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Encyclopedia > Oligodendroglioma
Oligodendroglioma
Classification & external resources
ICD-10 C71
ICD-9 191.9
ICD-O: 9450/3-9451/3
eMedicine neuro/281 

Oligodendrogliomas are a type of glioma that are believed to originate from the oligodendrocytes of the brain or from a glial precursor cell. They occur primarily in adults (9.4% of all primary brain and hihihicentral nervous system tumors) and are only rarely found in children (4% of all primary brain tumors). The median age of diagnosis for oligodendroglioma is 41 years of age. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... A glioma is a type of primary central nervous system (CNS) tumor that arises from glial cells. ... These are a variety of neuroglias that wrap around neurons in Central Nervous System to for the mtolin sheath, increasing impulse speed. ... Italic text // ahh addiing sum spiice iin hurr`` For other uses, see Brain (disambiguation). ...

Contents

Etiology

The aetiology of oligodendrogliomas is unknown. Some studies have linked oligodendroglioma with a viral cause, a single case report has linked oligodendroglioma to irradiation of pituitary adenoma.


Symptoms

In anywhere from fifty to eighty percent of cases, the first symptom of an oligodendroglioma is the onset of seizure activity. They occur mainly in the frontal lobe thus affecting personality. Headaches combined with increased intracranial pressure are also a common symptom of oligodendroglioma. Depending on the location of the tumor, any neurological deficit can be induced, from visual loss, motor weakness and cognitive decline. A Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scan is necessary to characterize the anatomy of this tumor (size, location, heter/homogeneity). However, final diagnosis of this tumor, like most tumors, relies on histopathologic examination (biopsy examination). This article is about the medical term, epileptic seizure, as distinct from a non-epileptic seizure. ... The frontal lobe is an area in the brain of vertebrates. ... A headache is a condition of mild to severe pain in the head; sometimes upper back or neck pain may also be interpreted as a headache. ... Intracranial pressure, (ICP), is the pressure exerted by the cranium on the brain tissue, cerebrospinal fluid (CSF), and the brains circulating blood volume. ... This article does not cite any references or sources. ... Magnetic Resonance Image showing a median sagittal cross section through a human head. ... Tumor or tumour literally means swelling, and is sometimes still used with that meaning. ... Histopathology is a field of pathology which specialises in the histologic study of diseased tissue. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...


Microscopic Appearance

Oligodendrogliomas cannot currently be differentiated from other brain lesions solely by their clinical or radiographic appearance. As such, a brain biopsy is the only method of definitive diagnosis. Oligodendrogliomas recapitulate the appearance of the normal resident oligodendroglia of the brain. (Their name derives from the Greek roots 'oligo' meaning “ few” and 'dendro' meaning “trees”.) They are generally composed of cells with small to slightly enlarged round nuclei with dark, compact nuclei and a small amount of eosinophilic cytoplasm. They are often referred to as "fried egg" cells due to their histologic appearance. They appear as a monotonous population of mildly enlarged round cells infiltrating normal brain parenchyma and producing vague nodules. Although the tumor may appear to be vaguely circumscribed, it is by definition a diffusely infiltrating tumor. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Oligodendroglia are the myelin producing cells of the central nervous system. ...


Classically they tend to have a vasculature of finely branching capillaries that may take on a “chicken wire” appearance . When invading grey matter structures such as cortex, the neoplastic oligodendrocytes tend to cluster around neurons exhibiting a phenomenon referred to as “perineuronal satellitosis”. Oligodendrogliomas may invade preferentially around vessels or under the pial surface of the brain. Neurons (also called nerve cells) are the primary cells of the nervous system. ... [www. ...


Oligodendrogliomas must be differentiated from the more common astrocytoma. Non-classical variants and combined tumors of both oligodendroglioma and astrocytoma differentiation are seen, making this distinction controversial between different neuropathology groups. In the US, in general, neuropathologists trained on the West Coast are more liberal in the diagnosis of oligodendroliomas than either East Coast or Midwest trained neuropathologists who render the diagnosis of oligodendroglioma for only classic variants. Molecular diagnostics may make this differentiation obsolete in the future. Astrocytomas are primary intracranial tumors derived from astrocytes cells of the brain. ... Neuropathology is the study of diseases of the nervous system, and is a medical subspecialty within the specialty of anatomical pathology, itself a division within pathology in many English speaking countries. ...


