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Review
. 2023 May;162(3):461-469.
doi: 10.1007/s11060-023-04250-5. Epub 2023 Jan 30.

Updates on the WHO diagnosis of IDH-mutant glioma

David E Reuss  1   2
Affiliations
Review

Updates on the WHO diagnosis of IDH-mutant glioma

David E Reuss. J Neurooncol. 2023 May.

Abstract

Purpose: The WHO classification of Tumors of the Central Nervous System represents the international standard classification for brain tumors. In 2021 the 5th edition (WHO CNS5) was published, and this review summarizes the changes regarding IDH-mutant gliomas and discusses unsolved issues and future perspectives.

Methods: This review is based on the 5th edition of the WHO Blue Book of CNS tumors (WHO CNS5) and relevant related papers.

Results: Major changes include taxonomy and nomenclature of IDH-mutant gliomas. Essential and desirable criteria for classification were established considering technical developments. For the first time molecular features are not only relevant for the classification of IDH-mutant gliomas but may impact grading as well.

Conclusion: WHO CNS5 classification moves forward towards a classification which is founded on tumor biology and serves clinical needs. The rapidly increasing knowledge on the molecular landscape of IDH-mutant gliomas is expected to further refine classification and grading in the future.

Keywords: CNS5; Classification; Glioma; IDH-mutant; Molecular pathology; Neuropathology; WHO.

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Conflict of interest statement

The author declares no competing interests.

Figures

Fig. 1
Fig. 1
Histology of IDH-mutant gliomas. Astrocytoma, IDH-mutant CNS WHO grade 2 with low cellularity and mild nuclear atypia (a), grade 3 showing increased cellularity and mitotic activity (M, arrows) (b), grade 4 exhibiting microvascular proliferation (c, MP) and palisading necrosis (d, N). Oligodendroglioma, IDH-mutant and 1p/19q-codeleted CNS WHO grade 2 displaying the typical honeycomb appearance (e) and grade 3 showing microvascular proliferation (MP) and increased mitotic activity (M)
Fig. 2
Fig. 2
Chromosomal copy number plots from an astrocytoma, IDH-mutant at its primary manifestation corresponding to CNS WHO grade 2 (a) and at recurrence, corresponding to CNS WHO grade 4 (b). Note the overall increase of chromosomal copy number alterations (gains marked green and losses marked red) in the recurrent tumor including a homozygous CDKN2A/B (arrow) deletion and a MET amplification (arrow-head)
See this image and copyright information in PMC

Comment in

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