The 2007 WHO classification of tumours of the central nervous system

David N. Louis, Hiroko Ohgaki, Otmar D. Wiestler, Webster K. Cavenee, Peter C. Burger, Anne Jouvet, Bernd W. Scheithauer, Paul Kleihues · Acta Neuropathologica · 2007 · medicine · 10.1007/s00401-007-0243-4 · record louis2007-the-2007-who-classification-of-tum
tag layer · index · concepts · authors · עברית
Where this record's text came from. 2026-08-23 schema-0.3 pass: every quote verified as an exact substring of the staged text and anchored at merge time; concept terms verified present; every edge endpoint an existing node.
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Tags on this paper

Every tag the record carries, each linking to every other paper in the corpus that carries it. A tag appears here whether or not its words occur in the article — the spans below are only the ones a sentence in this paper licenses. Of the 10 concept tags on this paper, all 10 are grounded in a quoted sentence. All carry the tagger's gloss of what the term means in this paper, which is not something the article can license.
Variants a previously defined, overarching entity a new entity an unusual histopathological pattern CNS PNET Supratentorial PNET the WHO system the St Anne/Mayo classification tumour grade the choice of therapies WHO grade clinico-pathological entities variants of entities histological patterns biologic behaviour a label that predicts opposite outcomes inside itself expert-consensus
Method, as described: an international Working Group of 25 pathologists and geneticists convened for one meeting in November 2006, with contributions from more than 70 experts overall

Legend

relation to other workclaim_relationshow this paper stands to another: agrees, contradicts, extends, qualifies
claim typeclaim_typethe shape of the claim: existence, mechanism, method, critique, prediction, null
concept edgeconcept_edgesan asserted relation between two concepts, with the sentence asserting it
conceptconceptsan idea the paper works with, quoted where the paper uses it
content tagcontent_tagsa finding, definition, quantity, statistic or variable named in the paper
contributioncontributionwhat the paper claims to add
controlcontrolsan experiment run to eliminate a rival explanation
limitationlimitationswhat the paper says its evidence cannot support
mechanismmechanismshow the reported effect is said to come about
methodmethodhow the paper produced its evidence
object of studyobject_of_studywhat the paper is about — the thing it investigates
phenomenonphenomenonthe effect or regularity under study
research questionresearch_questionthe question the paper sets itself
sensesensesa distinct use of a term, quoted where the paper fixes it

The paper

The full text is not reproduced here. This article is not cleared for redistribution, so the page carries the tag layer only. Its evidence sentences are withheld; the grounding status remains with each tag, and the article itself is at https://doi.org/10.1007/s00401-007-0243-4. The reading view exists for the papers whose licence permits it.

Every tag on this page

claim_relations 3 · claim_type 1 · concept_edges 5 · concepts 10 · content_tags 18 · contribution 1 · controls 3 · limitations 5 · mechanisms 12 · method 1 · object_of_study 1 · phenomenon 1 · research_question 1 · senses 4

Relations on this page carry a quotation for the claim. Where a relation was separately evidenced — and so tested against the vocabulary for its type — the row says so; 5 of 5 relations here carry that mark. The rest are the tagger’s reading of the sentence quoted beside them.

