J Pathol Transl Med.  2024 May;58(3):127-133. 10.4132/jptm.2024.03.11.

The spectrum of microvascular patterns in adult diffuse glioma and their correlation with tumor grade

• S
• Walke V
• Joshi D
• Sharma T
• Shrivastava A
• Agrawal A

• KMID: 2555538
• DOI: http://doi.org/10.4132/jptm.2024.03.11

Abstract

Background
Primary brain tumors constitute the leading cause of cancer-related mortality. Among them, adult diffuse gliomas are the most common type, affecting the cerebral hemispheres and displaying a diffuse infiltrative pattern of growth in the surrounding neuropil that accounts for about 80% of all primary intracranial tumors. The hallmark feature of gliomas is blood vessel proliferation, which plays an important role in tumor growth, tumor biological behavior, and disease outcome. High-grade gliomas exhibit increased vascularity, the worst prognosis, and lower survival rates. Several angiogenic receptors and factors are upregulated in glioblastomas and stimulate angiogenesis signaling pathways by means of activating oncogenes and/or down-regulating tumor-suppressor genes. Existing literature has emphasized that different microvascular patterns (MVPs) are displayed in different subtypes of adult diffuse gliomas.
Methods
We examined the distribution and biological characteristics of different MVPs in 50 patients with adult diffuse gliomas. Haematoxylin and eosin staining results, along with periodic acid–Schiff and CD34 dual-stained sections, were examined to assess the vascular patterns and correlate with different grades of diffuse glioma.
Results
The present observational study on adult diffuse glioma evaluated tumor grade and MVPs. Microvascular sprouting was the most common pattern, while a bizarre pattern (type 2) was associated with the presence of a high-grade glioma. Vascular mimicry was observed in 6% of cases, all of which were grade 4 gliomas.
Conclusions
This study supplements the role of neo-angiogenesis and aberrant vasculature patterns in the grading and progression of adult diffuse gliomas, which can be future targets for planning treatment strategies.

Keyword

Angiogenesis; Microvascular patterns; Adult diffuse glioma

Figure

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  Fig. 1. (A) Microvascular sprouting: simple vessels which are delicate capillary-like with a defined lumen. (B) Vascular garlands: clustered vessels arranged in garland like formation, with/without connective stroma. (C) Vascular clusters seen as focal aggregations of vessels without the connective stroma. (D) The glomeruloid tufts: clustered vessels embedded within the connective stroma with a glomerulus-like appearance (CD34 immunohistochemical staining).

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  Fig. 2. Vasculogenic mimicry seen as vascular channels lined by cells, negative for endothelial markers, but exhibit periodic acid–Schiff positivity (CD34–periodic acid–Schiff dual staining).

Reference

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