Is necrosis helpful in the grading of gliomas? Editorial opinion.
The major function of a classification of neoplasms is to correlate with prognosis. During the 1980s two trends developed in the classification of gliomas: 1) the presence of necrosis in astrocytomas defines a subset with the worst prognosis (glioblastoma multiforme) and 2) no comparable subset of oligodendroglioma appears to exist, either histologically or prognostically. Even the worst of the oligodendrogliomas has a better prognosis than glioblastomas. These asymmetries must be kept in mind when one is considering the diagnosis of glioblastoma. The absence of a specific stain for oligodendrogliomas, the difficulty in differentiating small anaplastic cells from oligodendroglial cells and the common occurrence of mixtures of normal and/or reactive oligodendroglia and astrocytes in gliomas combine to create potentially confusing misclassification of many gliomas.
Alvord
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Department of Pathology, University of Washington School of Medicine, Seattle.
D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology*; D005910:Glioma / Q000401:mortality / Q000473:pathology*; D006801:Humans; D009336:Necrosis / Q000473:pathology; D016019:Survival Analysis