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. 2024 Jun 22;11(6):753-762.
doi: 10.1093/nop/npae059. eCollection 2024 Dec.

Histopathologic and molecular profile of gliomas diagnosed in Lagos, Nigeria

Lateef A Odukoya  1 , Cristiane M Ida  1 , Jeanette E Eckel-Passow  2 , Thomas M Kollmeyer  1 , Rachael Vaubel  1 , Daniel H Lachance  3 , Ekokobe Fonkem  4 , Kabir B Badmos  5 , Olufemi B Bankole  6 , Henry Llewellyn  7 , Gasper J Kitange  8 , Kenneth Aldape  9 , Adetola O Daramola  5 , Charles C Anunobi  5 , Robert B Jenkins  1
Affiliations

Histopathologic and molecular profile of gliomas diagnosed in Lagos, Nigeria

Lateef A Odukoya et al. Neurooncol Pract. .

Abstract

Background: The optimal diagnosis and management of patients with brain tumors currently uses the 2021 WHO integrated diagnosis of histomorphologic and molecular features. However, neuro-oncology practice in resource-limited settings usually relies solely on histomorphology. This study aimed to classify glioma cases diagnosed in the Department of Anatomic and Molecular Pathology, Lagos University Teaching Hospital, using the 2021 WHO CNS tumor classification.

Methods: Fifty-six brain tumors from 55 patients diagnosed with glioma between 2013 and 2021 were reevaluated for morphologic diagnosis. Molecular features were determined from formalin-fixed paraffin-embedded (FFPE) tissue using immunohistochemistry (IHC) for IDH1-R132H, ATRX, BRAF-V600E, p53, Ki67, and H3-K27M, OncoScan chromosomal microarray for copy number, targeted next generation sequencing for mutation and fusion and methylation array profiling.

Results: Of 55 central nervous system tumors, 3 were excluded from histomorphologic reevaluation for not being of glial or neuroepithelial origin. Of the remaining 52 patients, the median age was 20.5 years (range: 1 to 60 years), 38(73%) were males and 14(27%) were females. Seventy-one percent of the gliomas evaluated provided adequate DNA from archival FFPE tissue blocks. After applying the 2021 WHO diagnostic criteria the initial morphologic diagnosis changed for 35% (18/52) of cases. Diagnoses of 5 (9.6%) gliomas were upgraded, and 7 (14%) were downgraded.

Conclusions: This study shows that the incorporation of molecular testing can considerably improve brain tumor diagnoses in Nigeria. Furthermore, this study highlights the diagnostic challenges in resource-limited settings and what is at stake in the global disparities of brain tumor diagnosis.

Keywords: brain tumors; glioma; histomorphology; neuro-oncology.

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Conflict of interest statement

There are no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
An abridged flowchart depicting the approach used for tumor diagnosis and testing decisions.
Figure 2.
Figure 2.
Comparison of the Lagos pathologic diagnosis, the Mayo Clinic pathologic diagnosis, and the final 2021 WHO integrated diagnosis.
Figure 3.
Figure 3.
Specific genetic alterations detected in the gliomas evaluated in this study. The tumors are arranged in the same order as in Supplementary Table 2.
See this image and copyright information in PMC

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