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A juvenile case of epilepsy-associated, isocitrate dehydrogenase wild-type/histone 3 wild-type diffuse glioma with a rare BRAF A598T mutation.
Sadashima, Shoko; Suzuki, Satoshi O; Haruyama, Hironori; Mukae, Nobutaka; Fujioka, Yutaka; Hata, Nobuhiro; Mizoguchi, Masahiro; Ishimatsu, Keisuke; Hiwatashi, Akio; Iwaki, Toru.
Afiliação
  • Sadashima S; Department of Neuropathology, Kyushu University, Fukuoka, Japan.
  • Suzuki SO; Department of Neuropathology, Kyushu University, Fukuoka, Japan.
  • Haruyama H; Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
  • Mukae N; Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
  • Fujioka Y; Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
  • Hata N; Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
  • Mizoguchi M; Department of Neurosurgery, Kyushu University, Fukuoka, Japan.
  • Ishimatsu K; Department of Clinical Radiology, Kyushu University, Fukuoka, Japan.
  • Hiwatashi A; Department of Molecular Imaging & Diagnosis, Kyushu University, Fukuoka, Japan.
  • Iwaki T; Department of Neuropathology, Kyushu University, Fukuoka, Japan.
Neuropathology ; 40(6): 646-650, 2020 Dec.
Article em En | MEDLINE | ID: mdl-32996219
Here, we report a juvenile (18-year-old male) case of epilepsy-associated, isocitrate dehydrogenase wild-type/histone 3 wild-type diffuse glioma with a rare BRAF mutation and a focal atypical feature resembling diffuse astrocytoma. The patient presented with refractory temporal lobe epilepsy. Subsequently, magnetic resonance imaging revealed a hyperintense lesion in the right temporal lobe on fluid attenuated inversion recovery images. The patient underwent right lateral temporal lobectomy and amygdalohippocampectomy. Histopathologically, the tumor showed isomorphic, diffuse, infiltrative proliferation of glial tumor cells and intense CD34 immunoreactivity. The tumor cells were immunonegative for isocitrate dehydrogenase 1 (IDH1) R132H and BRAF V600E. Notably, the tumor cells showed the lack of nuclear staining for α-thalassemia/mental retardation syndrome, X-linked (ATRX). In addition, the Ki-67 labeling index, using a monoclonal antibody MIB-1, was elevated focally at tumor cells with p53 immunoreactivity. Molecular analyses identified a BRAFA598T mutation, the first case reported in a glioma. BRAFA598T is predicted to result in loss of kinase action; however, inactive mutants can stimulate mitogen-activated protein kinase kinase (MEK)-extracellular signal-regulated kinase (ERK) signaling through CRAF activation. Thus, according to the recent update of the consortium to inform molecular and practical approaches to central nervous system tumor taxonomy (cIMPACT-NOW update 4), our case is also compatible with diffuse glioma with the mitogen-activated protein kinase (MAPK) pathway alteration. Thorough immunohistochemical and molecular studies are necessary for diagnosis of epilepsy-associated, diffuse gliomas. Partial resemblance in histopathological and molecular genetic features to diffuse astrocytoma also calls for attention.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Proteínas Proto-Oncogênicas B-raf / Epilepsia do Lobo Temporal / Glioma Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adolescent / Humans / Male Idioma: En Revista: Neuropathology Assunto da revista: NEUROLOGIA / PATOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Japão

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Encefálicas / Proteínas Proto-Oncogênicas B-raf / Epilepsia do Lobo Temporal / Glioma Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adolescent / Humans / Male Idioma: En Revista: Neuropathology Assunto da revista: NEUROLOGIA / PATOLOGIA Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Japão