Other glial and glioneuronal tumors with which they are often confused due to their monotonous round cell appearance include pilocytic astrocytoma, central neurocytoma, the so-called dysembryoplastic neuroepithelial tumor, or occasionally ependymoma. A glioma is a type of primary central nervous system (CNS) tumor that arises from glial cells. ... It occurs predominantly in children and involves the midline, basal and posterior fossa structures. ... Dysembryoplastic neuroepithelial tumour, commonly abbreviated DNT, is a type of brain tumour that arises from the oligodendrocyte, a type of brain cell. ... Ependymoma are tumors arising from the inner lining of the cerebral ventricles (= intracranial) and the remnants of the central canal in the spinal cord. ...



Histopathological Grading


The histopathologic grading of oligodendrogliomas is controversial. Currently the most commonly used grading schema is based on year 2000 World Health Organization (WHO) guidelines. Oligodendrogliomas are generally dichotomized into grade II (low grade) and grade III (high grade) tumors. The designation of grade III oligodendroglioma (high grade) generally subsumes the previous diagnoses of anaplastic or malignant oligodendroglioma. The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ...


Unfortunately, the 2000 WHO guidelines include subjective criteria in differentiating grade II and grade III tumors including the appreciation of “significant” hypercellularity and pleomorphism in the higher grade lesion. In addition, the presence of low mitotic activity, vascular proliferation and necrosis, including pseudopalliasing necrosis are insufficient by themselves to elevate the grade of these tumors. This leads to inevitable interobserver variability in diagnosis by pathologists. The ultimate responsibility for making treatment decisions and interpretation of these diagnoses lies with the oncologist in consultation with the patient and their family.


The WHO guidelines contain a category for grade IV oligodendrogliomas which essentially appear to be glial neoplasms with overwhelming features of glioblastoma multiforme (GBM) arising from known lower grade oligodendrogliomas or GBM with a significant proportion of oligodendroglial differentiation. The diagnostic ultility of this latter category is uncertain as these tumors may behave either like glioblastoma or grade III oligodendrogliomas. As such, this is an exceptionally unusual diagnosis. The World Health Organization (WHO) is a specialized agency of the United Nations (UN) that acts as a coordinating authority on international public health. ... Image 1a. ...


New WHO guidelines due to be published in the last quarter of 2006 may resolve some of these diagnostic issues.


Molecular Genetics

By far, the most common structural deformity found is co-deletion of chromosomal arms 1p and 19q. The high frequency of co-deletion (~70%) is a striking feature of this glial tumour, and is considered as a "genetic signature" of oligodendroglioma. 1p/19q deletion has been correlated with both chemosensitivity and improved prognosis in oligodendrogliomas.[1][2] A t(1;19)(q10;p10) translocation mediates the combined deletions of 1p and 19q.


Prognosis & Treatment

Oligodendrogliomas are generally felt to be incurable using current treatments. However compared to the more common astrocytomas, they are slowly growing with prolonged survival. In one series, median survival times for oligodendrogliomas were 11.6 years for grade II and 3.5 years for grade III.[3] Because of the indolent nature of these tumors and the potential morbidity associated with neurosurgery, chemotherapy and radiation therapy, most neurooncologists will intitially pursue a course of watchful waiting and treat patients symptomatically. Symptomatic treatment often includes the use of anticonvulsants for seizures and steroids for brain swelling. PCV chemotherapy has been shown to be effective and is currently the most commonly used chemotherapy regimen used for treating anaplastic oligodendrogliomas.[4] Temozolomide is a common chemotheraputic drug to which oligodendrogliomas appear to be quite sensitive. It is often used as a first line therapy. Astrocytomas are intracranial tumors derived from astrocytes. ... In probability theory and statistics, a median is a number dividing the higher half of a sample, a population, or a probability distribution from the lower half. ... In medicine, epidemiology and actuarial science, the term morbidity can refer to the state of being diseased (from Latin morbidus: sick, unhealthy), the degree or severity of a disease, the prevalence of a disease: the total number of cases in a particular population at a particular point in time, the... Insertion of an electrode during neurosurgery for Parkinsons disease. ... Chemotherapy is the use of chemical substances to treat disease. ... Clinac 2100 C100 accelerator Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... Oncology is the branch of medicine that studies tumors (cancer) and seeks to understand their development, diagnosis, treatment, and prevention. ... Watchful waiting, also referred to as observation, is an approach to a medical problem in which time is allowed to pass before further testing or therapy is pursued. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... Edema (BE: oedema, formerly known as dropsy) is swelling of any organ or tissue due to accumulation of excess fluid. ... Temozolomide (brand name Temodar® Schering-Plough Corporation) is an oral alkylating agent used for the treatment of refractory anaplastic astrocytoma -- a type of cancerous brain tumor. ...