facettagfieldconf.whose words
object_of_studyAN ENTIRE TAXONOMY BEING REVISED BY A NAMING AUTHORITY - the fourth edition of the WHO classification of CNS tumours, with eight entities added, three variants added, two entities demoted to descriptive phrases, and the admission rules for each rank printed
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object_of_studythe paper's words
research_questionwhat must be true of a lesion before it may be called a new entity, a variant, or merely a pattern of differentiation
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research_questionthe paper's words
contributiona three-rank membership vocabulary with explicit criteria, an updated grading scheme, and ICD-O codes for every entity - presented as 'the standard for the definition of brain tumours' worldwide
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contributionthe paper's words
claim_typemethod
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claim_typethe paper's words
phenomenona classification whose grade label decides therapy while spanning outcomes from death within a year to 80% five-year survival
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phenomenonthe paper's words
methodexpert-consensus
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methodthe paper's words
mechanismsA THREE-RANK MEMBERSHIP VOCABULARY WITH PUBLISHED ADMISSION RULES: `The Working Group distinguished between clinico-pathological entities, variants of entities and histological patterns. To be included in the WHO classification, two or more reports from different institutions were considered mandatory. Quotation withheld` An evidence threshold, an independence requirement and three ranks of thinghood - the most complete published set of admission rules for a class in this corpus
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mechanisms[0]0.95the tagger's words
mechanismsAND THE AUTHORITY SAYS ITS OWN PAST ADMISSIONS FAILED ITS OWN RULE: `histological variants have been introduced if there was evidence that a particular morphological pattern was associated with a different biological or clinical behaviour. Admittedly, in retrospect, this criterion was not always fulfilled.` Four editions of a standard, and the fourth says the first three admitted things they should not have
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mechanisms[1]0.95the tagger's words
mechanismsAND AN ENTITY IS DEMOTED TO A DESCRIPTIVE PHRASE, WITH ITS CODE REDIRECTED: `Medulloblastoma with myogenic differentiation was previously termed MEDULLOMYOBLASTOMA ... since its clinical features and genetic profile are similar to those of other medulloblastomas, this lesion is no longer considered A DISTINCT ENTITY and it is suggested that the code for medulloblastoma (9470/3) be applied.` The name survives as a description and loses its standing as a thing - and melanotic medulloblastoma goes the same way in the next paragraph
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mechanisms[2]0.95the tagger's words
mechanismsAND A CLASS IS PARKED WITH THE CONDITION FOR ITS PROMOTION NAMED: `Quotation withheld` A pre-registered promotion criterion for a category - and the glioneuronal tumour with neuropil-like islands is parked the same way, needing `more cases with genetic analysis and clinical follow-up`
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mechanisms[3]0.95the tagger's words
mechanismsAND THE DISSENT IS PRESERVED WITH THE RIVAL NAMES: `At the WHO consensus meeting, the designation of these tumours was controversial. Some participants proposed the term `OLIGOASTROCYTOMA WHO GRADE IV` or `OLIGODENDROGLIAL GLIOBLASTOMA MULTIFORME`. The majority of pathologists thought that more clinico-pathological data should be available before this tumour is considered a new disease entity.` The losing names are printed, and the interim label - `glioblastoma with oligodendroglioma component` - is explicitly provisional
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mechanisms[4]0.95the tagger's words
mechanismsAND A TERM IS NARROWED, WITH ITS DEPRECATED SYNONYMS LISTED: `In the past, the term pituicytoma was also applied to other tumours in the sellar and suprasellar region, particularly granular cell tumours and pilocytic astrocytomas. Presently, it is reserved for low-grade glial neoplasms that originate in the neurohypophysis ... Less preferred terms for pituicytoma include `POSTERIOR PITUITARY ASTROCYTOMA` and ... `INFUNDIBULOMA`.` Our `alternatives` layer again, in a real classification, with a preference order
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mechanisms[5]0.95the tagger's words
mechanismsAND A PREFIX IS ADDED BECAUSE ANOTHER FIELD USES THE SAME NAME: the previous edition's `supratentorial primitive neuroectodermal tumours` becomes the more general PNET, and then `Since this designation is also used for similar ... tumours at extracerebral sites, the WHO Working Group proposes to add the prefix CNS to these entities, in order to avoid any confusion.` A name disambiguated by construction rather than by context
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mechanisms[6]0.95the tagger's words
mechanismsAND THE GRADING SCHEME DISCLAIMS ITSELF AND IS OPTIONAL: `The WHO classification ... includes a grading scheme that is A `MALIGNANCY SCALE` ranging across a wide variety of neoplasms rather than a strict histological grading system. It is widely used, but not a requirement for the application of the WHO classification.` The instrument that decides radiation and chemotherapy is declared not to be part of the classification it accompanies
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mechanisms[7]0.95the tagger's words
mechanismsAND ONE GRADE LABEL SPANS UNDER A YEAR AND OVER 80% FIVE-YEAR SURVIVAL: `The majority of glioblastoma patients ... succumb to the disease within a year. For those with other grade IV neoplasms, the outlook may be considerably better. For example, cerebellar medulloblastomas and germ cell tumours such as germinomas, both WHO grade IV lesions, are rapidly fatal if untreated, while state-of-the-art radiation and chemotherapy result in 5-year survival rates exceeding 60 and 80%.` A class whose members are not alike in the thing the class predicts
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mechanisms[8]0.95the tagger's words
mechanismsAND THE GRADES OF THE NEW ENTITIES ARE PROVISIONAL BECAUSE n IS SMALL: `since the number of cases of some newly defined entities is limited, the assignment of grades remains preliminary, pending publication of additional data and long-term follow-up.` Angiocentric glioma rests on 28 reported cases, RGNT on 17, spindle cell oncocytoma on ten from three institutions - and the grade decides the therapy
