Anaplasia and Grading in Medulloblastomas

Brain Pathol. 2003 Jul;13(3):376-85. doi: 10.1111/j.1750-3639.2003.tb00037.x.

Abstract

The variable clinical outcomes of medulloblastoma patients have prompted a search for markers with which to tailor therapies to individuals. In this review, we discuss clinical, histological and molecular features that can be used in such treatment customization, focusing on how histopathological grading can impact both patient care and research on the molecular basis of CNS embryonal tumors. Medulloblastomas span a histological spectrum ending in overtly malignant large cell/anaplastic lesions characterized by increased nuclear size, marked cytological anaplasia, and increased mitotic and apoptotic rates. These "high-grade" lesions make up approximately one quarter of medulloblastomas, and recur and metastasize more frequently than tumors lacking anaplasia. We believe anaplastic change represents a type of malignant progression common to many medulloblastoma subtypes and to other CNS embryonal lesions as well. Correlation of these histological changes with the accumulation of genetic events suggests a model for the histological and molecular progression of medulloblastoma.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anaplasia
  • Carcinoma, Large Cell / pathology
  • Cerebellar Neoplasms / pathology*
  • Cerebellar Neoplasms / physiopathology
  • Cerebellar Neoplasms / therapy
  • Disease Progression
  • Gene Expression Profiling / methods
  • Humans
  • Medulloblastoma / pathology*
  • Medulloblastoma / physiopathology
  • Medulloblastoma / therapy
  • Neoplasm Metastasis
  • Neoplasms, Germ Cell and Embryonal / genetics
  • Neoplasms, Germ Cell and Embryonal / pathology