Oligodendroglioma

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The oligodendroglioma (outdated: oligodendrocytoma) is a neuroepithelial tumor of different dignity , which probably originates from the oligodendrocytes , a cell type of the glia .

introduction

The oligodendroglioma was first described by Harvey Williams Cushing and Bailey in 1926 and named as such because of its morphological similarity to oligodendrocytes . However, there is no evidence that an oligodendroglioma arises from an oligodendrocyte. In the current scientific literature, stem cells or glial progenitor cells , among other things, are discussed. The tumor occurs particularly in middle-aged adults (35–50 years of age), but has also been observed in children. About 4 to 8% of all brain tumors are oligodendrogliomas. The incidence of oligodendrogliomas appears to be increasing in recent years. The reason discussed is that the positive therapeutic successes are increasingly motivating neuropathologists to judge glial tumors less as astrocytomas than as oligodendrogliomas.

causes

The cause of oligodendrogliomas is unclear. In individual cases, these tumors have been described after brain radiation, brain injuries or in multiple sclerosis . There are also case reports with family clusters. Conflicting data are available on viral induction.

Clinical symptoms

In addition to general signs of intracranial pressure such as headache, persistent nausea and vomiting, the initial clinical symptoms can typically also include epileptic seizures .

Imaging

Typically, the diagnosis is made by magnetic resonance imaging with and without administration of contrast agent or by computer tomography , which sometimes shows calcifications. A contrast enhancement does not indicate a transition to anaplasia as reliably as with astrocytomas .

Neuropathology

Oligodendrogliomas occur mainly in the cerebrum with a distribution frequency of 3: 2: 2: 1 between the frontal , parietal , temporal and occipital lobes . The oligodendroglioma belongs to the group of diffuse gliomas . According to the WHO classification of tumors of the central nervous system , the oligodendroglioma is WHO grade II. Microscopically, one can see optically empty spaces around the cell nuclei , a so-called typical "honeycomb pattern" - an artifact from histological processing.

You can also see very uniform, round cell nuclei and elongated, straight capillaries . Sometimes one also finds mixed tumors with astrocytomas , here one speaks of oligoastrocytomas . Since there are no defined figures on the proportion of oligodendroglial and astrocytic tumor tissue in oligoastrocytomas, the number of diagnoses of oligodendrogliomas and oligoastrocytomas varies considerably between the neuropathological institutes.

Molecular genetics

About 90% of WHO grade II oligodendrogliomas show combined allele losses on the short arm of chromosome 1 (1p) and the long arm of chromosome 19 (19q). Temporally located oligodendrogliomas mostly show no allele losses on 1p and 19q, extra-temporal ones very often show these changes. A centromeric or pericentromeric translocation was identified as the cause of this combined allele loss of 1p and 19q. With the loss of the short arm of chromosome 1 (1p) and the long arm of chromosome 19 (19q), the short arm of chromosome 19 (19p) merges with the long arm of chromosome 1 (1q). The mutations in the p53 gene that are commonly found in astrocytic gliomas (astrocytoma, glioblastoma) are almost completely absent in oligodendrogliomas.

therapy

The therapy of oligodendrogliomas consists primarily in the surgical removal of the tumor. Due to the biological character of diffuse infiltrating gliomas, however, surgical cure is almost impossible. The success of chemotherapy and / or radiation therapy of these two therapeutic options can be estimated in advance based on the genetic profile of the tumor: Oligodendrogliomas with combined allele losses on 1p and 19q respond well to these therapies, while those without losses respond poorly. However, since therapeutic successes using chemotherapy or radiation therapy are also observed in oligodendrogliomas without allele losses, such a therapy is definitely recommended. In the meantime, genetic testing has become established alongside histopathological diagnostics and should be carried out.

forecast

The published survival times of oligodendrogliomas vary significantly in the scientific literature. The 5-year survival rate of oligodendrogliomas WHO grade II is given between 38% and 83%. WHO grade II oligodendrogliomas show a tendency to malignant degeneration and can become anaplastic oligodendrogliomas WHO grade III.

