局限性 IDH 野生型组织学弥漫性星形细胞瘤的影像学特征:单机构病例系列。

Imaging features of localized IDH wild-type histologically diffuse astrocytomas: a single-institution case series.

机构信息

Department of Neurosurgery, Nagoya University School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8550, Japan.

出版信息

Sci Rep. 2023 Jan 16;13(1):23. doi: 10.1038/s41598-022-25928-2.

Abstract

Isocitrate dehydrogenase wild-type (IDHwt) diffuse astrocytomas feature highly infiltrative patterns, such as a gliomatosis cerebri growth pattern with widespread involvement. Among these tumors, localized IDHwt histologically diffuse astrocytomas are rarer than the infiltrative type. The aim of this study was to assess and describe the clinical, radiographic, histopathological, and molecular characteristics of this rare type of IDHwt histologically diffuse astrocytomas and thereby provide more information on how its features affect clinical prognoses and outcomes. We retrospectively analyzed the records of five patients with localized IDHwt histologically diffuse astrocytomas between July 2017 and January 2020. All patients were female, and their mean age at the time of the initial treatment was 55.0 years. All patients had focal disease that did not include gliomatosis cerebri or multifocal disease. All patients received a histopathological diagnosis of diffuse astrocytomas at the time of the initial treatment. For recurrent tumors, second surgeries were performed at a mean of 12.4 months after the initial surgery. A histopathological diagnosis of glioblastoma was made in four patients and one of gliosarcoma in one patient. The initial status of IDH1, IDH2, H3F3A, HIST1H3B, and BRAF was "wild-type" in all patients. TERT promoter mutations (C250T or C228T) were detected in four patients. No tumors harbored a 1p/19q codeletion, EGFR amplification, or chromosome 7 gain/10 loss (+ 7/ - 10). We assessed clinical cases of localized IDHwt histologically diffuse astrocytomas that resulted in malignant recurrence and a poor clinical prognosis similar to that of glioblastomas. Our case series suggests that even in patients with histologically diffuse astrocytomas and those who present with radiographic imaging findings suggestive of a localized tumor mass, physicians should consider the possibility of IDHwt histologically diffuse astrocytomas.

摘要

异柠檬酸脱氢酶野生型(IDHwt)弥漫性星形细胞瘤具有高度浸润性模式,例如广泛浸润的脑胶质瘤样生长模式。在这些肿瘤中,局部 IDHwt 组织学弥漫性星形细胞瘤比浸润性类型少见。本研究旨在评估和描述这种罕见类型的 IDHwt 组织学弥漫性星形细胞瘤的临床、影像学、组织病理学和分子特征,从而提供更多关于其特征如何影响临床预后和结果的信息。我们回顾性分析了 2017 年 7 月至 2020 年 1 月期间 5 例局部 IDHwt 组织学弥漫性星形细胞瘤患者的记录。所有患者均为女性,初始治疗时的平均年龄为 55.0 岁。所有患者均有局灶性疾病,不包括脑胶质瘤或多灶性疾病。所有患者在初始治疗时均被诊断为弥漫性星形细胞瘤。对于复发性肿瘤,二次手术在初始手术后平均 12.4 个月进行。4 例患者诊断为胶质母细胞瘤,1 例诊断为胶质肉瘤。所有患者的 IDH1、IDH2、H3F3A、HIST1H3B 和 BRAF 的初始状态均为“野生型”。4 例患者检测到 TERT 启动子突变(C250T 或 C228T)。没有肿瘤携带 1p/19q 缺失、EGFR 扩增或染色体 7 增益/10 缺失(+7/-10)。我们评估了局部 IDHwt 组织学弥漫性星形细胞瘤导致恶性复发和预后不良的临床病例,与胶质母细胞瘤相似。我们的病例系列表明,即使在组织学弥漫性星形细胞瘤患者和那些表现为局部肿瘤肿块的影像学表现的患者中,医生也应该考虑 IDHwt 组织学弥漫性星形细胞瘤的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8b81/9842655/cf955abfb777/41598_2022_25928_Fig1_HTML.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索