Gliomas Uncovered: A Deep Dive Into Immunohistochemical and Molecular Features From a Tertiary Care Facility Perspective

TL;DR

This study examines gliomas using histopathology, radiology, and molecular analysis to improve diagnosis accuracy in a hospital setting.

Contribution

The study emphasizes a combined histo-molecular approach for precise glioma diagnosis in clinical practice.

Findings

Astrocytoma, IDH mutant, WHO grade 2 was the most common glioma type observed.

The majority of cases occurred in the 6th decade of life.

Males slightly outnumbered females in the study population.

Abstract

Introduction

Central nervous system (CNS) tumors constitute a heterogeneous group of tumors comprising both benign and malignant populations. Central nervous system tumors carry substantial morbidity and mortality owing to their close anatomical relationship with vital neural structures. Although the exact etiology of CNS malignancies is not fully understood, several factors have been linked to an increased risk, such as genetic predisposition, previous exposure to ionizing radiation, and psychosocial stress. The tremendous increase in knowledge of the molecular markers for all CNS tumors during the last decade has allowed for a better understanding, evaluation, and treatment for the patients.

Materials and methods

This is a retrospective cross-sectional study carried out in the histopathology section of the Department of Pathology, Srirama Chandra Bhanj (SCB) Medical College and Hospital, Cuttack. The study lasted for 12 months, from June 2023 to June 2024. All the histopathologically confirmed cases of gliomas based on the recent 5th edition of the WHO classification were analyzed for further confirmation by molecular analyses. Clinical data (age, sex, grading), radiological investigations, and molecular studies were also done for the final diagnosis.

Results

A total of 66 histopathologically confirmed CNS lesions were analyzed, of which 34 (51.51%) were males and 32 (48.49%) were females. The majority of cases occurred in the 6th decade of life, with 13 cases observed. The maximum age recorded was 72 years, while the youngest patient was a one-month-old female. Twenty-one cases (31.8%) were classified as astrocytoma, IDH mutant, WHO grade 2, followed by WHO grade 4 (13 cases, 19.69%) and WHO grade 3 (nine cases, 13.6%).

Conclusion

This study highlights the importance of histopathological examination in conjunction with clinicoradiological features and molecular analysis to arrive at a final diagnosis especially for gliomas, glioneuronal and neuronal tumors. This combined ‘histo-molecular’ approach allows for a much more precise diagnosis of especially diffuse gliomas and all other CNS neoplasms.

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