Essentials of Diagnostic Surgical Neuropathology (eBook)

Chitra Sarkar, Vani Santosh, Geeta Chacko, Anita Mahadevan (Herausgeber)

eBook Download: EPUB

2024 | 2. Auflage
360 Seiten
Thieme Medical Publishers (Verlag)
978-93-95390-08-8 (ISBN)

Infos

<p>Keeping abreast of the major strides made in the field of neuropathology, <cite>Essentials of Diagnostic Surgical Neuropathology</cite> brings out its second edition with the aim of keeping the neuroscience community updated with the new developments in neuropathology.</p> <p>This second edition comes close on the heels of the fifth edition of the WHO Classification of Central Nervous System Tumours (WHO CNS5) which was published in 2021. This new edition has retained the concise, point wise format of the earlier edition, making it a handy reference book. While the major changes in this edition are in neoplastic pathology, this book also provides updates in the pathology of non-neoplastic lesions that need surgical intervention.</p> <p><strong>The highlights of the neoplastic section are:</strong></p> <ul> <li>Description of new tumour types and subtypes included in the WHO CNS5</li> <li>Grading of tumours as per WHO CNS5</li> <li>Relevant immune profile and diagnostic molecular pathology for each tumour according to WHO CNS5. Essential and desirable diagnostic criteria, as defined by WHO CNS5, in a tabular form at the end</li> </ul> <p> </p> <p><strong>The salient features of the non-neoplastic section include:</strong></p> <ul> <li>New section on Therapy-related Neuropathology</li> <li>Recent classifications of vascular malformations and epilepsy related lesions</li> <li>New section on Infectious and Inflammatory Lesions Mimicking Neoplasms</li> <li>New chapter on Surgical Pathology of Spinal Dysraphism and Other Neural Tube Defects</li> <li>Another important feature includes the addition of a new chapter on techniques viz.</li> <li>Smears in the Rapid Diagnosis of Central Nervous System Lesions</li> <li>Challenges in the Interpretation of Stereotactic Biopsies</li> </ul> <p> </p> <p><strong>Publisher's Note: Products purchased from Third Party sellers are not guaranteed by the publisher for quality, authenticity, or access to any online entitlements included with the product.</strong></p>

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1 Tumors of the Nervous System

1.1Introduction to the Fifth Edition of the World Health Organization Classification of Tumors of the Central Nervous System (WHO CNS5) Chitra Sarkar, Swati Mahajan, Vaishali Suri, and Mehar Chand Sharma 1.2Adult-Type Diffuse Gliomas Vani Santosh and Shilpa Rao 1.3Circumscribed Astrocytic Gliomas Vani Santosh and Shilpa Rao 1.4Pediatric-type Diffuse Low-Grade Gliomas Shilpa Rao and Vani Santosh 1.5Pediatric-type Diffuse High-grade Gliomas Ayushi Sahay, Saumya Sahu, and Vaishali Suri 1.6Glioneuronal and Neuronal Tumors Suvendu Purkait, Swati Mahajan, Mehar Chand Sharma, Chitra Sarkar, and Vaishali Suri 1.7Ependymal Tumors Rakesh Kumar Gupta, Ravindra Kumar Saran, and Mehar Chand Sharma 1.8Choroid Plexus Tumors Aparna Govindan and Yasha T. C. 1.9Embryonal Tumors Vaishali Suri, Swati Mahajan, Saumya Sahu, and Chitra Sarkar 1.10Pineal Tumors Lateef Zameer and Megha S. Uppin 1.11Meningioma Ranjani Jayachandran and Geeta Chacko 1.12Mesenchymal Non-meningothelial Tumors Involving the CNS Hemanth Kumar R., Ranjani Jayachandran, and Geeta Chacko 1.13Cranial and Paraspinal Nerve Tumors Yasha T. C. and Aditi Goyal 1.14Melanocytic Tumors Shilpa Rao, Sridhar Epari, and Megha Uppin 1.15Hematolymphoid Tumors Involving the CNS Debajyoti Chatterjee, Mayur Parkhi, Kirti Gupta, and Bishan D. Radotra 1.16Germ Cell Tumors Megha S. Uppin and Sundaram Challa 1.17Tumors of the Sellar Region Geeta Chacko, Abha Elizabeth John, and Rima S. 1.18Genetic Tumor Syndromes Involving the CNS Sushama V. Patil, Soutrik Das, Soumya Dey, and Uttara Chatterjee 1.19Metastases to the CNS Kirti Gupta and Bishan D. Radotra 1.20Tumors of the Spine Kiran Preet Malhotra and Nuzhat Husain 1.21Cysts of the Central Nervous System Kirti Gupta and Bishan D. Radotra 1.22Therapy-related Neuropathology Kirti Gupta and Bishan D. Radotra

1.1	Introduction to the Fifth Edition of the World Health Organization Classification of Tumors of the Central Nervous System (WHO CNS5)

Chitra Sarkar, Swati Mahajan, Vaishali Suri, and Mehar Chand Sharma

Introduction

The World Health Organization (WHO) classification is the well-accepted classification system for central nervous system (CNS) tumors globally. This classification system forms the foundation for neuropathologic diagnosis of CNS tumors and has prognostic and therapeutic significance. Until recently, there have been four editions of this classification, popularly known as the “Blue Books.” The first, second, third, and fourth editions were published in 1979, 1993, 2000, and 2007, respectively. In all these, the classification and grading have been based exclusively on histopathologic characteristics using the routine hematoxylin and eosin stains along with immunohistochemical markers as adjuncts to aid the diagnosis.

