Abstract
The present study has attempted to demonstrate that the morphological spectrum of oligodendrogliomas includes tumors which are traditionally misinterpreted as ‘diffuse fibrillary astrocytoma’. We have shown that these tumors are in fact made of isolated neoplastic oligodendrocytes which are entrapped in a fibrillary background composed of axons and fibrillary reactive gliosis. Analysis in a series of 153 ‘pure’ supratentorial oligodendrogliomas composed of ‘classical’ or pseudo ‘diffuse fibrillary oligodendrogliomas’ diagnosed by imaging-based serial stereotactic biopsies showed that 2/3 of the tumors were exclusively made of isolated tumor cells (ITCs) (structure type III) and that only 1/3 of them exhibited both ITCs and solid tumor tissue components (structure type II). The tumor tissue destroys the brain parenchyma and contains new formed microblood vessels whereas ITCs do not destroy the parenchyma and are not associated with microangiogenesis. These fundamentally opposite morphological characteristics were reflected by the following findings: 1) contrast enhancement was observed in 64% of structure type II but was never seen in structure type III oligodendrogliomas. 2) a neurological deficit occurred in 57% of structure type II but in only 8% of structure type III oligodendrogliomas. 3) using the new grading system described in the companion paper to this study, we found that the biological behavior of oligodendrogliomas was also closely related to the patterns of tumor growth. From a synthesis of data gathered in this study it is suggested that emergence of microangiogenesis within a tumor which at first grows slowly with a structure type III pattern is a crutial event toward more aggressive behavior.
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References
Bailey P, Cushing H: A Classification of Tumors of the Glioma Group. J.B. Lippincott, Philadelphia 1926
Burger PC, Scheithauer BW: Oligodendroglial neoplasms. In: AFIP Atlas of Tumor Pathology, Series 3, Fascicle 10. Armed Forces Institute of Pathology, Washington, DC 107–120, 1994
Bruner JM: Oligodendroglioma: diagnosis and prognosis. Seminars in Diagnostic Pathology 4: 251–261, 1987
Russel DS, Rubinstein LJ: Pathology of Tumours of the Nervous System. Edward Arnold, 5th edition, 172–186, 1989
Kleihues P, Burger PC, Scheithauer BW: Histological typing of tumours of the central nervous system. In: World Health Organization. Springer-Verlag, Berlin p 16, 1993
Lopes BS, Vandenberg SR, Scheithauer BW: The pathology of oligodendrogliomas. In: Appuzo MLS (ed) Benign Cerebral Glioma. Vol. 1, AANS 83–94, 1995
Daumas-Duport C, Monsaingeon V, Szenthe L et al.: Serial stereotactic biopsies: a double histological code of gliomas according to malignancy and 3-D configuration, as an aid to therapeutic decision and assessment of results. Appl Neurophysiol 45: 431–437, 1982
Daumas-Duport C, Scheithauer BW, Kelly PJ: A histologic and cytologic method for the spatial definition of gliomas. Mayo Clin Proc 62: 435–449, 1987
Daumas-Duport C: Histoprognosis of gliomas. Advances and Technical Standards in Neurosurgery, Vol. 21: 43–72, 1994
Daumas-Duport C: Patterns of tumor growth and problems associated with histological typing of low-grade gliomas. In: Benign Cerebral Glioma, Vol. 1: 125–147, 1995
Daumas-Duport C: Dysembryoplastic neuroepithelial tumours. Brain Pathol 3: 283–295, 1993
Zander E, Khamlichi AE: Etude d'une série opératoire homogène de 35 cas d'oligodendrogliomes. Neurochirurgie 24: 37–46, 1978
Mork SJ, Lindegaard KF, Halvorsey TB, Lehmann EH, Solgaard T, Hatlevoll R, Harvei S, Ganz J: Oligodendrogioma: incidence and biological behavior in a defined population. J Neurosurg 63: 881–889, 1985
Ludwig CL, Smith MT, Godfrey AD, Armbrustmacher VW: A clinicopathological study of 323 patients with oligodendrogliomas. Ann Neurol 19: 15–21, 1986
Wilkinson IMS, Anderson JR, Holmes AE: Oligodendroglioma: an analysis of 42 cases. J Neurol Neurosurg Phychiatry 50: 304–312, 1987
