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Tumor grade - grading of all tumors for which grading has been shown to be a significant prognostic variable with consideration given to recording of the particular grading scheme used unless it is standard and understood by all clinicians. WHO (or Daumas-Duport) grade II (none of the above criteria); previously known as astrocytoma WHO (or Daumas-Duport) grade III (one of the above, usually mitoses or VEH); includes some of the tumors previously known as anaplastic astrocytoma WHO (or Daumas-Duport) grade IV (two or more of the above criteria); includes some of the tumors previously known as anaplastic astrocytoma and all glioblastomas Oligodendroglial tumors - oligodendroglial tumors may be graded in two tiers (WHO) or four tiers (A-D, Smith et al) based on mitoses, VEH, and necrosis Oligodendroglioma - WHO grade II (alternately grades A-C) Anaplastic (malignant) oligodendroglioma - WHO grade III (grade D) Mixed gliomas
- WHO grades II-III based on the worst grade present; excluding grade IV which
is classified simply as glioblastoma Ependymal tumors - grading based on cellularity, mitoses, "pseudopalisading" necrosis, and rosette Ependymoma - WHO grade II Anaplastic (malignant) ependymoma - WHO grade III Choroid plexus tumors - grading based on mitoses, necrosis, pleomorphism, cellularity and brain invasion Papilloma Carcinoma Mixed neuronal-glial tumors - grading based on the grade of the glial component Ganglioglioma - WHO grade I-II Anaplastic (malignant) ganglioglioma - WHO grade III-IV Pineal parenchymal tumors - grading based on cellularity, and rosettes Pineocytoma (Pinealoma) Pineoblastoma Tumors of meningothelial cells Hemangiopericytomas are no longer considered angioblastic meningiomas. Subtypes that are prognostically significant for risk of recurrence/aggressive growth: papillary, clear cell, chordoid and rhabdoid. Grading: based on mitoses, necrosis, nuclear morphology, architectural pattern (lack thereof), and brain invasion. Meningioma Atypical meningioma Anaplastic (malignant) meningioma Teratoma - as in systemic tumors Mature Immature Malignant transformation |
