with higher rates of tumor control and seizure freedom. Chemotherapy and radiation therapy (RT), while not typically a component of first-line treatment in most cases, may be employed as adjunctive therapy in high-risk or recurrent tumors and in some select cases. The prognosis of benign gliomas varies widely; non-infiltrative tumor subtypes generally have an excellent prognosis, while diffusely infiltrative tumors, although slow-growing, are eventually fatal (Sturm et al. in J Clin Oncol 35:2370-2377, 2017). This chapter reviews the shared and unique individual features of the benign glioma including diffuse glioma, pilocytic astrocytoma and pilomyxoid astrocytoma (PMA), subependymal giant cell astrocytoma (SEGA), pleomorphic xanthoastrocytoma (PXA), subependymoma (SE), angiocentric glioma (AG), and chordoid glioma (CG). Also discussed is ganglioglioma (GG), a mixed neuronal-glial tumor that represents a notable diagnosis in the differential for other LGG (Wesseling and Capper 2018). Ependymomas of the brain and spinal cord, including major histologic subtypes, are discussed in other chapters.
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Affiliation(s)
- Peter B Wu
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, UCLA, Los Angeles, USA
| | - Anna C Filley
- Department of Neurosurgery, Columbia University Medical Center, New York, USA
| | - Michael L Miller
- Department of Pathology and Cell Biology, Columbia University Medical Center, New York, USA
| | - Jeffrey N Bruce
- Department of Neurosurgery, Columbia University Medical Center, New York, USA.
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9
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Fabbri VP, Caporalini C, Asioli S, Buccoliero A. Paediatric-type diffuse low-grade gliomas: a clinically and biologically distinct group of tumours with a favourable outcome. Pathologica 2022; 114:410-421. [PMID: 36534420 PMCID: PMC9763978 DOI: 10.32074/1591-951x-828] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/12/2022] [Indexed: 12/23/2022] Open
Abstract
The WHO 2021 classification of central nervous system cancers distinguishes diffuse gliomas that arise in adults (referred to as the "adult type") and those that arise in children (defined as "paediatric") based on clinical and molecular characteristics."). However, paediatric-type gliomas may occasionally be present in younger adults and occasionally adult-type gliomas may occur in children. Diffuse low-grade paediatric glioma includes diffuse astrocytoma altered by MYB or MYBL1, low-grade polymorphic juvenile neuroepithelial tumour, angiocentric glioma, and diffuse low-grade glioma with an altered MAPK pathway. Here, we examine these newly recognised entities according to WHO diagnostic criteria and propose an integrated diagnostic approach that can be used to separate these clinically and biologically distinct tumor groups.
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Affiliation(s)
- Viscardo Paolo Fabbri
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy,Azienda Ospedaliero Universitaria Policlinico Modena, Modena, Italy,Correspondence Viscardo Paolo Fabbri PhD Student of Department of Biomedical and Neuromotor Sciences (School of Oncology, Haemathology and Pathology Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Italy) Bellaria Hospital, via Altura 3, Bologna, Italy E-mail:
| | | | - Sofia Asioli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy, Programma Neurochirurgia Ipofisi- Pituitary Unit, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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10
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2021 WHO classification of tumours of the central nervous system: a review for the neuroradiologist. Neuroradiology 2022; 64:1919-1950. [DOI: 10.1007/s00234-022-03008-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
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11
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Zhang R, Xu X, Zhou H, Yao D, Wei R, Muhammad S. Pediatric angiocentric glioma with acute intracerebral hemorrhage: A case report with 36 months follow-up. Surg Neurol Int 2021; 12:499. [PMID: 34754549 PMCID: PMC8571264 DOI: 10.25259/sni_791_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background: Angiocentric glioma (AG) is an extremely rare intracranial tumor that was first described in 2005 and identified as a special type of intracranial tumor in 2007 by the WHO, which mainly affects children and young adolescents. Epilepsy is the main presentation; therefore, it was recognized as a seizure-related tumor in the past. Here, we report a case of AG with acute intracerebral hemorrhage (ICH) as the first symptom who never had a seizure onset. Case Description: A 3-year-old girl with the right limb weakness was admitted to our hospital 4 h after onset in 2018. Computed tomography showed a hematoma of about 20 ml accompanied by a hyper/iso-dense spheroid lesion located in the sub-cortex of the left parietal lobe. Magnetic resonance image (MRI) showed signs of hypointense signal in T1, T2, and fluid-attenuated inversion recovery sequence, distinct enhancement of this tumefactive lesion in the contrast-enhanced sequence. Thus, the admission diagnosis was neoplasm with acute ICH. A gross total resection of the tumor was achieved by parietal craniotomy. The histopathological diagnosis was AG. No signs showed tumor recurrence after 36 months of follow-up. Conclusion: This is the sole case of AGs with acute intracranial hemorrhage as the first symptom without any kind of epilepsy by far. This case had unique MRI signs that were different from the previous description. This case enriches the clinical and radiological manifestations of AG and reveals that further investigations are needed to further understand AG.
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Affiliation(s)
- Rui Zhang
- Department of Neurosurgery, Xingtai People's Hospital Hebei Medical University, Xingtai, China.,Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Xin Xu
- Department of Pathology, Xingtai People's Hospital Hebei Medical University
| | - Huakang Zhou
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Dongying Yao
- Department of Pathology, Xingtai People's Hospital Hebei Medical University
| | - Ru Wei
- Department of Microbiology and Immunology, Xingtai Medical College, Xingtai, China
| | - Sajjad Muhammad
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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12
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Wang Q, Xiong Y, Chen J, Shao Q. Cystic angiocentric glioma: a case report and literature review. Childs Nerv Syst 2021; 37:2701-2705. [PMID: 32979070 DOI: 10.1007/s00381-020-04882-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/06/2020] [Indexed: 12/14/2022]
Abstract
Angiocentric glioma (AG) is a rare form of brain tumor characterized by cortical epileptogenic lesions that show angiocentric patterns upon histopathological examination. Cystoid degeneration is a rare radiological manifestation of this condition. We report a case involving the left eloquent cortical areas and review the clinical features of angiocentric glioma. A 10-year-old girl presented with a history of refractory drug-resistant epilepsy. Imaging revealed a cystic-solid neoplasm within the left frontal lobe. Surgical procedures were performed, and it was observed that the pathological manifestations were consistent with those of AG. Angiocentric glioma should be considered for diagnosis when the supratentorial cortical neoplasm contains a cystic component. The diagnosis of AG can be confirmed by histopathological examination. Gross total resection is the recommended strategy for controlling seizures elicited by this condition.
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Affiliation(s)
- Qiqi Wang
- Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan, 430014, China
| | - Yubo Xiong
- Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan, 430014, China
| | - Jun Chen
- Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan, 430014, China
| | - Qiang Shao
- Department of Neurosurgery, Wuhan Brain Hospital, No. 5 Huiji Road, Wuhan, 430014, China.
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13
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Abstract
Angiocentric glioma is a rare brain tumor commonly found in frontal or temporal lobes. It has a benign course, and surgical resection can be curative. Brainstem location is extremely rare, with only six cases reported so far in the literature. In the present study, the seventh case of brainstem angiocentric glioma has been reported, and its course in comparison with supratentorial location and the role of molecular diagnosis has been discussed.
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Affiliation(s)
- Abdulaziz O Almubarak
- Neuroscience Department, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. E-mail:
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Angiocentric glioma-associated seizures: The possible role of EATT2, pyruvate carboxylase and glutamine synthetase. Seizure 2021; 86:152-154. [PMID: 33621827 DOI: 10.1016/j.seizure.2021.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Our purpose was to better understand the pathogenesis of seizures associated with angiocentric glioma. Angiocentric glioma is an indolent and rare low-grade glioma. Its typical clinical presentation is with epileptic seizures. The pathogenesis of tumor-associated seizures is poorly understood. Among the possible pathomechanisms, the increased neurotoxic concentrations of the glutamate has been proposed. Glutamate transporters, pyruvate carboxylase and glutamine synthetase are involved in maintaining the physiological concentration of glutamate in the inter synaptic spaces. METHODS We evaluated the immunohistochemical expression of EAAT2 (the most important glutamate transporter), pyruvate carboxylase and glutamine synthetase in 17 angiocentric gliomas. RESULTS EAAT2 was never expressed (0%) in the neoplastic cells in none of the cases studied. Pyruvate carboxylase was expressed in the cytoplasm of the neoplastic cells in 16/17 cases (94 %). Glutamine synthetase was expressed in the cytoplasm of the neoplastic cells in 15/17 cases (88 %). CONCLUSION The net result of this enzymatic expression, in particular considering the loss of EAAT2, could be an increased glutamate concentration in the synaptic clef, which might increase local network excitability initially involving intratumoral neurons. The observation that the angiocentric glioma-associated epilepsy might be at least in part related to EAAT2 deficiency opens up interesting therapeutic perspectives.
