The Frequency of Focal Cortical Dysplasia-Like Histologic Features Near Adult-Type Diffuse Gliomas

Mireille Bitar; Yevgen Chornenkyy; Margaret E. Flanagan; Alicia Steffens; Kathleen McCortney; Craig Horbinski

doi:10.1093/jnen/nlab120

The Frequency of Focal Cortical Dysplasia-Like Histologic Features Near Adult-Type Diffuse Gliomas

Mireille Bitar, Yevgen Chornenkyy, Margaret E. Flanagan, Alicia Steffens, Kathleen McCortney, Craig Horbinski^*

^*Corresponding author for this work

Pathology

Research output: Contribution to journal › Article › peer-review

Abstract

While the coexistence of focal cortical dysplasia (FCD) and grade 1 noninfiltrative gliomas has been described, to date, only rare case reports have described FCD adjacent to infiltrating gliomas. We therefore sought to determine how often FCD-like findings occur near adult-type diffuse gliomas. This was a retrospective survey of 186 consecutive, newly diagnosed, en bloc glioma resections. Fifty-nine (31.7%) had sufficient adjacent cortex to evaluate for FCD-like features. Among IDH mutant (“IDH^mut”) gliomas, 40/77 (52%) had adjacent evaluable cortex, whereas only 19/109 (17%) of IDH wild-type (“IDH^wt”) gliomas did (p < 0.0001). Among cases with evaluable cortex, 15 (25.4%) contained features suggestive of FCD, including radial/tangential dyslamination and/or maloriented neurons. In a multivariable analysis, increasing glioma grade (OR ¼ 4.0, 95% CI ¼ 1.2–13.5, p ¼ 0.027) and IDH^mut (OR ¼ 6.5, 95% CI ¼ 1.3–32.2, p ¼ 0.022) emerged as independently positive correlates with the appearance of FCD-like findings. However, FCD-like features were also found in 13/32 (40.6%) cortical samples from adult brains without any neoplastic disease or seizure histories (p ¼ 0.16). Together, these data suggest that, while FCD-like histologic features can be incidentally found in at least a subset of diffusely infiltrative gliomas, the frequencies are not significantly different from that seen in otherwise nonneoplastic brains, and are therefore most likely nonpathologic.

Original language	English (US)
Pages (from-to)	48-53
Number of pages	6
Journal	Journal of neuropathology and experimental neurology
Volume	81
Issue number	1
DOIs	https://doi.org/10.1093/jnen/nlab120
State	Published - Jan 1 2022

Funding

Send correspondence to: Craig Horbinski, MD, PhD, Departments of Pathol-ogy and Neurological Surgery, Northwestern University Feinberg School of Medicine, SQ6-518, 303 East Superior Street, Chicago, IL 60611, USA; E-mail: [email protected] M.B. was supported by faculty research funds from the Northwestern Uni-versity Department of Pathology. Y.C. was supported by an institutional grant from the Northwestern University Department of Pathology Resi-dent Research Committee. C.H. was supported by National Institue of Neurological Disorders and Stroke grants R01NS102669, R01NS117104, R01NS118039, the Northwestern University SPORE in Brain Cancer P50CA221747 from the National Cancer Institute, and the Lou and Jean Malnati Brain Tumor Institute. M.E.F. was supported by National Institutes of Health grant K08AG065463. Postmortem control brain tissue samples were obtained from the Neuropathology Core in Northwestern University’s Alzheimer’s Disease Research Center which is supported by the National Institute on Aging (P30AG013854 and P30AG072977).

Keywords

Focal cortical dysplasia, Glioma

ASJC Scopus subject areas

General Medicine

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10.1093/jnen/nlab120

Cite this

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title = "The Frequency of Focal Cortical Dysplasia-Like Histologic Features Near Adult-Type Diffuse Gliomas",

abstract = "While the coexistence of focal cortical dysplasia (FCD) and grade 1 noninfiltrative gliomas has been described, to date, only rare case reports have described FCD adjacent to infiltrating gliomas. We therefore sought to determine how often FCD-like findings occur near adult-type diffuse gliomas. This was a retrospective survey of 186 consecutive, newly diagnosed, en bloc glioma resections. Fifty-nine (31.7%) had sufficient adjacent cortex to evaluate for FCD-like features. Among IDH mutant (“IDHmut”) gliomas, 40/77 (52%) had adjacent evaluable cortex, whereas only 19/109 (17%) of IDH wild-type (“IDHwt”) gliomas did (p < 0.0001). Among cases with evaluable cortex, 15 (25.4%) contained features suggestive of FCD, including radial/tangential dyslamination and/or maloriented neurons. In a multivariable analysis, increasing glioma grade (OR ¼ 4.0, 95% CI ¼ 1.2–13.5, p ¼ 0.027) and IDHmut (OR ¼ 6.5, 95% CI ¼ 1.3–32.2, p ¼ 0.022) emerged as independently positive correlates with the appearance of FCD-like findings. However, FCD-like features were also found in 13/32 (40.6%) cortical samples from adult brains without any neoplastic disease or seizure histories (p ¼ 0.16). Together, these data suggest that, while FCD-like histologic features can be incidentally found in at least a subset of diffusely infiltrative gliomas, the frequencies are not significantly different from that seen in otherwise nonneoplastic brains, and are therefore most likely nonpathologic.",