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literature

  • P. Kleihues, WK Cavenee: Pathology and genetics of tumors of the nervous system. 2nd edition. IARC Press, Lyon 2000.
  • G. Reifenberger, DN Louis: Oligodendroglioma: toward molecular definitions in diagnostic neuro-oncology. In: J Neuropathol Exp Neurol . 62, 2003, pp. 111-126. Review.
  • C. Hartmann, W. Mueller, A. von Deimling: Pathology and molecular genetics of oligodendroglial tumors. In: J Mol Med . 82 (10), 2004 Oct, pp. 638-655. Review.
  • P. Bailey, H. Cushing: A Classification of Tumors of the Glioma Group on a Histogenetic basis with a Correlation Study of Prognosis. Lippincott, Philadelphia 1926.
  • B. Herbarth, H. Meissner, M. Westphal, M. Wegner: Absence of polyomavirus JC in glial brain tumors and glioma-derived cell lines. In: Glia. 22, 1998, pp. 415-420.
  • RH Eibl, P. Kleihues, PS Jat, OD Wiestler: A model for primitive neuroectodermal tumors in transgenic neural transplants harboring the SV40 large T antigen. In: Am J Pathol . 144 (3), 1994 Mar, pp. 556-564.
  • H. Huang, R. Reis, Y. Yonekawa, JM Lopes, P. Kleihues, H. Ohgaki: Identification in human brain tumors of DNA sequences specific for SV40 large T antigen. In: Brain Pathol . 9, 1999, pp. 33-42.