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Tran S, Mathon B, Morcos-Sauvain E, Lerond J, Navarro V, Bielle F. [Neuropathology of epilepsy]. Ann Pathol 2020; 40:447-460. [PMID: 33092907 DOI: 10.1016/j.annpat.2020.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/02/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
The neuropathology of epilepsy aims at diagnosing the cerebral lesions underlying epilepsy that are obtained from epilepsy surgery, or rarely from biopsy or autopsy. The main histopathological and immunohistochemical characteristics of several entities are described: epilepsy-associated hippocampal sclerosis, long-term epilepsy-associated tumours, cortical malformations, vascular malformations, glial scars, encephalitides, and focal neuronal lipofuscinosis. The diagnostic approach, the differential diagnosis and the histochemical and immunohistochemical tools are detailed in order to provide the pathologist with a summarized toolkit to handle the broad range of epileptogenic lesions.
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Affiliation(s)
- Suzanne Tran
- Département de neuropathologie, laboratoire Escourolle, hôpital de la Pitié-Salpêtrière, AP-HP, 46-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Bertrand Mathon
- Inserm, CNRS, Paris brain institute, ICM, Sorbonne université, AP-HP, Paris, France; Service de neurochirurgie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France
| | - Elise Morcos-Sauvain
- Département de neuropathologie, laboratoire Escourolle, hôpital de la Pitié-Salpêtrière, AP-HP, 46-83, boulevard de l'Hôpital, 75013 Paris, France
| | - Julie Lerond
- Inserm, CNRS, Paris brain institute, ICM, Sorbonne université, AP-HP, Paris, France; SiRIC curamus (cancer united research associating medicine, university & society), site de recherche intégrée sur le cancer IUC, Sorbonne université, AP-HP, Paris, France
| | - Vincent Navarro
- Inserm, CNRS, Paris brain institute, ICM, Sorbonne université, AP-HP, Paris, France; Service de neurologie, hôpital de la Pitié-Salpêtrière, AP-HP, Paris, France; Centre de référence des épilepsies rares, Paris, France
| | - Franck Bielle
- Département de neuropathologie, laboratoire Escourolle, hôpital de la Pitié-Salpêtrière, AP-HP, 46-83, boulevard de l'Hôpital, 75013 Paris, France; Inserm, CNRS, Paris brain institute, ICM, Sorbonne université, AP-HP, Paris, France; SiRIC curamus (cancer united research associating medicine, university & society), site de recherche intégrée sur le cancer IUC, Sorbonne université, AP-HP, Paris, France.
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16
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Han G, Zhang J, Ma Y, Gui Q, Yin S. Clinical characteristics, treatment and prognosis of angiocentric glioma. Oncol Lett 2020; 20:1641-1648. [PMID: 32724405 PMCID: PMC7377082 DOI: 10.3892/ol.2020.11723] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 05/18/2020] [Indexed: 01/21/2023] Open
Abstract
Angiocentric glioma (AG) is a rare subtype of neuroepithelial tumor in children and young adults that commonly presents with seizures. To study the clinical characteristics, treatment and prognosis of patients with AG, the features of two cases of AG were described and 108 cases reported in the literature were assessed. The cases of the present study were two males aged 8 and 16 years, who mainly presented with seizures. MRI revealed superficial, non-enhanced lesions in the left temporal and right frontal lobe, respectively. The two patients underwent gross total resection (GTR) and remained seizure-free without neurological deficits after 3.5 and 2.5 years, respectively. Histopathological examination revealed that the tumors consisted of monomorphous cells that surrounded the blood vessels and neurons in the cerebral cortex, and formed concentric sleeves or pseudorosettes. Furthermore, immunostaining indicated that the diffuse infiltrative neoplastic cells were positive for glial fibrillary acidic protein and a dot-like pattern of epithelial membrane antigen was observed. AG mostly appeared similar to low-grade gliomas on MRI. GTR of the lesions was curative and radiation or chemotherapy were not required. AG typically has a favorable prognosis, with low mortality and incidence of disability.
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Affiliation(s)
- Guoqing Han
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300350, P.R. China
| | - Junsi Zhang
- Department of Neurology, Tianjin Children's Hospital, Tianjin 300074, P.R. China
| | - Yue Ma
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin 300350, P.R. China
| | - Qiuping Gui
- Department of Pathology, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Shi Yin
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, P.R. China
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17
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Meredith DM. Advances in Diagnostic Immunohistochemistry for Primary Tumors of the Central Nervous System. Adv Anat Pathol 2020; 27:206-219. [PMID: 30720470 DOI: 10.1097/pap.0000000000000225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
As genomic characterization becomes increasingly necessary for accurate diagnosis of tumors of the central nervous system, identification of rapidly assessible biomarkers is equally important to avoid excessive cost and delay in initiation of therapy. This article reviews novel immunohistochemical markers that may be used to determine mutation status, activation of signaling pathways, druggable targets, and cell lineage in many diverse tumor types. In particular, recently added entities to the 2016 WHO classification of central nervous system tumors will be addressed, including IDH-mutant gliomas, diffuse midline glioma, epithelioid glioblastoma, angiocentric glioma, RELA-rearranged ependymoma, embryonal tumors (medulloblastoma, atypical teratoid/rhabdoid tumor, pineoblastoma, embryonal tumor with multilayered rosettes, and other genetically defined high-grade neuroepithelial tumors), and meningiomas associated with germline alterations.
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18
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Senthilvelan S, Kandasamy S, Chandrasekharan K, Thomas B, An D. Unusual imaging appearance of a rare cortical ependymoma mimicking angiocentric glioma. Neurol Sci 2020; 41:1935-1938. [PMID: 32239344 DOI: 10.1007/s10072-020-04364-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/20/2020] [Indexed: 11/28/2022]
Abstract
Cortical ependymomas are uncommon lesions. We report a cortical ependymoma displaying an unusual imaging pattern. The lesion demonstrated a T1 hyperintense rim and limited perilesional edema but lacked contrast enhancement. T1 hyperintense rim and stalk-like ventricular extension of FLAIR hyperintensity have previously been considered pathognomonic of angiocentric glioma. Hence, we conclude that the radiologists should be aware of this uncommon imaging pattern of cortical ependymoma. The condition warrants prompt surgical management in view of the increased potential for higher grade transformation, unlike grade I roman numeral may be given angiocentric gliomas.
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Affiliation(s)
- Santhakumar Senthilvelan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal, Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India.
| | - Sathish Kandasamy
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal, Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - Kesavadas Chandrasekharan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal, Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - Bejoy Thomas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal, Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695011, India
| | - Deepti An
- Department of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
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Gupta S, Rangari KV, Mehrotra A, Pal L, Jaisawal AK, Kumar R. Temporal lobe angiocentric glioma with oligodendroglioma-like areas: a rare association of an uncommon tumor. A case report with review of literature. Childs Nerv Syst 2020; 36:641-646. [PMID: 31897632 DOI: 10.1007/s00381-019-04445-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 11/19/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Angiocentric glioma (AG) is a relatively uncommon clinico-pathological entity that presents in childhood. Angiocentric glioma displays various histopathological features which resemble cortical ependymoma, astroblastoma, and pilomyxoid astrocytoma and schwannoma. The astrocytes in angiocentric glioma appear peculiarly elongated, bipolar in shape, and characteristically arranged around blood vessels. They resemble radial glia and tanycytes morphologically. Unlike ependymomas, AG is a diffusely infiltrating lesion and perivascular processes are often much thicker than those in classic ependymomas. CASE PRESENTATION AG usually present clinically as seizures, often as medically intractable epilepsy. In the indexed case, apart from unusual presentation with features of raised intra-cranial tension, an unusual histological picture of a more cellular oligodendroglioma like component was also seen. CONCLUSION The appropriate diagnosis is critical as AG is usually slowly growing and treatable by surgical excision alone.