Because of their diffusely infiltrating nature, oligodendrogliomas cannot be completely resected and are not curable by surgical excision. If the tumor mass compresses adjacent brain structures, a neurosurgeon will typically remove as much of the tumor as he or she can without damaging other critical, healthy brain structures. Surgery may be followed up by chemotherapy, radiation, or a mix of both. Oligodendrogliomas, like all other infiltrating gliomas, have a very high (almost uniform) rate of recurrence and gradually increase in grade over time. Recurrent tumors are generally treated with more aggressive chemotherapy and radiation therapy. Recently, stereotactic surgery has proven successful in treating small tumors that have been diagnosed early. “Surgeon” redirects here. ... Insertion of an electrode during neurosurgery for Parkinsons disease. ... Chemotherapy is the use of chemical substances to treat disease. ... Radiation as used in physics, is energy in the form of waves or moving subatomic particles. ... A glioma is a type of primary central nervous system (CNS) tumor that arises from glial cells. ... Stereotactic surgery or stereotaxy is a minimally-invasive form of surgical intervention which makes use of a three-dimensional coordinates system to locate small targets inside the body and to perform on them some action such as ablation (removal), biopsy, lesion, injection, stimulation, implantation, radiosurgery etc. ...


Long-term survival is reported in a minority of patients.[5] With aggressive treatment and close monitoring, it is possible to outlive the typical life expectancies for both low grade and high grade oligodendrogliomas. In rare cases, patients have survived for up to fifteen years post-diagnosis. Westergaard’s study (1997) showed that patients younger than 20 years had a median survival of 17.5 years.[6] Another study shows a 34% survival rate after 20 years. [7]


References

  1. ^ Laigle-Donadey F, Benouaich-Amiel A, Hoang-Xuan K, Sanson M. [Molecular biology of oligodendroglial tumors]. Neurochirurgie. 2005 Sep;51(3-4 Pt 2):260-8. PMID: 16292170
  2. ^ Walker C, Warnke PC, et al. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16769937&query_hl=13&itool=pubmed_docsum Clinical use of genotype to predict chemosensitivity in oligo
  3. ^ Ohgaki H, Kleihues P. Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol. 2005 Jun;64(6):479-89. PMID: 15977639
  4. ^ Herbert H. Engelhard, M.D., Ph.D., Ana Stelea, M.D., and Arno Mundt, M.D.[1] p.452
  5. ^ Tatter SB. Recurrent malignant glioma in adults. Curr Treat Options Oncol. 2002 Dec;3(6):509-24. PMID: 12392640,
  6. ^ Herbert H. Engelhard, M.D., Ph.D., Ana Stelea, M.D., and Arno Mundt, M.D.[2] p.449
  7. ^ http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=PubMed&list_uids=12796617&dopt=Abstract

  Results from FactBites:
 
Oligodendroglioma : Cancerbackup (1508 words)
Oligodendroglioma is a type of glioma and develops from cells called oligodendrocytes.
Grade 1 and 2 oligodendrogliomas may be referred to as low-grade tumours, and grade 3 and 4 as high-grade.
Oligodendrogliomas can grow in different parts of the brain, and symptoms may relate to the area of the brain which is affected.
Oligodendroglioma - WrongDiagnosis.com (631 words)
Oligodendroglioma is a well-differentiated (WHO grade II), diffusely infiltrating tumor of adults, typically located in the cerebral hemispheres and composed predominantly of cells which morphologically resemble oligodendroglia.
Oligodendrogliomas generally recur locally, with median post-operative survival times ranging from 3 to 5 years for patients with all histological grades.
Oligodendrogliomas are a type of glioma that are believed to originate from the oligodendrocytes of the brain or from a glial precursor cell.
  More results at FactBites »

 
 

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