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Test Name

dualCORE unlimited markers

Specimen information

Received two paraffin blocks and two stained slides labeled with B/509687/20 & B/509688/ 20 for review and immunohistochemistry. Test is performed on the block labeled with B/509688/20.

Clinical History

Features are suggestive of diffuse glioma - Low grade (WHO grade III).

Methodology

Immunohistochemistry

Final Diagnosis

Thalamic tumor from 3rd lateral ventricle, paraffin block for review and immunohistochemistry:

  • Integrated diagnosis: Diffuse glioma,H3K27 mutant , WHO grade IV
  • Histologic diagnosis : Diffuse astrocytoma , WHO grade II of IV , IDH-1 negative by IHC

commentComments from the pathologists on their approach to the rendered diagnosis with further recommendations for molecular/ cytogenetic studies

Specimen consists of biopsy fragments of while matter with a moderately atypical infiltrate of astrocytic cells. there is no evidence of vascular proliferation or necrosis. Scattered mitosis is seen.

Although histologic grade is that of a grade II astrocytoma the positivity for H3K27 M is consistent with a diagnosis of a diffuse midline glioma, H3K27 M mutant which are considered as grade IV lesions due to their historically aggressive clinical behaviour.

Recommendation
  • Microscopic and immunohistochemically assessments
  • Detailed clinico-pathologic correlation predicting the response and guiding the treatment.
  • In specialized branches, like neuropathology, giving an integrated report

Correlation with radiology findings is recommended to confirm midline location of the tumor

Immunohistochemistry studies

GFAP : Diffuse positive

IDH : Negative (R132 H IHC),

ATRX : Lost

P53: Negative(wild type),

H3K27 M : Positive(consistent with mutant)

Ki67 5 -7%,

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IMMUNOHISTOCHEMISTRY STUDIESIHC images for the better view of the positive/ relevant markers

H&E

P53 (BP 53-12)

GFAP (Polyclonal)

ATRX (D-5)

H3K27 M.

Ki67 (MIB-1)

IDH-1 (R132 H)

TECHNICAL NOTE

All immunohistochemistry markers have been evaluated in the context of appropriate positive and negative controls. A result is considered uninterpretable as a result of the type of fixative used (non 10% neutral buffered formalin), time to fixation (> 1 hour), duration of fixation (> 6 hr or <72 hour), strong decalcification, or inappropriate staining of normal internal or external assay controls. An alternative sample for retesting is then usually recommended.

These assays have not been validated on decalcified specimens.

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CONDITIONS OF REPORTING

  1. The tests are carried out in the lab with the presumption that the specimen belongs to the patient named or identified in the bill/test request form.
  2. The test results relate specifically to the sample received in the lab and are presumed to have been generated and transported per specific instructions given by the physicians/laboratory.
  3. The reported results are for information and are subject to confirmation and interpretation by the referring doctor.
  4. Some tests are referred to other laboratories to provide a wider test menu to the customer.
  5. CORE Diagnostics Pvt. Ltd. shall in no event be liable for accidental damage, loss, or destruction of specimen,which is not attributable to any direct and mala fide act or omission of CORE Diagnostics Pvt. Ltd. or its employees. Liability of CORE Diagnostics Pvt. Ltd. for deficiency of services, or other errors and omissions shall be limited to fee paid by the patient for the relevant laboratory services.

This report is the property of CORE Diagnostics. The information contained in this report is strictly confidential and is only for the use of those authorized. If you have received this report by mistake, please contact CORE Diagnostics

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