produced by 平野宏文 Hirofumi Hirano a neurosurgeon, to communicate with his patients and friends

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WHO Classification of Tumours 5th Edhition から Central nervous system tumours メモ
Gliomas, glioneuronal tumours,and neuronal tumours

完全な分子分類が実施されていないこと示すNOS(not otherwise specified)
分子学的特性は明らかにされたが,分類体系に当てはまらない腫瘍を示すNEC(not elsewhere classified)がある.

Adult-type diffuse gliomas
      Astrocytoma, IDH-mutant
        Astrocytoma, IDH-mutant, grade 2
        Astrocytoma, IDH-mutant, grade 3
        Astrocytoma, IDH-mutant, grade 4

      Oligodendroglioma, IDH-mutant and 1p/19q-codeleted
        Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, grade 2
        Oligodendroglioma, IDH-mutant and 1p/19q-codeleted, grade 3

      Glioblastoma, IDH-wildtype

Paediatric-type diffuse low-grade gliomas
      Diffuse astrocytoma, MYB- or MYBL1-altered
        Angiocentric glioma
        Polymorphous low-grade neuroepithelial tumour of the young
        Diffuse low-grade glioma, MAPK pathway-altered

Paediatric-type diffuse high-grade gliomas
        Diffuse midline glioma, H3 K27-altered
        Diffuse hemispheric glioma, H3 G34-mutant
        Diffuse paediatric-type high-grade glioma, H3-wildtype and IDH-wildtype
        Infant-type hemispheric glioma

Circumscribed astrocytic gliomas
        Pilocytic astrocytoma
        High-grade astrocytoma with piloid features
        Pleomorphic xanthoastrocytoma
        Subependymal giant cell astrocytoma
        Chordoid glioma
        Astroblastoma, MN1-altered

Glioneuronal and neuronal tumours
        Ganglioglioma
        Gangliocytoma
        Desmoplastic infantile ganglioglioma
        Desmoplastic infantile astrocytoma
        Dysembryoplastic neuroepithelial tumour
        Diffuse glioneuronal tumour with oligodendroglioma-like features and nuclear clusters (provisional entity)
        Papillary glioneuronal tumour
        Rosette-forming glioneuronal tumour
        Myxoid glioneuronal tumour
        Diffuse leptomeningeal glioneuronal tumour
        Multinodular and vacuolating neuronal tumour
        Dysplastic cerebellar gangliocytoma(Lhermitte-Duclos disease)
        Central neurocytoma
        Extraventricular neurocytoma
        Cerebellar liponeurocytoma

Ependymal tumours
        Supratentorial ependymoma, NOS
        Supratentorial ependymoma, ZFTA fusion-positive
        Supratentorial ependymoma, YAPI fusion-positive
        Posterior fossa ependymoma, NOS
        Posterior fossa group A (PFA) ependymoma
        Posterior fossa group B (PFB) ependymoma
        Spinal ependymoma, NOS
        Spinal ependymoma, MYCN-amplified
        Myxopapillary ependymoma
        Subependymoma

Choroid plexus tumours
        Choroid plexus papilloma
        Atypical choroid plexus papilloma
        Choroid plexus carcinoma

Embryonal tumours
Medulloblastomas, molecularly defined
        Medulloblastoma, WNT-activated
        Medulloblastoma, SHH-activated and TP53-wildtype
        Medulloblastoma, SHH-activated and TP53-mutant
        Medulloblastoma, non-WNT/non-SHH
Medulloblastomas, histologically defined
        Medulloblastoma, histologically defined
           Desmoplastic nodular medulloblastoma
           Medulloblastoma with extensive nodularity
           Large cell medulloblastoma
           anaplastic medulloblastoma

Other CNS embryonal tumours Introduction
        Atypical teratoid/rhabdoid tumour
        Cribriform neuroepithelial tumour(provisional entity)
        Embryonal tumour with multilayered rosettes
        CNS neuroblastoma, FOXR2-activated
        CNS tumour with BCOR internal tandem duplication
        CNS embryonal tumour, NEC/NOS

Pineal tumours
        Pineocytoma
        Pineal parenchymal tumour of intermediate differentiation
        Pineoblastoma
        Papillary tumour of the pineal region
        Desmoplastic myxoid tumour of the pineal region, SMARCB1-mutant(provisional entity)

Cranial and paraspinal nerve tumours
      Schwannoma
      Neurofibroma
        Plexiform neuroblastoma
      Perineurioma
      Hybrid nerve sheath tumours
      Malignant melanotic nerve sheath tumour
      Malignant peripheral nerve sheath tumour
      Cauda equina neuroendocrine tumour(previously paraganglioma)

Meningioma
      Meningioma

Mesenchymal, non-meningothelial tumours involving the CNS
Fibroblastic and myofibroblastic tumours
      Solitary fibrous tumour

Vascular tumours
        Cavernous haemangioma
        Capillary haemangioma
        Arteriovenous malformation
        Haemangioblastoma  

Skeletal muscle tumours
        Embryonal rhabdomyosarcoma
        Alveolar rhabdomyosarcoma
        Rhabdomyosarcoma, pleomorphic-type
        Spindle cell rhabdomyosarcoma

Tumours of uncertain differentiation
        Intracranial mesenchymal tumour,FET::CREB fusion-positive(provisional entity)
        CIC-rearranged sarcoma
        Primary intracranial sarcoma,DICER1-mutant
        Ewing sarcoma

Chondrogenic tumours
        Mesenchymal chondrosarcoma
        Chondrosarcoma
        Dedifferentiated chondrosarcoma

Notochordal tumours
        Chordoma

Melanocytic tumours
Diffuse meningeal melanocytic neoplasms
        Meningeal melanocytosis
        Meningeal melanomatosis

Circumscribed meningeal melanocytic neoplasms
        Meningeal melanocytoma
        Meningeal melanoma


Haematolymphoid tumours involving the CNS
CNS lymphomas
        Primary diffuse large B-cell lymphoma of the CNS
        Lymphomatoid granulomatosis
           Lymphomatoid granulomatosis, grade1
           Lymphomatoid granulomatosis, grade2
           Lymphomatoid granulomatosis, grade3
        Intravascular large B-cell lymphoma

Miscellaneous rare lymphomas in the CNS
        MALT lymphoma of the dura
        Lymphoplasmatic lymphoma
        Follicular lymphoma
        Anaplastic large cell lymphoma(ALK+/ALK-)
        T-cell lymphoma
        NK/T-cell lymphomas

Histiocytic tumours
        Erdheim-Chester disease
        Rosai-Dorfman disease
        Juvenile xanthogranuloma
        Langerhans cell histiocytosis
        Histiocytic sarcoma

Germ cell tumours
        Mature teratoma
        Immature teratoma
        Teratoma with somatic-type malignancy
        Germinoma
        Embryonal carcinoma
        Yolk sac tumor
        Choriocarcinoma
        Mixed germ cell tumour

Tumours of the sellar region
        Adamantinomatous craniopharyngioma
        Papillary craniopharyngioma
        Pituicytoma
        Granular cell tumour of the sellar region
        Spindle cell oncocytoma
        Pituitary adenoma / pituitary neuroendocrine tumour(PitNET)
        Pituitary blastoma

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Hirofumi Hirano MD, PhD, Department of Neurosurgery