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Radiologie up2date 2023; 23(04): 301-316
DOI: 10.1055/a-2067-1148
Neuroradiologie

Wichtige Neuerungen in der WHO-Klassifikation der ZNS-Tumoren mit neuroradiologischer Relevanz

Important Innovations in the WHO Classification of CNS Tumors with Neuroradiological Relevance
Reinhold Nafe
,
Patrick Felix Samp
,
Elke Hattingen
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Die 5. Edition der WHO-Klassifikation der ZNS-Tumoren beinhaltet viele neue Aspekte, vor allem zu den molekularen Kriterien der Diagnostik. Einige Neuerungen muss auch der Neuroradiologe im Rahmen der Routinediagnostik kennen, z. B. die geänderten Kriterien der Tumorgraduierung oder auch die Tatsache, dass bei bestimmten Tumoren mit molekular bestätigtem Tumorgrad 4 die bildgebenden Merkmale eines hochgradigen Tumors im Einzelfall fehlen können.

Abstract

The 5th edition of the WHO classification of CNS tumors contains many new aspects, especially with regard to the molecular diagnostic criteria. Even neuroradiologists must be familiar with some innovations in the context of routine diagnostics, such as new molecular criteria for tumor grading or the fact that in certain tumors with molecularly confirmed tumor grade 4, the imaging features of a high-grade tumor may be absent in individual cases.

Kernaussagen

  • Die molekulare Analyse der Tumoren des Zentralnervensystems gehört mittlerweile neben Bildgebung und Histopathologie zu den 3 wichtigsten diagnostischen Verfahren bei der Differenzierung der einzelnen Entitäten.

  • Auch im Rahmen der bildgebenden Diagnostik, etwa bei der Nachuntersuchung mit vorliegendem neuropathologischem Befund, kann die Kenntnis der Bedeutung der genannten molekularen Veränderungen zur gesamtklinischen und prognostischen Einschätzung im individuellen Fall beitragen.

  • Bei einzelnen Entitäten sind in der aktuellen Edition der WHO-Klassifikation neue molekulare Kriterien im Rahmen der Graduierung hinzugetreten, insbesondere bei den diffusen Astrozytomen, IDH-mutiert, Tumorgrad 4, den Glioblastomen, IDH-Wildtyp, Tumorgrad 4 und bei den Meningeomen Tumorgrad 3.

  • Bildmorphologische Zeichen eines höheren Tumorgrades können in einzelnen Fällen von hochgradigen Tumoren fehlen, insbesondere bei den folgenden 4 Tumorarten: Astrozytom, IDH-mutiert, Tumorgrad 4; Glioblastom, IDH-Wildtyp, Tumorgrad 4; diffuses Gliom der Mittellinie, H3K27M-alteriert; hemisphärisches Gliom, H3G34-mutiert.

Schlüsselwörter

diffuse Gliome - High-Grade-Astrozytom mit piloiden Merkmalen - Ependymome - embryonale Tumoren - Tumoren der Glandula pinealis

Key words

diffuse gliomas - high-grade astrocytoma with piloid features - ependymomas - embryonal tumors - tumors of the pineal gland


Publication History

Article published online:
08 December 2023

© 2023. Thieme. All rights reserved.

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