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Affiliation(s)
- Shruti Gupta
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Kamlesh Vasant Rangari
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Anant Mehrotra
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
| | - Lily Pal
- Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Awadhesh Kumar Jaisawal
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
| | - Raj Kumar
- Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India
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O'Halloran PJ, Amoo M, Dablouk MO, Beausang A, MacNally S. Angiocentric glioma: Drop Metastases to the Spinal Cord. World Neurosurg 2020; 136:110-116. [PMID: 31953098 DOI: 10.1016/j.wneu.2020.01.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/04/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND Angiocentric glioma (AG) is an epileptogenic low grade (World Health Organization grade I) glial tumor with astrocytic and ependymal differentiation, most commonly affecting the pediatric and adolescent population. Despite its infiltrating histological growth kinetics, it is widely accepted that AG has a low potential for aggressive behavior. CASE DESCRIPTION We present the case of a 42-year-old man who represents the first documented case of not only extracranial manifestation of AG, but also spinal metastatic dissemination. Our patient initially presented with a generalized tonic clonic seizure; following a biopsy, he was diagnosed with a low-grade supratentorial astrocytoma and subsequently received fractionated radiotherapy. He presented 10 months later with worsening dorsal column symptoms and was found to have a contrast-enhancing intradural extramedullary lesion that was surgically resected and histologically confirmed as an AG. CONCLUSION Further research is required to examine the microenvironment and potential for malignant change in this tumor.
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Affiliation(s)
- Philip J O'Halloran
- Department of Neurosurgery, National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland; Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Michael Amoo
- Department of Neurosurgery, National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland
| | - Mohamed O Dablouk
- Department of Neurosurgery, National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland
| | - Alan Beausang
- Department of Neuropathology, Beaumont Hospital, Dublin, Ireland
| | - Stephen MacNally
- Department of Neurosurgery, National Neurosurgical Centre, Beaumont Hospital, Dublin, Ireland
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21
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da Silva JFC, de Souza Machado GH, Pedro MKF, Vosgerau R, Hunhevicz SC, Ramina R. Angiocentric glioma: Literature review and first case in Brazil. INTERDISCIPLINARY NEUROSURGERY 2019. [DOI: 10.1016/j.inat.2019.100508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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22
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Freiburg Neuropathology Case Conference : Hypersalivatory Seizures in a 6-year-old Child. Clin Neuroradiol 2019; 29:581-586. [PMID: 31388687 DOI: 10.1007/s00062-019-00820-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Abstract
Gliomas are common primary central nervous system neoplasms of dogs and cats, but atypical glioma subtypes are rare. Herein we report an angiocentric astrocytoma in a 15-y-old spayed female domestic shorthaired cat that was euthanized after therapy-resistant seizures. Gross anatomic changes consisted of swelling of the rostral leptomeninges over the olfactory bulbs and rostral telencephalon. Histologically, polygonal-to-elongate atypical neoplastic cells were arranged along perivascular spaces within these areas. Neoplastic cells were positive for glial fibrillary acidic protein, S100 protein, and vimentin. Ultrastructurally, round-to-elongate neoplastic cells emitting long processes with aggregates of intermediary filaments expanded and occupied the spaces between the vascular basement membrane and the glia limitans; nuclei had marginal and central heterochromatin. Tight junctions connected the plasma membrane of neighboring cells. The cell morphology, immunohistochemistry, and ultrastructural findings were consistent with an astrocytoma; the exclusive perivascular arrangement of neoplastic cells with no parenchymal mass warranted the diagnosis of angiocentric astrocytoma.
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Affiliation(s)
- Daniel R Rissi
- Department of Pathology (Rissi, McHale), University of Georgia College of Veterinary Medicine, Athens, GA.,Athens Veterinary Diagnostic Laboratory (Rissi), University of Georgia College of Veterinary Medicine, Athens, GA.,Veterinary Diagnostic Laboratory, Department of Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St. Paul, MN (Armién)
| | - Brittany J McHale
- Department of Pathology (Rissi, McHale), University of Georgia College of Veterinary Medicine, Athens, GA.,Athens Veterinary Diagnostic Laboratory (Rissi), University of Georgia College of Veterinary Medicine, Athens, GA.,Veterinary Diagnostic Laboratory, Department of Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St. Paul, MN (Armién)
| | - Anibal G Armién
- Department of Pathology (Rissi, McHale), University of Georgia College of Veterinary Medicine, Athens, GA.,Athens Veterinary Diagnostic Laboratory (Rissi), University of Georgia College of Veterinary Medicine, Athens, GA.,Veterinary Diagnostic Laboratory, Department of Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St. Paul, MN (Armién)
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Harmsen H, Mobley BC, Davis LT. Angiocentric glioma mimicking encephalomalacia. Radiol Case Rep 2019; 14:700-703. [PMID: 30976372 PMCID: PMC6441711 DOI: 10.1016/j.radcr.2019.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/10/2019] [Accepted: 03/13/2019] [Indexed: 11/29/2022] Open
Abstract
Angiocentric glioma is a rare low-grade neoplasm of the central nervous system which typically presents with medication-refractory seizures in children and young adults. On magnetic resonance imaging, angiocentric glioma is classically T1 hypointense and T2/FLAIR hyperintense. We present the case of a 40-year-old male who had been followed by our institution for 17 years for management of epilepsy. Initial and repeat brain imaging showed an apparent region of cystic encephalomalacia in the right frontal lobe. In an attempt to control his seizures, the lesion was resected. Grossly, the cut surface of the specimen was characterized by multiple small cystic spaces. Microscopically, the lesion was composed of an infiltrative population of glial cells variably arranged in perivascular “pseudorosettes,” nodules, and subpial “palisades.” The final diagnosis was angiocentric glioma. This is the second reported case of an angiocentric glioma mistaken for encephalomalacia.
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Affiliation(s)
- Hannah Harmsen
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA
| | - Bret C Mobley
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA
| | - Larry T Davis
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, 1211 Medical Center Dr, Nashville, TN 37232, USA
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25
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Blümcke I, Coras R, Wefers AK, Capper D, Aronica E, Becker A, Honavar M, Stone TJ, Jacques TS, Miyata H, Mühlebner A, Pimentel J, Söylemezoğlu F, Thom M. Review: Challenges in the histopathological classification of ganglioglioma and DNT: microscopic agreement studies and a preliminary genotype-phenotype analysis. Neuropathol Appl Neurobiol 2018; 45:95-107. [PMID: 30326153 DOI: 10.1111/nan.12522] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/03/2018] [Indexed: 12/28/2022]
Abstract
Low-grade epilepsy-associated brain tumours (LEAT) are the second most common cause for drug-resistant, focal epilepsy, that is ganglioglioma (GG) and dysembryoplastic neuroepithelial tumours (DNT). However, molecular pathogenesis, risk factors for malignant progression and their frequent association with drug-resistant focal seizures remain poorly understood. This contrasts recent progress in understanding the molecular-genetic basis and targeted treatment options in diffuse gliomas. The Neuropathology Task Force of the International League Against Epilepsy examined available literature to identify common obstacles in diagnosis and research of LEAT. Analysis of 10 published tumour series from epilepsy surgery pointed to poor inter-rater agreement for the histopathology diagnosis. The Task Force tested this hypothesis using a web-based microscopy agreement study. In a series of 30 LEAT, 25 raters from 18 countries agreed in only 40% of cases. Highest discordance in microscopic diagnosis occurred between GG and DNT variants, when oligodendroglial-like cell patterns prevail, or ganglion cells were difficult to discriminate from pre-existing neurons. Suggesting new terminology or major histopathological criteria did not satisfactorily increase the yield of histopathology agreement in four consecutive trials. To this end, the Task Force applied the WHO 2016 strategy of integrating phenotype analysis with molecular-genetic data obtained from panel sequencing and 450k methylation arrays. This strategy was helpful to distinguish DNT from GG variants in all cases. The Task Force recommends, therefore, to further develop diagnostic panels for the integration of phenotype-genotype analysis in order to reliably classify the spectrum of LEAT, carefully characterize clinically meaningful entities and make better use of published literature.
