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Related Experiment Video

Updated: Jul 2, 2026

Translational Orthotopic Models of Glioblastoma Multiforme
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Translational Orthotopic Models of Glioblastoma Multiforme

Published on: February 17, 2023

Gray zones in brain tumor classification: evolving concepts.

Dimitri Trembath1, Christopher Ryan Miller, Arie Perry

  • 1Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC, USA.

Advances in Anatomic Pathology
|August 30, 2008
PubMed
Summary
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Brain pathology (Zurich, Switzerland)·2026

The World Health Organization updated brain tumor classifications, introducing new entities and variants. This review addresses challenging diagnostic "gray zones" in neuropathology to provide practical guidelines for difficult cases.

Area of Science:

  • Neuropathology
  • Oncology
  • Histopathology

Background:

  • The World Health Organization (WHO) CNS tumor classification has been updated, introducing 8 new entities and refining existing ones.
  • Despite advancements, diagnostic challenges persist in classifying and grading central nervous system (CNS) tumors, creating
  • gray zones
  • for pathologists.

Purpose of the Study:

  • To discuss current challenges in CNS tumor classification and grading.
  • To offer practical guidelines for navigating diagnostic ambiguities in neuropathology.

Main Methods:

  • Review of recent updates to the WHO classification of CNS tumors.
  • Discussion of specific diagnostic challenges including oligodendroglial features, glioblastoma (GBM) variants, meningioma classification, medulloblastoma and ependymoma grading, and gliomas with unusual features.

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Published on: February 17, 2023

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09:29

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Published on: July 29, 2022

Main Results:

  • The WHO classification continues to evolve, presenting new entities and morphologic patterns.
  • Several areas remain diagnostically challenging, including mixed oligoastrocytomas, small cell GBM, meningioma grading, and low-grade gliomas with high proliferation indices.

Conclusions:

  • Accurate classification and grading of CNS tumors are crucial for patient management.
  • Addressing these diagnostic "gray zones" with practical guidelines aids pathologists in challenging cases.