For the past two decades, there has been an upsurge of molecular data, from which clinically relevant molecular biomarkers have evolved and these have been found to have prognostic and predictive benefits within tumor groups. This augmented understanding of the molecular data on brain tumors led to the release of a prior “update” of the revised WHO CNS tumor classification, fourth edition, in 2016, rather than awaiting the fifth edition. A drastic transformation was observed in the 2016 WHO classification of tumors of the CNS that incorporated for the first time molecular information along with classic histological characteristics in an integrated diagnosis format, in an endeavor to define distinct tumor entities.

However, while the WHO 2016 revision was being compiled, the swift emergence of promising molecular biomarkers, novel distinct entities, and new therapeutic targets necessitated the formation of the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT) to provide recommendations for future WHO classifications. Seven updates were published by cIMPACT, which contributed significantly to the preparation of the fifth edition of the WHO classification of CNS tumors released in 2021 (WHO CNS5). This edition has added important changes related to taxonomy, nomenclature, and grading of CNS tumors as well as introduced several newly recognized tumor types and subtypes.

This chapter provides a summary of the major changes introduced in the WHO CNS5.

1.1.1 CNS Tumor Taxonomy

Reorganization of Tumor Groups

A hybrid/mixed approach has been used for grouping of tumors viz.

•Grouping based on genetic changes that are essential for diagnosis, e.g., IDH and H3 status, MN1 alteration, etc.

•Grouping based on histological and histogenetic similarities (though molecular alterations are different), e.g., glione­uronal and neuronal tumors.

•Grouping based mainly on morphological features (molecular approaches rarely or never used), e.g., meningiomas.

Restructuring of Tumor Groups

•Diffuse gliomas have for the first time been divided into adult and pediatric types, based on their clinical and molecular parameters, despite sharing similar histomorphological features.

•Pediatric-type diffuse gliomas have been further classified into pediatric-type low- and high-grade gliomas.

•A new classification system has been introduced for ependymomas based on a combination of features, namely anatomic site, histopathology, and molecular alterations.

•Major tumor groups in WHO CNS5 are shown in Table 1.1.1.

Table 1.1.1 Major tumor groups in WHO CNS5

1.

Gliomas, glioneuronal, and neuronal tumors

•Adult-type diffuse gliomas •Pediatric-type diffuse low-grade gliomas •Pediatric-type diffuse high-grade gliomas •Circumscribed astrocytic gliomas •Glioneuronal and neuronal tumors •Ependymal tumors

2.	Choroid plexus tumors

3.

Embryonal tumors

•Medulloblastoma, molecularly defined •Medulloblastoma, histologically defined •Other CNS embryonal tumors

4.	Pineal tumors

5.	Cranial and paraspinal nerve tumors

6.	Meningioma

7.

Mesenchymal, nonmeningothelial tumors

•Soft-tissue tumors •Chondro-osseous tumors •Notochordal tumors

8.

Melanocytic tumors

•Diffuse meningeal melanocytic neoplasms •Circumscribed meningeal melanocytic neoplasms

9.

Hematolymphoid tumors

•Lymphomas •Histiocytic tumors

10.	Germ cell tumors

11.	Tumors of the sellar region

12.	Metastases to the CNS

Introduction of the Terms “Type” and “Subtype”

•In WHO CNS5, the earlier terms “entity” and “variant” have been replaced by “type” and “subtype,” respectively.

•“Type” is used to define a neoplasm in which multiple parameters (e.g., clinical, anatomic, histopathologic, and/or molecular) differ from other types.

•“Subtype” defines a variant of a type in which a single or couple of parameters (clinical, anatomic, histopathologic, and/ or molecular) differ from other subtypes, thus making it essential to acknowledge the variant independently (e.g., three subtypes of glioblastoma, IDH wildtype).

•Only “types” are enumerated in the main classification, whereas “subtypes” are narrated under individual sections/chapters. For example, meningioma is a single type enlisted in the classification, whereas all the histological subtypes are discussed within the meningioma chapter.

1.1.2 Modifications in Grading of CNS Tumors

Use of the Term CNS WHO Grade

•Done to emphasize that the WHO grading criteria of CNS tumors are different from that of non-CNS neoplasms, e.g., glioblastoma, IDH wild type, CNS WHO grade 4.

Use of Arabic Numerals (1, 2, 3, 4) Instead of Roman Numerals (I, II, III, IV) for Grading

•Done...

Produkt-Details

• Erscheint lt. Verlag: 10.1.2024
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Allgemeines / Lexika
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie
• Schlagworte: Management of Central Nervous Tumors • Neoplastic Pathology • Neurosurgery Book
• ISBN-10: 93-95390-08-5 / 9395390085
• ISBN-13: 978-93-95390-08-8 / 9789395390088