International Society Of Neuropathology--Haarlem consensus guidelines for nervous system tumor classification and grading

David N. Louis, Arie Perry, Peter Burger, David W. Ellison, Guido Reifenberger, Andreas von Deimling, Kenneth Aldape, Daniel Brat, V. Peter Collins, Charles Eberhart, Dominique Figarella-Branger, Gregory N. Fuller, Felice Giangaspero, Caterina Giannini, Cynthia Hawkins, Paul Kleihues, Andrey Korshunov, Johan M. Kros, M. Beatriz Lopes, Ho Keung NgHiroko Ohgaki, Werner Paulus, Torsten Pietsch, Marc Rosenblum, Elisabeth Rushing, Figen Soylemezoglu, Otmar Wiestler, Pieter Wesseling

Research output: Contribution to journalArticlepeer-review


Major discoveries in the biology of nervous system tumors have raised the question of how non-histological data such as molecular information can be incorporated into the next World Health Organization (WHO) classification of central nervous system tumors. To address this question, a meeting of neuropathologists with expertise in molecular diagnosis was held in Haarlem, the Netherlands, under the sponsorship of the International Society of Neuropathology (ISN). Prior to the meeting, participants solicited input from clinical colleagues in diverse neuro-oncological specialties. The present "white paper" catalogs the recommendations of the meeting, at which a consensus was reached that incorporation of molecular information into the next WHO classification should follow a set of provided "ISN-Haarlem" guidelines. Salient recommendations include that (i) diagnostic entities should be defined as narrowly as possible to optimize interobserver reproducibility, clinicopathological predictions and therapeutic planning; (ii) diagnoses should be "layered" with histologic classification, WHO grade and molecular information listed below an "integrated diagnosis"; (iii) determinations should be made for each tumor entity as to whether molecular information is required, suggested or not needed for its definition; (iv) some pediatric entities should be separated from their adult counterparts; (v) input for guiding decisions regarding tumor classification should be solicited from experts in complementary disciplines of neuro-oncology; and (iv) entity-specific molecular testing and reporting formats should be followed in diagnostic reports. It is hoped that these guidelines will facilitate the forthcoming update of the fourth edition of the WHO classification of central nervous system tumors.

Original languageEnglish
Pages (from-to)429-435
Number of pages7
JournalBrain Pathology
Issue number5
Publication statusPublished - Sep 1 2014


  • Astrocytoma
  • atypical teratoid rhabdoid tumor
  • brain tumors
  • classification
  • glioblastoma
  • glioma
  • grading
  • medulloblastoma
  • oligodendroglioma
  • World Health Organization

ASJC Scopus subject areas

  • Medicine(all)

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