Bullard DE, Rawlings CE, Phillips B, Cox EB, Clifford Schold S, Burger P, Halperin EC: Oligodendroglioma: an analysis of the value of radiation therapy. Cancer 60: 2179–2188, 1987
Lee YY, Van Tassel P: Intracranial oligodendrogliomas: imaging findings in 35 untreated cases. AJR 152: 361–369, 1989
Shaw EG, Scheithauer BW, O'Fallon JR, Tazelaar HD, Davis DH: Oligodendrogliomas: the Mayo Clinic experience. J Neurosurg 76: 428–434, 1992
Shimizu KT, Tran LM, Mark RJ, Selch MT: Management of oligodendrogliomas. Radiology 186: 569–572, 1993
Nijjar TS, Simpson WJ, Gadalla T, Math M, McCartney M: Oligodendroglioma. The Princess Margaret Hospital experience (1958- 1984). Cancer 12, Vol. 71: 4002–4006, 1993
Celli P, Nofrone I, Palma L, Cantore G, Fortuna A: Cerebral oligodendroglioma: prognostic factors and life history. Neurosurg 6, Vol. 35: 1018–1035, 1994
Gannett DE, Wisbeck WM, Silbergeld DL, Berger MS: The role of postoperative irradiation in the treatment of oligodendroglioma. Int J Radiation Oncology Biol Phys, Vol. 30: 567–573, 1994
Roberts M, German WJ: A long term study of patients with oligodendrogliomas. J Neurosurg 82: 84–89, 1982
Weir B, Elvidge AR: Oligodendrogliomas: an analysis of 63 cases. J Neurosurg 29: 500–505, 1968
Chin HW, Hazel JJ, Kim TH, Webster JH: Oligodendrogliomas. 1. A clinical study of cerebral oligodendrogliomas. Cancer 45: 1458–1466, 1980
Afra MD, Schröder R: Supratentorial recurrences of gliomas. Morphological studies in relation to time intervals with oligodendrogliomas. Acta Neurochir 39: 15–25, 1977
Kros JM, Troost D, Eden GV, Van Der Werf JM, Uylings BM: Oligodendroglioma: a comparison of two grading systems. Cancer 61: 2251–2259, 1988
Rubinstein LJ: Tumors of the central nervous system. AFIP atlas of tumor pathology, Series 2, Fascicle 6. Armed Forces Institute of Pathology, Washington, DC 85–104, 1972
Nov AA, Peirce KR, Mauney M, Shaw CM: Thalamic oligodendrogliomas of childhood: CT and clinical course. J Neuroradiol 15: 23–30, 1988
Favier J, Pizzolato GP, Berney J: Oligodendroglial tumors in childhood. Child's Nerv Syst 1: 33–38, 1985
Hirsch JF, Sainte-Rose C, Pierre-Kahn A, Pfister A, Hoppe-Hirsch E: Benign astrocytic and oligodendrocytic tumors of the cerebral hemispheres in children. J Neurosurg 70: 568–572, 1989
Tice H, Barnes PD, Goumnerova L, Scott RM, Tarbell NJ: Pediatric and adolescent oligodendrogliomas. AJNR 14: 1293–1300, 1993
de la Monte SM: Uniform lineage of oligodendrogliomas. Am J Pathol 3, Vol. 135: 529–540, 1989
Lewis PD: Cell proliferation in the postnatal nervous system and its relationship to the origin of gliomas. Seminars in Neurol 3, Vol. 1: 181–187, 1981
Daumas-Duport C, Monsaingeon V, N'Guyen JP et al.: Some correlations between histological and CT aspects of cerebral gliomas contributing to the choice of significant trajectories for stereotactic biopsies. Acta Neurochir Suppl 33: 185–194, 1984
Daumas-Duport C, Monsaingeon V, Blond S et al.: Serial stereotactic biopsies and CT scan in gliomas: correlative study in 100 astrocytomas, oligo-astrocytomas and oligodendrocytomas. J Neurooncol 4: 317–328, 1986
Kelly PJ, Daumas-Duport C, Scheithauer BW et al.: Stereotactic histologic correlations of computed tomography - and magnetic resonance imaging - defined abnormalities in patients with glial neoplasm. Mayo Clin Proc 62: 450–459, 1987
Kelly PJ: Tumor Stereotaxis. WB Saunders, Philadelphia 296–357, 1991
Kelly PJ, Daumas-Duport C, Kispert DB: Imaging-based stereotactic serial biopsies in untreated intracranial glial neoplasms. J Neurosurg 66: 865–874, 1987
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Daumas-Duport, C., Varlet, P., Tucker, ML. et al. Oligodendrogliomas. Part I: Patterns of growth, histological diagnosis, clinical and imaging correlations: A study of 153 cases. J Neurooncol 34, 37–59 (1997). https://doi.org/10.1023/A:1005707203596
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DOI: https://doi.org/10.1023/A:1005707203596