Diffuse astrocytic glioma, IDH-Wildtype, with molecular features of glioblastoma, WHO grade IV: A single-institution case series and review

Diagnostic Utility of the Immunohistochemical Expression of Serine and Arginine Rich Splicing Factor 1 (SRSF1) in the Differential Diagnosis of Adult Gliomas

“…Many morphological and immunohistochemical features are commonly shared by several neoplasms: the most emblematic example is that—while in the past, the presence of round cells with a “fried-egg” appearance was considered a specific diagnostic clue of oligodendroglioma [ 31 , 32 , 33 , 34 ]—it is now well known that other entities, such as diffuse astrocytic tumors, PAs and ependymomas, may focally or extensively show the same oligodendroglioma-like morphology [ 35 , 36 , 37 , 38 ], and, conversely, many oligodendrogliomas may contain an astrocytic cellular component [ 31 , 32 , 33 , 34 ]. In this regard, the absence of specific pathological and immunohistochemical markers has led to the introduction of molecular biology as an essential tool for the diagnosis of CNS tumors [ 30 , 39 ]. Our purpose was to provide a new potential immunohistochemical marker to include in the antibody panel when approaching an adult glioma in pathology practice.…”

Adult-type and Pediatric-type Diffuse Gliomas

“…Dominant imaging features of glioblastomas are diffuse infiltration of surrounding brain regions, spatial heterogeneity of signal intensities and contrast enhancement, often appearing as a typical ring-like enhancement around necrotic areas. Varying amounts of perifocal edema, necrosis, and even hemorrhages can be observed [23][24][25][26][27][28]. Beside standard sequences, susceptibility weighted imaging (SWI) and perfusion techniques (PWI), such as dynamic contrast enhanced (DCE) perfusion, as well as diffusion-weighting imaging (DWI) can improve the diagnostic accuracy.…”

Radiotherapy of High-Grade Gliomas: First Half of 2021 Update with Special Reference to Radiosensitization Studies

“…Similarly, the joint guideline committee of the Chinese Glioma Cooperative Group, the Society for Neuro-Oncology of China, and the Chinese Brain Cancer Association updated their clinical practice guidelines [15] providing recommendations for the diagnostic and management decisions as well as limiting unnecessary treatments and costs [15]. It was concluded that WHO grade II/III isocitrate dehydrogenase (IDH)wildtype diffuse astrocytoma containing telomerase reverse transcriptase (TERT) promoter mutations, chromosome 7 gain/10 loss, and/or EGFR amplification correspond to a WHO grade IV diagnosis and should be classified as diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma [GB-WHO grade IV (DAG-G)] [16]. Compared to patients with classic IDH-mutant astrocytoma, the mean age is older, tumors are more diffuse, and overall survival (OS) is significantly shorter [16].…”

“…It was concluded that WHO grade II/III isocitrate dehydrogenase (IDH)wildtype diffuse astrocytoma containing telomerase reverse transcriptase (TERT) promoter mutations, chromosome 7 gain/10 loss, and/or EGFR amplification correspond to a WHO grade IV diagnosis and should be classified as diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma [GB-WHO grade IV (DAG-G)] [16]. Compared to patients with classic IDH-mutant astrocytoma, the mean age is older, tumors are more diffuse, and overall survival (OS) is significantly shorter [16]. Importantly, IDH genotypes and other molecular characteristics can now be identified by radiomics features from multiparameter MRI, thus further increasing pre-and post-operative diagnostic possibilities [17][18][19].…”