Glioma Diagnosis 2021: Something old, Something new

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The document is a presentation by Jesse Lee Kresak, MD, from the University of Florida, focusing on advancements in glioma diagnosis in anticipation of the new WHO classification guidelines. The presentation aims to educate on the application of current molecular methods, such as surrogate immunohistochemical studies, in surgical neuropathology and their implications for integrated glioma diagnosis and patient management.<br /><br />Key points include:<br /><br />1. <strong>Historical Context and Classification Changes</strong>: The document discusses past and current classifications, highlighting the distinction between primary and secondary glioblastomas. Secondary glioblastomas develop from lower grade gliomas in younger patients, contrasting with the de novo onset in older patients typical of primary glioblastomas.<br /><br />2. <strong>Molecular Characteristics</strong>: The presentation underscores the importance of molecular markers, such as IDH mutations, EGFR amplification, and 1p/19q co-deletions, in defining glioma subtypes and prognoses.<br /><br />3. <strong>Tumor Entities and Grading</strong>: It describes various glioma subtypes, such as astrocytomas and oligodendrogliomas, categorized by WHO grades and molecular features, including IDH-mutant and IDH-wildtype status. Emerging entities like pediatric high-grade diffuse astrocytic tumors and genetically defined pediatric diffuse gliomas are introduced.<br /><br />4. <strong>Clinical Implications</strong>: The integration of molecular data in glioma diagnosis influences therapeutic strategies. The framework from cIMPACT-NOW updates is set to guide future classifications and treatment plans.<br /><br />5. <strong>New Diagnostic Principles</strong>: The emergence of new entities based on genetic features is discussed, emphasizing the need for updated WHO guidelines to reflect these advancements.<br /><br />The presentation concludes with take-home points stressing the impact of molecular diagnostics in refining glioma diagnosis and highlights the role of ongoing updates in shaping the future of brain tumor classification and management.

Keywords

glioma diagnosis

WHO classification

molecular methods

surgical neuropathology

IDH mutations

EGFR amplification

1p/19q co-deletions

astrocytomas

oligodendrogliomas

cIMPACT-NOW