Pathology of malignant gliomas: Challenges of everyday practice and the WHO 2007

The recent revision of the “2007 World Health Organization Classification of Tumours of the Central Nervous System” introduces a series of new entities and variants in addition to bringing more clarity to existing ones. It is critical for the practicing surgical pathologist to be aware of these changes, especially those relating to common primary tumors such as malignant gliomas. This study presents a critical review of the changes and attempts to provide practical insights for the surgical pathologist.The morphological spectrum of malignant gliomas is quite diverse, and with definition of newer variants and patterns, there is an increasing need to be more specific on the type and the grade of these aggressive neoplasms. The added value of special stains, immunohistochemistry and molecular/genetic analysis is expected to gradually increase in everyday practice. Thus, the surgical pathologist must be in tune with the progress in these fields and must be in a position to apply and interpret these techniques.Appropriate management of the patients and the correct interpretation of the disease always depend on effective, direct communication of the neuropathologist, neuroradiologist and the neurosurgeon, coupled with the application of carefully chosen ancillary techniques. The combination of collaborative efforts and special techniques is certain to be more critical in the future, and effective utilization of all these elements will better characterize these neoplasms and improve patient management.