keywords = "Focal cortical dysplasia, Glioma",

author = "Mireille Bitar and Yevgen Chornenkyy and Flanagan, {Margaret E.} and Alicia Steffens and Kathleen McCortney and Craig Horbinski",

note = "Funding Information: Send correspondence to: Craig Horbinski, MD, PhD, Departments of Pathol-ogy and Neurological Surgery, Northwestern University Feinberg School of Medicine, SQ6-518, 303 East Superior Street, Chicago, IL 60611, USA; E-mail: [email protected] M.B. was supported by faculty research funds from the Northwestern Uni-versity Department of Pathology. Y.C. was supported by an institutional grant from the Northwestern University Department of Pathology Resi-dent Research Committee. C.H. was supported by National Institue of Neurological Disorders and Stroke grants R01NS102669, R01NS117104, R01NS118039, the Northwestern University SPORE in Brain Cancer P50CA221747 from the National Cancer Institute, and the Lou and Jean Malnati Brain Tumor Institute. M.E.F. was supported by National Institutes of Health grant K08AG065463. Postmortem control brain tissue samples were obtained from the Neuropathology Core in Northwestern University{\textquoteright}s Alzheimer{\textquoteright}s Disease Research Center which is supported by the National Institute on Aging (P30AG013854 and P30AG072977). Publisher Copyright: {\textcopyright} 2021 American Association of Neuropathologists, Inc. All rights reserved.",

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AU - Steffens, Alicia

AU - McCortney, Kathleen

AU - Horbinski, Craig

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N2 - While the coexistence of focal cortical dysplasia (FCD) and grade 1 noninfiltrative gliomas has been described, to date, only rare case reports have described FCD adjacent to infiltrating gliomas. We therefore sought to determine how often FCD-like findings occur near adult-type diffuse gliomas. This was a retrospective survey of 186 consecutive, newly diagnosed, en bloc glioma resections. Fifty-nine (31.7%) had sufficient adjacent cortex to evaluate for FCD-like features. Among IDH mutant (“IDHmut”) gliomas, 40/77 (52%) had adjacent evaluable cortex, whereas only 19/109 (17%) of IDH wild-type (“IDHwt”) gliomas did (p < 0.0001). Among cases with evaluable cortex, 15 (25.4%) contained features suggestive of FCD, including radial/tangential dyslamination and/or maloriented neurons. In a multivariable analysis, increasing glioma grade (OR ¼ 4.0, 95% CI ¼ 1.2–13.5, p ¼ 0.027) and IDHmut (OR ¼ 6.5, 95% CI ¼ 1.3–32.2, p ¼ 0.022) emerged as independently positive correlates with the appearance of FCD-like findings. However, FCD-like features were also found in 13/32 (40.6%) cortical samples from adult brains without any neoplastic disease or seizure histories (p ¼ 0.16). Together, these data suggest that, while FCD-like histologic features can be incidentally found in at least a subset of diffusely infiltrative gliomas, the frequencies are not significantly different from that seen in otherwise nonneoplastic brains, and are therefore most likely nonpathologic.

AB - While the coexistence of focal cortical dysplasia (FCD) and grade 1 noninfiltrative gliomas has been described, to date, only rare case reports have described FCD adjacent to infiltrating gliomas. We therefore sought to determine how often FCD-like findings occur near adult-type diffuse gliomas. This was a retrospective survey of 186 consecutive, newly diagnosed, en bloc glioma resections. Fifty-nine (31.7%) had sufficient adjacent cortex to evaluate for FCD-like features. Among IDH mutant (“IDHmut”) gliomas, 40/77 (52%) had adjacent evaluable cortex, whereas only 19/109 (17%) of IDH wild-type (“IDHwt”) gliomas did (p < 0.0001). Among cases with evaluable cortex, 15 (25.4%) contained features suggestive of FCD, including radial/tangential dyslamination and/or maloriented neurons. In a multivariable analysis, increasing glioma grade (OR ¼ 4.0, 95% CI ¼ 1.2–13.5, p ¼ 0.027) and IDHmut (OR ¼ 6.5, 95% CI ¼ 1.3–32.2, p ¼ 0.022) emerged as independently positive correlates with the appearance of FCD-like findings. However, FCD-like features were also found in 13/32 (40.6%) cortical samples from adult brains without any neoplastic disease or seizure histories (p ¼ 0.16). Together, these data suggest that, while FCD-like histologic features can be incidentally found in at least a subset of diffusely infiltrative gliomas, the frequencies are not significantly different from that seen in otherwise nonneoplastic brains, and are therefore most likely nonpathologic.

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The Frequency of Focal Cortical Dysplasia-Like Histologic Features Near Adult-Type Diffuse Gliomas

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