© 2003 by Society
© 2003 by the Society forNeuro-Oncology
Pathology of low-grade gliomas: An update of emerging concepts
Division of Neuropathology, Washington University School of Medicine,St. Louis, MO 63110, USA
1 Address correspondence to Arie Perry, Division of Neuropathology, Box 8118,Washington University School of Medicine, 660 South Euclid Ave., St. Louis, MO63110-1093, USA(aperry{at}pathology.wustl.edu)
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Abstract |
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Although the term low-grade glioma (LGG) is useful for itsconnotation of a slow-growing, better prognosis CNS primary neoplasm typicallyoccurring in a young patient, it also serves as a potential diagnosticwastebasket, occasionally leading to conceptual errors, therapeuticuncertainty, or misinterpretation of clinical data. For example, the LGGdesignation is occasionally invoked as a justification for lumping togetherbiologically unrelated entities such as pilocytic astrocytoma and diffuseastrocytoma. Whereas the former represents a benign and potentially surgicallycurable neoplasm that virtually never undergoes malignant transformation, thelatter is a surgically incurable low-grade malignancy, prone to furthermalignant progression and eventual fatality. Therefore, although rare caseslacking a clear distinction may be encountered, the term LGG should beabandoned for a more specific diagnosis whenever possible. The primary goalsof this paper are to review practical surgical pathology issues related to thediagnosis of diffuse LGGs and to update the reader on emergingclinicopathologic and molecular genetic concepts. Also discussed are currentcontroversies of classification/grading and the role of ancillary testing viaimmunohistochemical and genetic techniques.
Received November 5, 2002; Accepted December 13, 2003
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