A review of molecular alterations with clinical impact in adult and paediatric gliomas

The practice of neuropathology underwent major changes due to the discovery of molecular alterations with diagnostic, prognostic, and therapeutic implications. Many of these alterations are incorporated in the updated 2016 edition of the World Health Organization (WHO) Classification of Tumours of the Central Nervous System (CNS), which represents a shift from the principle that neuropathology diagnosis is based entirely on microscopy. Molecularly defined entities were introduced, and a diagnosis that integrates the histology and molecular results is strongly recommended. This complex approach is timely because the neuro-oncologists seek specific diagnoses that can lead to more precise treatment. In the current review, we present the most common molecular alterations with known clinical implications in gliomas, and provide a practical guide to an integrated diagnosis.