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Affiliation(s)
- I Blümcke
- Department of Neuropathology, University Hospital, Erlangen, Germany.,Epilepsy Center, Cleveland Clinic, Cleveland, OH, USA
| | - R Coras
- Department of Neuropathology, University Hospital, Erlangen, Germany
| | - A K Wefers
- Department of Neuropathology, Institute of Pathology, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - D Capper
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.,Institute of Neuropathology, Berlin Institute of Health, Berlin, Germany.,German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - E Aronica
- Department of (Neuro)Pathology, Academic Medisch Centrum (AMC), Amsterdam, The Netherlands.,Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands
| | - A Becker
- Department of Neuropathology, University of Bonn Medical Centre, Bonn, Germany
| | - M Honavar
- Department of Anatomic Pathology, Hospital Pedro Hispano, Matosinhos, Portugal
| | - T J Stone
- Developmental Biology and Cancer Section, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - T S Jacques
- Developmental Biology and Cancer Section, UCL Great Ormond Street Institute of Child Health, London, UK.,Department of Histopathology, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - H Miyata
- Department of Neuropathology, Research Institute for Brain and Blood Vessels -AKITA, Akita, Japan
| | - A Mühlebner
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, The Netherlands.,Department of Pediatrics, Medical University Vienna, Vienna, Austria
| | - J Pimentel
- Laboratory of Neuropathology, Department of Neurology, Hospital de Santa Maria (CHLN), Lisbon, Portugal
| | - F Söylemezoğlu
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - M Thom
- Department of Clinical and Experimental Epilepsy UCL Queens Square, Institute of Neurology, London
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26
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Chaudhari JP, Kothari KS, Pandya TP, Goel NA. Angiocentric Glioma: Report of a Rare Case Presenting with Psychosis. Asian J Neurosurg 2018; 13:1186-1192. [PMID: 30459891 PMCID: PMC6208224 DOI: 10.4103/ajns.ajns_371_16] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Angiocentric glioma (AG), first described in 2005, was included as a distinct entity in the 2007 World Health Organization Classification of Tumors of the Central Nervous System. It is a very rare cerebrocortical tumor mainly affecting children and young adults with a history of intractable partial seizures. The histopathological features of this entity are perivascular arrangement of monomorphic, bipolar spindled cells with subpial aggregation of tumor cells and variable neuroparenchymal colonization. Of uncertain histogenesis, this is a stable/slowly growing tumor. Prognosis following total surgical resection is favorable. We describe an AG in a 16-year-old, intellectually disabled, male patient, with psychosis. This is a rare presentation with only one such case in literature. Patient's symptoms ameliorated following surgery.
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Affiliation(s)
| | - Kanchan Snehal Kothari
- Department of Pathology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Tejal Pratin Pandya
- Department of Pathology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Naina Atul Goel
- Department of Pathology, Seth G.S. Medical College and KEM Hospital, Mumbai, Maharashtra, India
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27
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Weaver KJ, Crawford LM, Bennett JA, Rivera-Zengotita ML, Pincus DW. Brainstem angiocentric glioma: report of 2 cases. J Neurosurg Pediatr 2017; 20:347-351. [PMID: 28753090 DOI: 10.3171/2017.5.peds16402] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Angiocentric glioma is a rare tumor that was recognized by the WHO Classification of Tumours of the Central Nervous System as a distinct clinicopathological entity in 2007. Since this initial description, the vast majority of cases of angiocentric glioma reported in the literature have involved tumors of the cerebral hemispheres. To date, only 1 case of angiocentric glioma arising from the posterior midbrain has been reported. The authors present the cases of 2 pediatric patients who were found to have brainstem angiocentric gliomas. The clinical course, radiological and pathological features, treatment, and follow-up are described. The first case is one of a 5-year-old girl who presented with double vision, headache, and nausea and was found to have a midbrain lesion with pathological features consistent with angiocentric glioma. She was treated with resection and endoscopic third ventriculostomy (ETV), followed by close observation and serial neuroimaging. The second case is one of a 6-year-old boy who presented with progressive mouth drooping and problems with balance. He was found to have a pontine lesion with pathological features consistent with angiocentric glioma. This patient was treated with ETV, followed by close observation and serial neuroimaging. This report includes 6 and 1.5 years of follow-up of the patients, respectively. While there are limited data regarding the prognosis or long-term management of patients with brainstem angiocentric gliomas, the cases described in this report suggest an indolent course for this tumor, similar to the course of angiocentric gliomas located in the cerebral hemispheres.
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28
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Myers KA, Mandelstam SA, Ramantani G, Rushing EJ, de Vries BB, Koolen DA, Scheffer IE. The epileptology of Koolen-de Vries syndrome: Electro-clinico-radiologic findings in 31 patients. Epilepsia 2017; 58:1085-1094. [DOI: 10.1111/epi.13746] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Kenneth A. Myers
- Department of Medicine; Epilepsy Research Centre; The University of Melbourne, Austin Health; Heidelberg Victoria Australia
- Section of Neurology; Department of Pediatrics; Alberta Children's Hospital; Cumming School of Medicine; University of Calgary; Calgary Alberta Canada
| | - Simone A. Mandelstam
- Department of Paediatrics; The University of Melbourne; Parkville Victoria Australia
- Department of Radiology; The University of Melbourne; Parkville Victoria Australia
- The Florey Institute of Neuroscience and Mental Health; Heidelberg Victoria Australia
| | - Georgia Ramantani
- Division of Child Neurology; University Children's Hospital; Zurich Switzerland
- Swiss Epilepsy Center; Zurich Switzerland
| | | | - Bert B. de Vries
- Department of Human Genetics; Donders Institute for Brain, Cognition and Behavior; Radboud University Medical Center; Nijmegen The Netherlands
| | - David A. Koolen
- Department of Human Genetics; Donders Institute for Brain, Cognition and Behavior; Radboud University Medical Center; Nijmegen The Netherlands
| | - Ingrid E. Scheffer
- Department of Medicine; Epilepsy Research Centre; The University of Melbourne, Austin Health; Heidelberg Victoria Australia
- Department of Paediatrics; The University of Melbourne; Parkville Victoria Australia
- The Florey Institute of Neuroscience and Mental Health; Heidelberg Victoria Australia
- Department of Neurology; Royal Children's Hospital; Parkville Victoria Australia
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29
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[An unusual glial tumor]. Ann Pathol 2017; 37:193-196. [PMID: 28285809 DOI: 10.1016/j.annpat.2016.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 10/28/2015] [Accepted: 10/16/2016] [Indexed: 11/20/2022]
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30
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Kasper BS, Kasper EM. New classification of epilepsy-related neoplasms: The clinical perspective. Epilepsy Behav 2017; 67:91-97. [PMID: 28110204 DOI: 10.1016/j.yebeh.2016.12.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 12/08/2016] [Accepted: 12/17/2016] [Indexed: 12/28/2022]
Abstract
Neoplastic CNS lesions are a common cause of focal epilepsy refractory to anticonvulsant treatment, i.e. long-term epilepsy-associated tumors (LEATs). Epileptogenic tumors encompass a variety of intriguing lesions, e.g. dysembryoplastic neuroepithelial tumors or gangliogliomas, which differ from more common CNS neoplasms in their clinical context as well as on histopathology. Long-term epilepsy-associated tumor classification is a rapidly evolving issue in surgical neuropathology, with new entities still being elucidated. One major issue to be resolved is the inconsistent tissue criteria applied to LEAT accounting for high diagnostic variability between individual centers and studies, a problem recently leading to a proposal for a new histopathological classification by Blümcke et al. in Acta Neuropathol. 2014; 128: 39-54. While a new approach to tissue diagnosis is appreciated and needed, histomorphological criteria alone will not suffice and we here approach the situation of encountering a neoplastic lesion in an epilepsy patient from a clinical perspective. Clinical scenarios to be supported by an advanced LEAT classification will be illustrated and discussed.
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Affiliation(s)
- Burkhard S Kasper
- Epilepsy Center, Dept. Neurology, Erlangen University, Schwabachanlage 6, 91054 Erlangen, Germany.
| | - Ekkehard M Kasper
- Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
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31
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Gonzalez-Quarante LH, Fernández Carballal C, Agarwal V, Vargas Lopez AJ, Gil de Sagredo del Corral OL, Sola Vendrell E. Angiocentric Glioma in an Elderly Patient: Case Report and Review of the Literature. World Neurosurg 2017; 97:755.e5-755.e10. [DOI: 10.1016/j.wneu.2016.10.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/03/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
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32
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Abstract
Gliomas form a heterogeneous group of tumors of the central nervous system (CNS) and are traditionally classified based on histologic type and malignancy grade. Most gliomas, the diffuse gliomas, show extensive infiltration in the CNS parenchyma. Diffuse gliomas can be further typed as astrocytic, oligodendroglial, or rare mixed oligodendroglial-astrocytic of World Health Organization (WHO) grade II (low grade), III (anaplastic), or IV (glioblastoma). Other gliomas generally have a more circumscribed growth pattern, with pilocytic astrocytomas (WHO grade I) and ependymal tumors (WHO grade I, II, or III) as the most frequent representatives. This chapter provides an overview of the histology of all glial neoplasms listed in the WHO 2016 classification, including the less frequent "nondiffuse" gliomas and mixed neuronal-glial tumors. For multiple decades the histologic diagnosis of these tumors formed a useful basis for assessment of prognosis and therapeutic management. However, it is now fully clear that information on the molecular underpinnings often allows for a more robust classification of (glial) neoplasms. Indeed, in the WHO 2016 classification, histologic and molecular findings are integrated in the definition of several gliomas. As such, this chapter and Chapter 6 are highly interrelated and neither should be considered in isolation.
