Pathology of tumours of the central nervous system

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Pathological assessment of biopsied or resected central nervous system (CNS) tumours is essential for diagnosis and patient management; both the histological subtype of the tumour and the tumour grade (determined by the World Health Organization (WHO) classification) have major implications for therapy and prognosis. Intraoperative diagnosis of CNS tumours is often required, not only to confirm a clinical diagnosis, but also to determine patient management during the neurosurgical procedure. Recent research has identified a number of genetic abnormalities in primary CNS tumours that have a significant influence on patient management, some of which are now standard investigations that provide information to help determine treatment. This article describes the approach to the intraoperative and histological diagnosis of CNS tumours in adults and children, and reviews recent advances in the genetic analysis of CNS tumours and their clinical significance.

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