Subscribe to RSS
Pleomorphic Xanthoastrocytoma with Oligodendroglioma-Like Areas with Negative 1p19q Co-Deletion
The most common mixed glioma encountered in routine surgical practice is oligoastrocytoma (OA); however, its is currently considered a vanishing entity. The 2016 classification of the World Health Organization (WHO) discourages the diagnosis of tumors as mixed glioma. The recommendations are that diffuse gliomas, including those with mixed or ambiguous histological features, should be subjected to molecular testing. Dual-genotype OAs are not yet a distinct entity or variant in the classification. We report a case of mixed glioma: a pleomorphic xanthoastrocytoma (PXA) mixed with an oligodendroglioma. The immunohistochemistry (IHC) pattern of isocitrate dehydrogenase 1 (IDH1) negativity with retained nuclear expression of the alpha-thalassemia x-linked intellectual disability syndrome (ATRX) protein, and 1p19q co-deletion negativity in both the components enabled its identification as a mixed glioma rather than a collision tumor. To the best of our knowledge, the case herein presented is the fourth case of PXA with oligodendroglioma. Out of the other three reported cases, only one was of a collision tumor with a dual genotype, and the other two showed similar molecular signatures in both components. The present article discusses the histological, immunohistochemical and molecular features of the aforementioned case.
Keywordspleomorphic xanthoastrocytoma - mixed glioma - composite glioma - oligodendroglioma - 1p19q
Contribution of the Authors
1 Deepa Goel - data analysis, manuscript preparation, manuscript editing.
2 - literature search, manuscript review.
3 - manuscript review.
Guarantor - Dr. Deepa Goel.
Received: 13 August 2020
Accepted: 16 November 2020
18 January 2021 (online)
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
- 1 Louis DN, Ohgaki H, Weistler OD, Cavenee WK. Eds. WHO classification of tumours of the central nervous system (Revised 4th edition). IARC; Lyon: 2016
- 2 Perry A, Giannini C, Scheithauer BW. et al. Composite pleomorphic xanthoastrocytoma and ganglioglioma: report of four cases and review of the literature. Am J Surg Pathol 1997; 21 (07) 763-771
- 3 Ishizawa K, Terao S, Kobayashi K, Yoshida K, Hirose T. A neuroepithelial tumor showing combined histological features of dysembryoplastic neuroepithelial tumor and pleomorphic xanthoastrocytoma–a case report and review of the literature. Clin Neuropathol 2007; 26 (04) 169-175
- 4 Perry A, Scheithauer BW, Szczesniak DM, Atkinson JL, Wald JT, Hammak JE. Combined oligodendroglioma/pleomorphic xanthoastrocytoma: a probable collision tumor: case report. Neurosurgery 2001; 48 (06) 1358-1361
- 5 Hattab EM, Martin SE, Shapiro SA, Cheng L. Pleomorphic xanthoastrocytoma and oligodendroglioma: collision of 2 morphologically and genetically distinct anaplastic components. J Neurosurg 2011; 114 (06) 1648-1653
- 6 Murakami C, Ikota H, Nobusawa S. et al. Oligodendroglioma showing pleomorphic xanthoastrocytoma-like perivascular microlesion: With IDH1, TERT promoter mutation and 1p/19q codeletion detected in both components. Pathol Int 2020; 70 (01) 40-46
- 7 Yamada S, Kipp BR, Voss JS, Giannini C, Raghunathan A. Combined “infiltrating astrocytoma/pleomorphic xanthoastrocytoma” harboring IDH1 R132H and BRAF V600E mutations. Am J Surg Pathol 2016; 40 (02) 279-284
- 8 Aisner DL, Newell KL, Pollack AG. et al. Composite pleomorphic xanthoastrocytoma-epithelioid glioneuronal tumor with BRAF V600E mutation - report of three cases. Clin Neuropathol 2014; 33 (02) 112-121
- 9 Sahm F, Reuss D, Koelsche C. et al. Farewell to oligoastrocytoma: in situ molecular genetics favor classification as either oligodendroglioma or astrocytoma. Acta Neuropathol 2014; 128 (04) 551-559