Individual evidence

  1. ^ A. Helseth, SJ Mork: Neoplasms of the central nervous system in Norway. III. Epidemiological characteristics of intracranial gliomas according to histology. In: APMIS. 97, 1989, pp. 547-555. PMID 2736107 .
  2. ^ SJ Mork, KF Lindegaard, TB Halvorsen, EH Lehmann, T. Solgaard, R. Hatlevoll, S. Harvei, J. Ganz: Oligodendroglioma: incidence and biological behavior in a defined population. In: J Neurosurg. 63, 1985, pp. 881-889. PMID 4056902 .
  3. ↑ CI Huang, WH Chiou, DM Ho: Oligodendroglioma occurring after radiation therapy for pituitary adenoma. In: J Neurol Neurosurg Psychiatry. 50, 1987, pp. 1619-1624.
  4. ↑ C. Perez-Diaz, A. Cabello, RD Lobato, JJ Rivas, A. Cabrera: Oligodendrogliomas arising in the scar of a brain contusion. Report of two surgically verified cases. In: Surgical Neurology . 24, 1985, pp. 581-586.
  5. ^ MT Giordana, A. Mauro, R. Soffietti, M. Leone: Association between multiple sclerosis and oligodendroglioma. Case report. In: Ital J Neurol Sci. 2, 1981, pp. 403-409.
  6. ↑ JM Kros, ST Lie, SZ Stefanko: Familial occurrence of polymorphous oligodendroglioma. In: Neurosurgery 34, 1994, pp. 732-736; discussion p. 736.
  7. ↑ EC Holland, Y. Li, J. Celestino, C. Dai, L. Schaefer, RA Sawaya, GN Fuller: Astrocytes give rise to oligodendrogliomas and astrocytomas after gene transfer of polyoma virus middle T antigen in vivo. In: Am J Pathol. 157, 2000, pp. 1031-1037.
  8. ↑ MC Zlatescu, A. Tehraniyazdi, H. Sasaki, JF Megyesi, RA Betensky, DN Louis, JG Cairncross: Tumor location and growth pattern correlate with genetic signature in oligodendroglial neoplasms. In: Cancer Res. 61, 2001, pp. 6713-6715.
  9. ^ W. Mueller, C. Hartmann, A. Hoffmann, W. Lanksch, J. Kiwit, J. Tonn, J. Veelken, J. Schramm, M. Weller, OD Wiestler, DN Louis, A. von Deimling: Genetic signature of oligoastrocytomas correlates with tumor location and denotes distinct molecular subsets. In: Am J Pathol. 161, 2002, pp. 313-319.
  10. ↑ A. von Deimling, DN Louis, K. von Ammon, I. Petersen, OD Wiestler, BR Seizinger: Evidence for a tumor suppressor gene on chromosome 19q associated with human astrocytomas, oligodendrogliomas, and mixed gliomas. In: Cancer Res. 52, 1992, pp. 4277-4279.
  11. ↑ J. Reifenberger, G. Reifenberger, L. Liu, CD James, W. Wechsler, VP Collins: Molecular genetic analysis of oligodendroglial tumors shows preferential allelic deletions on 19q and 1p. In: Am J Pathol. 145, 1994, pp. 1175-1190.
  12. ^ JA Kraus, J. Koopmann, P. Kaskel, D. Maintz, S. Brandner, J. Schramm, DN Louis, OD Wiestler, A. von Deimling: Shared allelic losses on chromosomes 1p and 19q suggest a common origin of oligodendroglioma and oligoastrocytoma. In: J Neuropathol Exp Neurol. 54, 1995, pp. 91-95.
  13. ↑ A. von Deimling, R. Fimmers, MC Schmidt, B. Bender, F. Fassbender, J. Nagel, R. Jahnke, P. Kaskel, EM Duerr, J. Koopmann, D. Maintz, S. Steinbeck, W. Wick, M. Platten, DJ Muller, R. Przkora, A. Waha, B. Blumcke, R. Wellenreuther, B. Meyer-Puttlitz, O. Schmidt, J. Mollenhauer, A. Poustka, AP Stangl, D. Lenartz, K. von Ammon: Comprehensive allelotype and genetic analysis of 466 human nervous system tumors. In: J Neuropathol Exp Neurol. 59, 2000, pp. 544-558.
  14. ↑ RB Jenkins, H. Blair, KV Ballman, C. Giannini, RM Arusell, M. Law, H. Flynn, S. Passe, S. Felten, PD Brown, EG Shaw, JC Buckner: A t (1; 19) (q10; p10) mediates the combined deletions of 1p and 19q and predicts a better prognosis of patients with oligodendroglioma. In: Cancer Res. 66, 2006, pp. 9852-9861.
  15. ↑ CA Griffin, P. Burger, L. Morsberger, R. Yonescu, S. Swierczynski, JD Weingart, KM Murphy: Identification of der (1; 19) (q10; p10) in five oligodendrogliomas suggests mechanism of concurrent 1p and 19q loss . In: J Neuropathol Exp Neurol. 65, 2006, pp. 988-994.
  16. ↑ H. Ohgaki, RH Eibl, OD Wiestler, MG Yasargil, EW Newcomb, P. Kleihues: p53 mutations in brain tumors nonastrocytic human. In: Cancer Res. 51, 1991, pp. 6202-6205.
  17. ↑ A. von Deimling, RH Eibl, H. Ohgaki, DN Louis, K. von Ammon, I. Petersen, P. Kleihues, RY Chung, OD Wiestler, BR Seizinger: p53 mutations are associated with 17p allelic loss in grade II and grade III astrocytoma. In: Cancer Res. 52, 1992, pp. 2987-2990.
  18. ↑ JG Cairncross, K. Ueki, MC Zlatescu, DK Lisle, DM Finkelstein, RR Hammond, JS Silver, PC Stark, DR Macdonald, Y. Ino, DA Ramsay, DN Louis: Specific genetic predictors of chemotherapeutic response and survival in patients with anaplastic oligodendrogliomas. In: J Natl Cancer Inst. 90, 1998, pp. 1473-1479.

Web links

Commons : Oligodendroglial tumors  - collection of images, videos and audio files
  • Glioma German Society for Neurology