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33
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McCracken JA, Gonzales MF, Phal PM, Drummond KJ. Angiocentric glioma transformed into anaplastic ependymoma: Review of the evidence for malignant potential. J Clin Neurosci 2016; 34:47-52. [PMID: 27742374 DOI: 10.1016/j.jocn.2016.08.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 08/01/2016] [Accepted: 08/10/2016] [Indexed: 01/30/2023]
Abstract
Angiocentric glioma (AG) is a low grade glioma, that was first described in 2002. Since this description, 83 patients with AG have been described, including ours. AG typically presents in childhood with medically refractory seizures that are cured with gross surgical resection. Whilst the natural history is that of a benign tumour, there have been reports of recurrence, transformation, and malignant features that suggest that AG is potentially malignant. We add to the literature a case of a 16-year-old girl who presented in May 2011 with a 3-month history of complex partial seizures, with MRI showing a T2-weighted hyperintense lesion in the left insula and inferior frontal lobe. This was confirmed on biopsy as AG and was followed with surveillance imaging. In April 2012, she presented with disease progression and underwent a left temporal lobectomy, with histology showing both AG and grade II astrocytoma. Adjuvant radiotherapy of 50 Gray in 28 fractions was administered. A small area of contrast enhancement appeared in the left parietal lobe in December 2012, which progressed over subsequent months. In June 2013, she underwent a near total excision, with histology showing anaplastic ependymoma. She received six cycles of adjuvant temozolamide. Despite this, the tumour continued to progress, with her seizure control deteriorating, and the development of a right hemiparesis. The patient died in January 2014, aged 19years.
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Affiliation(s)
- James A McCracken
- Department of Neurosurgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC 3050, Australia.
| | - Michael F Gonzales
- Department of Pathology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Pramit M Phal
- Department of Radiology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Katharine J Drummond
- Department of Neurosurgery, Royal Melbourne Hospital, 300 Grattan Street, Parkville, VIC 3050, Australia
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34
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Raybaud C. Cerebral hemispheric low-grade glial tumors in children: preoperative anatomic assessment with MRI and DTI. Childs Nerv Syst 2016; 32:1799-811. [PMID: 27659823 DOI: 10.1007/s00381-016-3188-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 07/07/2016] [Indexed: 12/01/2022]
Abstract
PURPOSE The aims of this study are to analyze how the nature and the behavior of low-grade glial tumors (LGGT) in children may correlate with the anatomy of the cerebral hemispheres and to evaluate the consequent impact of diffusion tensor imaging (DTI) techniques in the presurgical assessment. METHODS This is a combined review of a series of 155 cases of LGGT and of the recent literature on the subject. RESULTS The cases retrieved from our data bank were divided in central hemispheric tumors (basal ganglia and thalami) (36 cases), glioneuronal cortical-based tumors (49 cases), and glial tumors of the cerebral mantle (70 cases). A close correlation was found in the thalamus between the primary location of the tumor (juxta-ventricular, inferior, lateral, bilateral) and its extension (ventricular lumen, midbrain and mesial temporal, globus pallidus, respectively) which may relate to the connectivity. Among the glioneuronal tumors, most gangliogliomas were located in the temporal lobe and especially in the mesial temporal structures. In addition, the morphologic feature of the ganglioglioma was different there from the neocortical areas. As a complementary approach, DTI data may assist in evaluating the structure and the extension of the LGGT, in addition to planning the surgical strategy. CONCLUSIONS In the cerebral hemispheres like in the rest of the central nervous system, there is some degree of correlation between the anatomy and the nature, appearance, and behavior of the LGGT in children.
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Affiliation(s)
- Charles Raybaud
- Division of Neuroradiology, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G1X8, Canada.
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35
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Lehman NL, Hattab EM, Mobley BC, Usubalieva A, Schniederjan MJ, McLendon RE, Paulus W, Rushing EJ, Georgescu MM, Couce M, Dulai MS, Cohen ML, Pierson CR, Raisanen JM, Martin SE, Lehman TD, Lipp ES, Bonnin JM, Al-Abbadi MA, Kenworthy K, Zhao K, Mohamed N, Zhang G, Zhao W. Morphological and molecular features of astroblastoma, including BRAFV600E mutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults. Neuro Oncol 2016; 19:31-42. [PMID: 27416954 DOI: 10.1093/neuonc/now118] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Astroblastomas (ABs) are rare glial tumors showing overlapping features with astrocytomas, ependymomas, and sometimes other glial neoplasms, and may be challenging to diagnose. METHODS We examined clinical, histopathological, and molecular features in 28 archival formalin-fixed, paraffin-embedded AB cases and performed survival analyses using Cox proportional hazards and Kaplan-Meier methods. RESULTS Unlike ependymomas and angiocentric gliomas, ABs demonstrate abundant distinctive astroblastic pseudorosettes and are usually Olig2 immunopositive. They also frequently exhibit rhabdoid cells, multinucleated cells, and eosinophilic granular material. They retain immunoreactivity to alpha thalassemia/mental retardation syndrome X-linked, are immunonegative to isocitrate dehydrogenase-1 R132H mutation, and only occasionally show MGMT promoter hypermethylation differentiating them from many diffuse gliomas. Like pleomorphic xanthoastrocytoma, ganglioglioma, supratentorial pilocytic astrocytoma, and other predominantly cortical-based glial tumors, ABs often harbor the BRAFV600E mutation, present in 38% of cases tested (n = 21), further distinguishing those tumors from ependymomas and angiocentric gliomas. Factors correlating with longer patient survival included age less than 30 years, female gender, absent BRAFV600E , and mitotic index less than 5 mitoses/10 high-power fields; however, only the latter was significant by Cox and Kaplan-Meier analyses (n = 24; P = .024 and .012, respectively). This mitotic cutoff is therefore currently the best criterion to stratify tumors into low-grade ABs and higher-grade anaplastic ABs. CONCLUSIONS In addition to their own characteristic histological features, ABs share some molecular and histological findings with other, possibly ontologically related, cortical-based gliomas of mostly children and young adults. Importantly, the presence of BRAFV600E mutations in a subset of ABs suggests potential clinical utility of targeted anti-BRAF therapy.
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Affiliation(s)
- Norman L Lehman
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Eyas M Hattab
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Bret C Mobley
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Aisulu Usubalieva
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Matthew J Schniederjan
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Roger E McLendon
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Werner Paulus
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Elisabeth J Rushing
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Maria-Magdalena Georgescu
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Marta Couce
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Mohanpal S Dulai
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Mark L Cohen
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Christopher R Pierson
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Jack M Raisanen
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Sarah E Martin
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Trang D Lehman
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Eric S Lipp
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Jose M Bonnin
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Mousa A Al-Abbadi
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Kara Kenworthy
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Kevin Zhao
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Nehad Mohamed
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Guojuan Zhang
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
| | - Weiqiang Zhao
- Department of Pathology, The Ohio State University, Columbus, Ohio (N.L.L., A.U., C.R.P., K.K., K.Z., N.M., G.Z., W.Z.); Department of Pathology and Laboratory Medicine, Indiana University, Indianapolis, Indiana (E.M.H., J.M.B.); Department of Pathology, Vanderbilt University, Nashville, Tennessee (B.C.M.); Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia (M.J.S.); Department of Pathology, Duke University, Durham, North Carolina (R.E.M., E.S.L.); Institute of Neuropathology, University Hospital Münster, Germany (W.P.); Institute for Neuropathology, University Hospital of Zurich, Switzerland (E.J.R.); Department of Pathology, The University of Texas Southwestern, Dallas, Texas (M.-M.G., J.M.R.); Department of Pathology, Case Western Reserve University, Cleveland, Ohio (M.C., M.L.C.); Department of Anatomic Pathology, Beaumont Hospital, Royal Oak, Michigan (M.S.D.); Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Columbus, Ohio (C.R.P.); Department of Pathology, University of Illinois, Peoria, Illinois (S.E.M.); Department of Pathology, Sheikh Khalifa Medical City, Abu Dhabi, UAE (M.A.A.-A.); Department of Family and Community Medicine, Contra Costa Regional Medical Center, Martinez, California (T.D.L.)
