Diagnosis and classification of diffuse gliomas by morphologic and molecular methods

Gregory N.Fuller; Teresa Ribalta

Abstract：The face of oncologic neuropathology is rapidly changing. Historically, critical technical advances made during the mid and late 19th century, including the development of the first high-quality microscopes, the manufacture of synthetic stains, the discovery of effective tissue fixation and embedding techniques, and the development of modern-style microtomes for cutting thin tissue sections produced the first revolutionary shifts in brain tumor classification. Since those early days, the discipline has taken full advantage of each new wave of technology, with neuropathologists always being well-represented among the earliest adopters of novel technical innovations. Additional revolutionary methodologies of the past that altered the practice of rumor neuropathology include electron microscopy and immunohistochemistry. Currently, the field is in the midst of the latest revolution, molecular diagnostics. Each wave of technological progress has resulted in improved tumor diagnosis, classification and prognosis. In addition,numerous previously unrecognized nosologic entities have been discovered as a direct result of improved diagnostic methodologies. The following review presents the broad panoply of tools employed by contemporary diagnostic neuropathologists, fiom the oldest, simplest and still most highly utilized tissue stain, hematoxylin & eosin, to the latest laboratory techniques for molecular classificationof gliomas through cDNA gene expression profiling.