Principles of the new World Health Organization (WHO) classification of brain tumors

1980 ◽  
Vol 19 (2) ◽  
pp. 59-66 ◽  
Author(s):  
K. J. Z�lch
Keyword(s):  
Brain Tumors ◽  
World Health Organization ◽  
New World ◽  
Who Classification ◽  
World Health ◽  
Health Organization

scholarly journals The new World Health Organization classification of lung tumours

2001 ◽  
Vol 18 (6) ◽  
pp. 1059-1068 ◽  
Author(s):  
E. Brambilla ◽  
W.D. Travis ◽  
T.V. Colby ◽  
B. Corrin ◽  
Y. Shimosato
Keyword(s):  
World Health Organization ◽  
New World ◽  
World Health ◽  
World Health Organization Classification ◽  
Lung Tumours ◽  
Health Organization

Expert Second Opinion Pathology Review of Lymphoma in the Era of the World Health Organization Classification.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3317-3317
Author(s):  
Matthew J. Matasar ◽  
Weiji Shi ◽  
Jonathan Silberstien ◽  
Julie T. Feldstein ◽  
Daniel Filippa ◽  
...  
Keyword(s):  
World Health Organization ◽  
Who Classification ◽  
Second Opinion ◽  
World Health ◽  
Cancer Center ◽  
Major Revision ◽  
The World ◽  
Health Organization ◽  
Pathology Review

Abstract Background: The effective management of lymphoma depends upon an accurate and precise pathologic diagnosis. However, the classification of lymphoma continues to evolve. Reports addressing the role of second opinion expert pathology review have found varying impact, and little is known regarding the predictors of a change in diagnosis. Furthermore, the impact of the World Health Organization (WHO) classification of lymphomas over the 5 years following their formal publication has not been formally assessed. Methods: All outside pathology is reviewed at Memorial Sloan-Kettering Cancer Center (MSKCC) before a clinical opinion is finalized. We performed a chart review of all externally referred lymphoma cases from 1/1/01 to 6/30/01 and from 1/1/06 to 6/30/06 with second opinions from MSKCC hematopathology. Statistical analysis was performed using Chi-square or Fisher’s exact test for univariate analysis and logistic regression for multivariate analysis. Results: 719 patients (365 in 2001, 354 in 2006) met inclusion criteria. Diagnostic revisions were classified as major or minor; major changes were those that would lead to management changes as per National Comprehensive Cancer Network guidelines. 122 patients (18% in 2001, 16% in 2006) had a major diagnostic revision and an additional 22 (4% in 2001, 2% in 2006) had confirmation of major revisions rendered previously at second opinion from another National Cancer Institute Comprehensive Cancer Center (CCC). This did not change significantly by era, with 79 major revisions (22%) in 2001 and 65 (18%) in 2006 (P=NS). An additional 55 patients [24 (7%) in 2001, 31 (9%) in 2006] received minor revisions. Common categories of major revision included changing from nondiagnostic/ambiguous to definitive [6 in 2001, 8 in 2006], definitive to nondiagnostic [9 in 2001, 9 in 2006], malignant to benign [1 in 2001, 6 in 2006], indolent B-cell lymphoma (BCL) to aggressive BCL [15 in 2001, 8 in 2006], and aggressive BCL to indolent BCL [4 in 2001, 1 in 2006]. Major diagnostic revision was significantly associated with additional immunohistochemistry (IHC) testing in 2001 (OR=2.3; 95%CI 1.3, 4). In 2006, additional IHC (OR=1.8; 95%CI 1, 3.4), repeat biopsy (OR=3.1; 95%CI 1.2, 8.0), and skin biopsy (versus lymph node biopsy; OR 3.3; 95%CI 1.6, 7.0) were significantly associated with major revision. Two of the 7 patients reclassified as benign received revisions based on additional IHC, whereas 7 of the 14 patients reclassified as malignant were revised due to either additional IHC (4) or repeat biopsy (3). No effect was seen by biopsy type, nor were patient gender, age, race or ethnicity associated with odds of major revision. Of cases seen first at another CCC, 12% in 2001 and 16% in 2006 received major revisions, compared to 19% (2001) and 16% (2006) of other cases; these differences were not statistically significant. Conclusion: The rate of clinically meaningful diagnostic revisions at second opinion expert pathology review was high for patients seen at MSKCC, and remained so despite five years of increased familiarity with the WHO classification schema. These data confirm the fact that an appropriate evaluation, including detailed IHC and an adequate biopsy specimen, plays a central role in the accurate diagnosis of lymphoma. The high rates of diagnostic revision reported here lend support to the routine application of expert second opinion hematopathology review.

scholarly journals The World Health Organization Classification of Skeletal Muscle Tumors in Pediatric Rhabdomyosarcoma: A Report From the Children's Oncology Group

2015 ◽  
Vol 139 (10) ◽  
pp. 1281-1287 ◽  
Author(s):  
Erin R. Rudzinski ◽  
James R. Anderson ◽  
Douglas S. Hawkins ◽  
Stephen X. Skapek ◽  
David M. Parham ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
World Health Organization ◽  
Who Classification ◽  
Spindle Cell ◽  
Risk Group ◽  
International Classification ◽  
World Health ◽  
Oncology Group ◽  
Health Organization

Context Since 1995, the International Classification of Rhabdomyosarcoma has provided prognostically relevant classification for rhabdomyosarcoma (RMS) and allowed risk stratification for children with RMS. The International Classification of Rhabdomyosarcoma includes botryoid and spindle cell RMS as superior-risk groups, embryonal RMS as an intermediate-risk group, and alveolar RMS as an unfavorable-risk group. The 2013 World Health Organization (WHO) classification of skeletal muscle tumors modified the histologic classification of RMS to include sclerosing RMS as a type of spindle cell RMS separate from embryonal RMS. The current WHO classification includes embryonal, alveolar, spindle cell/sclerosing, and pleomorphic subtypes of RMS and does not separate the botryoid subtype. Objective To determine if the WHO classification applies to pediatric RMS. Design To accomplish this goal, we reviewed 9 consecutive Children's Oncology Group clinical trials to compare the WHO and International Classification of Rhabdomyosarcoma classifications with outcome and site of disease. Results Except for a subset of low-risk RMS, the outcome for botryoid was not significantly different from typical embryonal RMS when analyzed by primary site. Similarly, pediatric spindle cell and sclerosing patterns of RMS did not appear significantly different from typical embryonal RMS, with one exception: spindle cell RMS in the parameningeal region had an inferior outcome with 28% event-free survival. Conclusion Our data support use of the WHO RMS classification in the pediatric population, with the caveat that histologic diagnosis does not necessarily confer the same prognostic information in children as in adults.

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