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Soylemezoglu F, Himmetoglu C, Oguz KK, Saygi S, Akalan N. A 41-Year-Old Man wıth Drug-Resıstant Complex Partıal Seızures. Brain Pathol 2016; 25:511-2. [PMID: 26095595 DOI: 10.1111/bpa.12271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Figen Soylemezoglu
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
| | - Cigdem Himmetoglu
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
| | - Kader K Oguz
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
| | - Serap Saygi
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
| | - Nejat Akalan
- Hacettepe University, Faculty of Medicine, Department of Pathology, Neurology, Radiology, Neurosurgery
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Bandopadhayay P, Ramkissoon LA, Jain P, Bergthold G, Wala J, Zeid R, Schumacher SE, Urbanski L, O'Rourke R, Gibson WJ, Pelton K, Ramkissoon SH, Han HJ, Zhu Y, Choudhari N, Silva A, Boucher K, Henn RE, Kang YJ, Knoff D, Paolella BR, Gladden-Young A, Varlet P, Pages M, Horowitz PM, Federation A, Malkin H, Tracy AA, Seepo S, Ducar M, Van Hummelen P, Santi M, Buccoliero AM, Scagnet M, Bowers DC, Giannini C, Puget S, Hawkins C, Tabori U, Klekner A, Bognar L, Burger PC, Eberhart C, Rodriguez FJ, Hill DA, Mueller S, Haas-Kogan DA, Phillips JJ, Santagata S, Stiles CD, Bradner JE, Jabado N, Goren A, Grill J, Ligon AH, Goumnerova L, Waanders AJ, Storm PB, Kieran MW, Ligon KL, Beroukhim R, Resnick AC. MYB-QKI rearrangements in angiocentric glioma drive tumorigenicity through a tripartite mechanism. Nat Genet 2016; 48:273-82. [PMID: 26829751 PMCID: PMC4767685 DOI: 10.1038/ng.3500] [Citation(s) in RCA: 189] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 01/06/2016] [Indexed: 12/15/2022]
Abstract
Angiocentric gliomas are pediatric low-grade gliomas (PLGGs) without known recurrent genetic drivers. We performed genomic analysis of new and published data from 249 PLGGs including 19 Angiocentric Gliomas. We identified MYB-QKI fusions as a specific and single candidate driver event in Angiocentric Gliomas. In vitro and in vivo functional studies show MYB-QKI rearrangements promote tumorigenesis through three mechanisms: MYB activation by truncation, enhancer translocation driving aberrant MYB-QKI expression, and hemizygous loss of the tumor suppressor QKI. This represents the first example of a single driver rearrangement simultaneously transforming cells via three genetic and epigenetic mechanisms in a tumor.
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Affiliation(s)
- Pratiti Bandopadhayay
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Lori A Ramkissoon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Payal Jain
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Cell and Molecular Biology Graduate Group, Gene Therapy and Vaccines Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Guillaume Bergthold
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department de Cancerologie de l'Enfant et de l'Adolescent et Unité Mixte de Recherche du Centre National de la Recherche Scientifique 8203 'Vectorologie et Nouvelles Therapeutiques du Cancer', Gustave Roussy, Université Paris XI Sud, Villejuif, France
| | - Jeremiah Wala
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Rhamy Zeid
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Steven E Schumacher
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA
| | - Laura Urbanski
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ryan O'Rourke
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA
| | - William J Gibson
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Kristine Pelton
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Shakti H Ramkissoon
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA
| | - Harry J Han
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yuankun Zhu
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Namrata Choudhari
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Amanda Silva
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Katie Boucher
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rosemary E Henn
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yun Jee Kang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - David Knoff
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Brenton R Paolella
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | | | - Pascale Varlet
- Laboratoire de Neuropathologie, Hopital Sainte-Anne, Université Paris V Descartes, Paris, France
| | - Melanie Pages
- Laboratoire de Neuropathologie, Hopital Sainte-Anne, Université Paris V Descartes, Paris, France
| | - Peleg M Horowitz
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Alexander Federation
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Hayley Malkin
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA
| | | | - Sara Seepo
- Broad Institute, Cambridge, Massachusetts, USA
| | - Matthew Ducar
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Paul Van Hummelen
- Center for Cancer Genome Discovery, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Mariarita Santi
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Mirko Scagnet
- Neurosurgery Unit, Anna Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Daniel C Bowers
- Division of Pediatric Hematology-Oncology, University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Caterina Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Stephanie Puget
- Departement de Neurochirurgie, Hopital Necker-Enfants Malades, Université Paris V Descartes, Paris, France
| | - Cynthia Hawkins
- Division of Pathology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Uri Tabori
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Almos Klekner
- Department of Neurosurgery, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Laszlo Bognar
- Department of Neurosurgery, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Peter C Burger
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Charles Eberhart
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Fausto J Rodriguez
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - D Ashley Hill
- Brain Tumor Institute, Children's National Medical Center, Washington, DC, USA.,Center for Neuroscience and Behavioral Medicine, Brain Tumor Institute, Children's National Medical Center, Washington, DC, USA.,Department of Pathology, Children's National Medical Center, Washington, DC, USA
| | - Sabine Mueller
- Department of Neurology, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Neurological Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California, USA
| | - Daphne A Haas-Kogan
- Department of Neurological Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Radiation Oncology, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Joanna J Phillips
- Department of Neurological Surgery, University of California San Francisco School of Medicine, San Francisco, California, USA.,Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Sandro Santagata
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA
| | - Charles D Stiles
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - James E Bradner
- Broad Institute, Cambridge, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Nada Jabado
- Division of Experimental Medicine, Montreal Children's Hospital, McGill University and McGill University Health Centre, Montreal, Quebec, Canada.,Department of Human Genetics, McGill University, Montreal, Quebec, Canada.,Department of Pediatrics, McGill University, Montreal, Quebec, Canada
| | - Alon Goren
- Broad Technology Laboratories, Broad Institute, Cambridge, Massachusetts, USA
| | - Jacques Grill
- Department de Cancerologie de l'Enfant et de l'Adolescent et Unité Mixte de Recherche du Centre National de la Recherche Scientifique 8203 'Vectorologie et Nouvelles Therapeutiques du Cancer', Gustave Roussy, Université Paris XI Sud, Villejuif, France
| | - Azra H Ligon
- Brigham and Women's Hospital Department of Pathology, Center for Advanced Molecular Diagnostics, Division of Cytogenetics, Boston, Massachusetts, USA
| | - Liliana Goumnerova
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.,Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Angela J Waanders
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Data-Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Phillip B Storm
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Center for Data-Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Mark W Kieran
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Keith L Ligon
- Broad Institute, Cambridge, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA
| | - Rameen Beroukhim
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Broad Institute, Cambridge, Massachusetts, USA.,Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Adam C Resnick
- Division of Neurosurgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Center for Data-Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Ampie L, Choy W, DiDomenico JD, Lamano JB, Williams CK, Kesavabhotla K, Mao Q, Bloch O. Clinical attributes and surgical outcomes of angiocentric gliomas. J Clin Neurosci 2016; 28:117-22. [PMID: 26778052 DOI: 10.1016/j.jocn.2015.11.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 11/27/2015] [Indexed: 11/29/2022]
Abstract
Angiocentric gliomas (AG) are exceedingly rare low-grade neoplasms which often present in the form of intractable epilepsy within younger patients. The current study extensively reviews all reported cases which were pathologically verified as AG in the literature to analyze clinical attributes and surgical outcomes of this neoplasm. There were 88 patients with AG reported in the literature consisting mostly of pediatric cases. The sex distribution consisted of 45 males and 36 females with the remaining seven cases not documenting sex. The average age of initial diagnosis was 16years with almost half of all diagnosed patients being within the first decade of life. In cases where extent of resection was reported, gross total resection (GTR) was achieved in 54 patients, subtotal resection (STR) in 16, and biopsy only in three. Post-operative complications were transient and only occurred in three patients with no reports of death following surgery. Only five cases reported tumor recurrence on follow-up. Eight patients had seizure recurrence post-operatively and GTR offered improved rates of seizure control when compared to STR (p=0.0005). Nearly half of the cases of AG are diagnosed within the first decade of life and they usually manifest with intractable seizures. GTR appears to offer better seizure control in the post-operative period. Surgical resection is the mainstay therapy for AG as post-operative complications and tumor recurrence remain uncommon. Since the number of reported cases is limited, future studies with longer follow-up periods will help elaborate more long-term outcomes.
