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Grading of the tumors of the central nervous system

Grading of the tumors of the
CNS
AFIP00405522M-GLIOBLASTOMA ARISING IN ASTROCYTOMA.jpg
Glioblastoma arising in an astrocytoma. This spinal cord exhibits both a lightly staining microcystic astrocytoma as well as a darkly staining glioblastoma.

The concept of grading of the tumors of the central nervous system, agreeing for such the regulation of the "progressiveness" of these neoplasias (from benign and localized tumors to malignant and infiltrating tumors), dates back to 1926 and was introduced by P. Bailey and H. Cushing, in the elaboration of what turned out the first systematic classification of gliomas.
In the following, the grading systems present in the current literature are introduced. Then, through a table, the more relevant are compared.

The first edition of the International Classification of Diseases (ICD) dates back to 1893. The current review (ICD-10) dates back to 1994, came into use in the U.S. in 2015, and is revised yearly, being very comprehensive.
In 1976 the World Health Organization (WHO) publishes the first edition of the International Classification of Diseases for Oncology (ICD-O), now at the third edition (ICD-O-3, 2000).
In this last edition, the Arabic numeral after the character "/" indicates the "behavior" of the neoplasia, with the following meaning:


For the concepts of benign and malignant neoplasia see Tumor and Cancer. For primary and secondary neoplasias see Metastasis.
A brain tumor composed of benign cells, but located in a vital area (as the brain is), can be considered to be life-threatening — although the tumor and its cells would not be classified as malignant.

The Kernohan grading system defines progressive malignancy of astrocytomas as follows:

The St Anne-Mayo grading system also is used to grade astrocytomas; however, this system uses four morphologic criteria to assign a grade:

a) nuclear atypia,
b) mitosis,
c) endothelial proliferation-'piled-up' endothelial cells. NOT hypervascularity


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