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Affiliation(s)
- Leonel Ampie
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Winward Choy
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Joseph D DiDomenico
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Jonathan B Lamano
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Christopher Kazu Williams
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Kartik Kesavabhotla
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA
| | - Qinwen Mao
- Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Orin Bloch
- Department of Neurological Surgery, Northwestern University, Feinberg School of Medicine, 676 N. St Clair Street, Suite 2210, Chicago, IL 60611-2911, USA.
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Abstract
Angiocentric glioma (AG) is a distinct group of tumors, grade I according to the 2007 WHO classification of tumors of the central nervous system. It is a rare group predominantly seen in children and young adults, with good prognosis following gross total resection. A young child presented with progressively worsening seizure activity; MRI revealed a lesion involving the left posterior frontal lobe. The lesion was surgically resected, and the child is now free of seizure medications, with good neurological function.
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40
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Cheng S, Lü Y, Xu S, Liu Q, Lee P. Cystoid angiocentric glioma: A case report and literature review. J Radiol Case Rep 2015; 9:1-9. [PMID: 26629293 DOI: 10.3941/jrcr.v9i7.2413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Angiocentric glioma is a rare subtype of neuroepithelial tumor that is associated with a history of epilepsy. We report a case of cystoid angiocentric glioma associated with an area of calcification. This 25 year old male patient presented with tonic clonic spasm. He underwent craniotomy with complete resection of the lesion. Pathologic specimen showed monomorphous bipolar cells with angiocentric growth pattern.
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Affiliation(s)
- Sainan Cheng
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Yubo Lü
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Shangchen Xu
- Department of Neurosurgery, Provincial Hospital, Shandong University, Jinan, China
| | - Qiang Liu
- Shandong Medical Imaging Research Institute, Shandong University, Jinan, China
| | - Pearlene Lee
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, USA
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41
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Yamasaki K, Yokogami K, Yamashita S, Takeshima H. Rapidly Enlarging Pediatric Cortical Ependymoma. J Korean Neurosurg Soc 2015; 57:487-90. [PMID: 26180622 PMCID: PMC4502251 DOI: 10.3340/jkns.2015.57.6.487] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 04/07/2014] [Accepted: 05/13/2014] [Indexed: 11/27/2022] Open
Abstract
We report a 10-year-old boy with supratentorial cortical ependymoma that rapidly grew in the course of 3 years. He suffered generalized seizures when he was 5 years old; MRI showed a small cortical lesion in the right postcentral gyrus. MRI performed 2 years later revealed no changes. For the next 3 years he was free of seizures. However, at the age of 10 he again suffered generalized seizures and MRI disclosed a large parietal tumor. It was resected totally and he remains free of neurological deficits. The histopathological diagnosis was ependymoma. Pediatric supratentorial cortical ependymomas are extremely rare. We recommend including cortical ependymoma as a differential diagnosis in pediatric patients with cortical mass lesions presenting with seizures and careful follow-up even in the absence of symptoms because these tumors may progress.
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Affiliation(s)
- Kouji Yamasaki
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kiyotaka Yokogami
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Shinji Yamashita
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Hideo Takeshima
- Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
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42
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Sajjad J, Kaliaperumal C, Bermingham N, Marks C, Keohane C. "Unusual brain stone": heavily calcified primary neoplasm with some features suggestive of angiocentric glioma. J Neurosurg 2015; 123:1256-60. [PMID: 26024003 DOI: 10.3171/2014.11.jns131158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This 40-year-old man presented with a 5-month history of progressive right-sided headache associated with visual blurring. He also had a history of epilepsy but had been seizure free with medication for the past 10 years. An initial CT scan of his brain performed 16 years previously had revealed a small area of calcification in the right parietal region. In the current presentation, he had a left-sided homonymous hemianopia but no other neurological deficits. A CT scan of his brain showed a much larger calcified, partly cystic lesion in the right parietal region. Because he was symptomatic, the lesion was excised and the cyst was drained. Histological examination of the excised tissue showed an unusual primary tumor that was difficult to classify but had some features of angiocentric glioma. The heavy calcification, mixed-density cell population, and regions with features of angiocentric glioma were most unusual. The patient remained asymptomatic 5 years after surgery, and follow-up scans did not show recurrence.
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43
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[A unusual brain cortical tumor: angiocentric glioma]. Ann Pathol 2015; 35:154-8. [PMID: 25765138 DOI: 10.1016/j.annpat.2015.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 01/05/2015] [Indexed: 11/24/2022]
Abstract
We report the case of an 11-year-old girl, who was admitted for surgery of an epilepsy-associated brain tumor. The radiological and clinical hypothesis was dysembryoplasic neuroepithelial tumor. Histopathological examination revealed a tumoral proliferation composed of spindle-shaped cells with palisade arrangements around vessels. Tumor cells have small, round and regular nuclei without atypia or mitosis. On immunohistochemistry, the neoplastic cells strongly expressed GFAP and showed a characteristic cytoplasmic dot-like staining with EMA (epithelial membrane antigen). Ki-67 labeling index was low. Molecular analysis failed to reveal the V600E mutation of BRAF gene. The patient was free of seizures after surgery. Angiocentric glioma is a rare brain tumor occuring preferably in children and young adults and is associated with seizures. The precise histogenesis remains debated. The treatment of choice is total resection. The prognosis is favorable if totally resected.
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Ni HC, Chen SY, Chen L, Lu DH, Fu YJ, Piao YS. Angiocentric glioma: a report of nine new cases, including four with atypical histological features. Neuropathol Appl Neurobiol 2015; 41:333-46. [PMID: 24861831 DOI: 10.1111/nan.12158] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 05/21/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Hai-Chun Ni
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
- Department of Pathology; Central Hospital of Wuhan; Wuhan China
| | - Shi-Yun Chen
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Li Chen
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
| | - De-Hong Lu
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Yong-Juan Fu
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
| | - Yue-Shan Piao
- Department of Neuropathology; Xuanwu Hospital; Capital Medical University; Beijing China
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45
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Gataullina S, Dulac O, Bulteau C. Temporal lobe epilepsy in infants and children. Rev Neurol (Paris) 2015; 171:252-8. [PMID: 25744768 DOI: 10.1016/j.neurol.2015.01.559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/17/2015] [Accepted: 01/27/2015] [Indexed: 12/28/2022]
Abstract
Clinical expression of temporal lobe seizures is different with a more diverse and more extensive etiology in infants and children than it is in adults. It is dominated by cortical dysplasia, low-grade tumors and perinatal damage. Hippocampal sclerosis, although less frequent, exists in children usually as a dual pathology associated with ipsilateral neocortical lesions. The clinical semiology of temporal seizures is more varied, and sometimes misleading. Motor features including tonic, clonic or myoclonic behaviors, and infantile spasms predominate in infants. Classical complex partial seizures with behavioral arrest and automatisms, as well as lateralizing signs are rare and occur mostly with onset after the age of two years. Interestingly, aura, emotional, and autonomic signs seem to be independent on the brain maturation process. Moreover, the neuropsychological profile varies according to age of onset and duration, lateralization of the focus and etiology. Quality of care benefits from individual cognitive assessment for memory and emotional processes.
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Affiliation(s)
- S Gataullina
- INSERM U1129 "Infantile Epilepsies and Brain Plasticity", service de neuropédiatrie, hôpital Necker-Enfants Malades, bâtiment Lavoisier, 149, rue de Sèvres, 75015 Paris, France; Neurophysiologique clinique, hôpital Mignot - Le Chesnay, 177, rue de Versailles, 78150 Le Chesnay, France; Neurochirurgie pédiatrique, fondation ophtalmologique Rothschild, 25, rue Manin, 75019 Paris, France.
| | - O Dulac
- INSERM U1129 "Infantile Epilepsies and Brain Plasticity", service de neuropédiatrie, hôpital Necker-Enfants Malades, bâtiment Lavoisier, 149, rue de Sèvres, 75015 Paris, France; Neurophysiologique clinique, hôpital Mignot - Le Chesnay, 177, rue de Versailles, 78150 Le Chesnay, France
| | - C Bulteau
- INSERM U1129 "Infantile Epilepsies and Brain Plasticity", service de neuropédiatrie, hôpital Necker-Enfants Malades, bâtiment Lavoisier, 149, rue de Sèvres, 75015 Paris, France; Neurophysiologique clinique, hôpital Mignot - Le Chesnay, 177, rue de Versailles, 78150 Le Chesnay, France
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46
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47
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Blumcke I, Aronica E, Urbach H, Alexopoulos A, Gonzalez-Martinez JA. A neuropathology-based approach to epilepsy surgery in brain tumors and proposal for a new terminology use for long-term epilepsy-associated brain tumors. Acta Neuropathol 2014; 128:39-54. [PMID: 24858213 PMCID: PMC4059966 DOI: 10.1007/s00401-014-1288-9] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 04/25/2014] [Accepted: 04/26/2014] [Indexed: 12/22/2022]
Abstract
Every fourth patient submitted to epilepsy surgery suffers from a brain tumor. Microscopically, these neoplasms present with a wide-ranging spectrum of glial or glio-neuronal tumor subtypes. Gangliogliomas (GG) and dysembryoplastic neuroepithelial tumors (DNTs) are the most frequently recognized entities accounting for 65 % of 1,551 tumors collected at the European Epilepsy Brain Bank (n = 5,842 epilepsy surgery samples). These tumors often present with early seizure onset at a mean age of 16.5 years, with 77 % of neoplasms affecting the temporal lobe. Relapse and malignant progression are rare events in this particular group of brain tumors. Surgical resection should be regarded, therefore, also as important treatment strategy to prevent epilepsy progression as well as seizure- and medication-related comorbidities. The characteristic clinical presentation and broad histopathological spectrum of these highly epileptogenic brain tumors will herein be classified as “long-term epilepsy associated tumors—LEATs”. LEATs differ from most other brain tumors by early onset of spontaneous seizures, and conceptually are regarded as developmental tumors to explain their pleomorphic microscopic appearance and frequent association with Focal Cortical Dysplasia Type IIIb. However, the broad neuropathologic spectrum and lack of reliable histopathological signatures make these tumors difficult to classify using the WHO system of brain tumors. As another consequence from poor agreement in published LEAT series, molecular diagnostic data remain ambiguous. Availability of surgical tissue specimens from patients which have been well characterized during their presurgical evaluation should open the possibility to systematically address the origin and epileptogenicity of LEATs, and will be further discussed herein. As a conclusion, the authors propose a novel A–B–C terminology of epileptogenic brain tumors (“epileptomas”) which hopefully promote the discussion between neuropathologists, neurooncologists and epileptologists. It must be our future mission to achieve international consensus for the clinico-pathological classification of LEATs that would also involve World Health Organization (WHO) and the International League against Epilepsy (ILAE).
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Affiliation(s)
- Ingmar Blumcke
- Department of Neuropathology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany,
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Bergthold G, Bandopadhayay P, Bi WL, Ramkissoon L, Stiles C, Segal RA, Beroukhim R, Ligon KL, Grill J, Kieran MW. Pediatric low-grade gliomas: how modern biology reshapes the clinical field. Biochim Biophys Acta Rev Cancer 2014; 1845:294-307. [PMID: 24589977 DOI: 10.1016/j.bbcan.2014.02.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 02/20/2014] [Indexed: 12/17/2022]
Abstract
Low-grade gliomas represent the most frequent brain tumors arising during childhood. They are characterized by a broad and heterogeneous group of tumors that are currently classified by the WHO according to their morphological appearance. Here we review the clinical features of these tumors, current therapeutic strategies and the recent discovery of genomic alterations characteristic to these tumors. We further explore how these recent biological findings stand to transform the treatment for these tumors and impact the diagnostic criteria for pediatric low-grade gliomas.
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Affiliation(s)
| | - Pratiti Bandopadhayay
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA; Division of Pediatric Hematology and Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Boston Children's Hospital, Boston, MA, USA
| | - Wenya Linda Bi
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lori Ramkissoon
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA; Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Charles Stiles
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rosalind A Segal
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Neurobiology, Harvard Medical School, Boston, MA, USA
| | - Rameen Beroukhim
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Keith L Ligon
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA; Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jacques Grill
- Departement de Cancerologie de l'enfant et de l'adolescent, Gustave Roussy and Unité Mixte de Recherche 8203 du Centre National de la Recherche Scientifique, Université Paris-Sud, Villejuif, France
| | - Mark W Kieran
- Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA, USA; Center for Molecular Oncologic Pathology, Dana-Farber Cancer Institute, Boston, MA, USA.
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Japp A, Gielen GH, Becker AJ. Recent aspects of classification and epidemiology of epilepsy-associated tumors. Epilepsia 2014; 54 Suppl 9:5-11. [PMID: 24328865 DOI: 10.1111/epi.12436] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Epileptic seizures are frequent manifestations of brain tumors. However, biopsy specimens of patients who undergo neurosurgical removal of circumscribed foci to control chronic recurrent pharmacoresistant seizures often reveal tumor entities that are rare in general brain tumor series. The spectrum of these "long-term epilepsy-associated neoplasms" comprises highly differentiated glial and glioneuronal tumors that show a benign biologic behavior and clinical course, and that rarely relapse. Several entities are well recognizable on the basis of histopathologic and immunohistochemical characteristics. An intriguing functional aspect of these tumors, sometimes collectively referred to as "epileptomas," is their prominent epileptogenicity, which may represent a clinical feature indicating rather than causing the generally benign biologic behavior of these tumors. A frequent feature of respective neoplasms is their coincidence with dysplastic lesions in the vicinity of the tumor itself. The recent advent of new molecular markers, including genomic alterations leading to activation of the protooncogene BRAF and impaired function of isocitrate dehydrogenase (IDH1), provides excellent new tools in the differential diagnosis of low grade brain tumors, and provides intriguing implications to further develop the pathogenetic concepts of these neoplasms. Despite this progress, a number of tumors from patients with chronic epilepsy show combinations of cytologic, histologic, and immunohistochemical characteristics that challenge the current neuropathologic classification schemes. Attempts are currently ongoing to develop further classification schemes.
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Affiliation(s)
- Anna Japp
- Department of Neuropathology, University of Bonn Medical Center, Bonn, Germany
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Chen G, Wang L, Wu J, Jin Y, Wang X, Jin Y. Intractable epilepsy due to angiocentric glioma: A case report and minireview. Exp Ther Med 2013; 7:61-65. [PMID: 24348765 PMCID: PMC3861307 DOI: 10.3892/etm.2013.1402] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 09/02/2013] [Indexed: 12/03/2022] Open
Abstract
The aim of this case report and minireview was to investigate the diagnosis of and therapeutic approaches for angiocentric glioma (AG) and to summarize the clinical manifestations and the pathological and imaging characteristics of the disease. Intraoperative cortical electroencephalogram (ECoG) monitoring was performed to locate the epileptic foci in a child with AG who presented with intractable epilepsy, prior to the total resection of the tumor being performed under the microscope. The clinical features, imaging characteristics, intraoperative conditions, surgical methods and pathological results were analyzed and compared with the literature. The review revealed that to date, the clinical features of the 52 reported cases of AG (including this case) have been mainly characterized by epilepsy. High T2-weighted image (WI) and fluid-attenuated inversion recovery (FLAIR) signals may be detected with magnetic resonance imaging (MRI) scanning of the cranium; however, no enhancement signals are detected by enhanced scanning. The prognosis following surgical resection is favorable. The lesions in the present case demonstrated clear boundaries with a central cystic affection accompanied by an arachnoid cyst on the left temporal pole. Pathological examination revealed that the lesion was positive for glial fibrillary acidic protein (GFAP), S-100 protein, vimentin, epithelial membrane antigen (EMA), cluster of differentiation 99 (CD99) and D2-40. The Ki-67/MIBk-1 labeling index was ~1%. In conclusion, AG exhibits characteristic features in imaging; however, its diagnosis depends on histopathological examination. The prognosis of total surgical resection is good and intraoperative ECoG may be used to assist positioning.
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Affiliation(s)
- Guoqiang Chen
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Lin Wang
- Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, P.R. China
| | - Jinting Wu
- Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, P.R. China
| | - Yongjian Jin
- Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, P.R. China
| | - Xiaosong Wang
- Department of Neurosurgery, Yuquan Hospital, Tsinghua University, Beijing 100049, P.R. China
| | - Yulan Jin
- Department of Pathology, Tongren Hospital, Capital Medical University, Beijing 100730, P.R. China
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