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mechanisms[9]0.95the tagger's words
mechanismsAND TWO GRADING SYSTEMS USE ONE NUMBER FOR DIFFERENT THINGS: `This system is similar to the St Anne/Mayo classification, with the only major difference being grade I; in the WHO system, grade I is assigned to the more circumscribed pilocytic astrocytoma, whereas the St Anne/Mayo classification assigns grade 1 to an exceedingly rare diffuse astrocytoma without atypia.` Same label, different extension, and both live in the same clinics
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mechanisms[10]0.95the tagger's words
mechanismsAND THE CRITERION FOR THE TOP GRADE VARIES BY AUTHOR: `For WHO grade IV, some authors accept only the criterion of endothelial proliferation, i.e. an apparent multi-layering of endothelium. The WHO classification also accepts glomeruloid microvascular proliferations. Necrosis may be of any type; perinecrotic palisading need not be present.` The classification is more permissive than some of its users, and says which way
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mechanisms[11]0.95the tagger's words
limitationsTWO DISTINCT ENTITIES SHARE ONE CODE, SO THE REGISTRY CANNOT SEE WHAT THE CLASSIFICATION DISTINGUISHES: `the rosette-forming glioneuronal tumour (RGNT) corresponds to WHO grade I. It shares the new ICD-O code 9509/1 with the papillary glioneuronal tumour (PGNT).` Anaplastic and large cell medulloblastoma likewise share 9474/3. The paper says ICD-O `assures that histopathologically stratified population-based incidence and mortality data become available` - and the stratification stops one level above the entities the same paper just created
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limitations[0]0.95the tagger's words
limitationsAND A PATTERN IS NOT A VARIANT, WHICH LEAVES REAL DIFFERENCES UNNAMED: `Surgical pathologists need to know such divergent patterns of differentiation but not every pattern warrants designation as a variant, since some patterns do not have distinct clinical or genetic features.` The rank is decided by consequence, not by appearance - so a reliably recognisable thing can have no name in the system
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limitations[1]0.95the tagger's words
limitationsAND THE WORKING GROUP IS ONE MEETING: `a group of 25 pathologists and geneticists convened at the German Cancer Research Center in Heidelberg in November 2006 and the results of their deliberations and those of an additional 50 contributors are contained in the 2007 WHO classification.` No voting rule, no agreement threshold and no dissent count is reported - against bishop2017 and staab2017, which publish all three
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limitations[2]0.95the tagger's words
limitationsAND THE NEW-VARIANT RULE IS LOOSER IN THE ABSTRACT THAN IN THE TEXT: the abstract says `Histological variants were added if there was evidence of a different age distribution, location, genetic profile or clinical behaviour` - four alternatives joined by OR - while the Entities section requires a new ENTITY to have distinctive morphology AND location AND age distribution AND biologic behaviour. The conjunction changes between the two statements of the same rule family
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limitations[3]0.95the tagger's words
limitationsTHE SHARED-CODE ACT IS PERFORMED THREE TIMES IN THIS PAPER AND THE CORPUS RECORDED IT ONCE. Already tagged: RGNT `shares the new ICD-O code 9509/1 with the papillary glioneuronal tumour`. Also in the text, untagged until now: `the 2007 WHO classification recommends the term `EXTRAVENTRICULAR NEUROCYTOMA` and proposes an ICD-O code identical to that of central neurocytoma (9506/1)`. The existing tag says `TWO DISTINCT ENTITIES SHARE ONE CODE, SO THE REGISTRY CANNOT SEE WHAT THE CLASSIFICATION DISTINGUISHES` - that sentence is equally true of 9506/1, and one instance made a policy look like a slip.
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limitations[4]0.95the tagger's words
controlsrequiring two or more reports from DIFFERENT INSTITUTIONS before a lesion may be admitted as an entity
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eliminates: a single centre's case series becoming a worldwide diagnostic category · outcome: held
controls[0]0.95the tagger's words
controlsthe three-rank scheme itself - refusing varianthood to patterns without distinct clinical or genetic features
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eliminates: a recognisable appearance being mistaken for a distinct disease · outcome: partial
controls[1]0.95the tagger's words
controlsmarking the grades of newly defined entities as preliminary until case numbers and follow-up accumulate
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eliminates: nothing at the bedside - the grade still decides radiation and chemotherapy while it is provisional · outcome: failed
controls[2]0.95the tagger's words
conceptsVariants
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also in: Variants
concepts[0]0.95the paper's words
conceptsa previously defined, overarching entity
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concepts[1]0.95the paper's words
conceptsa new entity
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also in: a new entity
concepts[2]0.95the paper's words
conceptsan unusual histopathological pattern
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[3]0.95the paper's words
conceptsCNS PNET
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
also in: CNS PNET
concepts[4]0.95the paper's words
conceptsSupratentorial PNET
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[5]0.95the paper's words
conceptsthe WHO system
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[6]0.95the paper's words
conceptsthe St Anne/Mayo classification
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[7]0.95the paper's words
conceptstumour grade
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
also in: tumour grade
concepts[8]0.95the paper's words
conceptsthe choice of therapies
Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above.
concepts[9]0.95the paper's words
senses`entity` (clinico-pathological) - admitted only on TWO OR MORE REPORTS FROM DIFFERENT INSTITUTIONS plus distinctive morphology, location, age distribution and biologic behaviour, and NOT on an unusual histopathological pattern alone
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senses[0]0.95the tagger's words
senses`variant` - reliably identifiable histologically and with some relevance for clinical outcome, but STILL PART OF a previously defined overarching entity
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senses[1]0.95the tagger's words
senses`pattern of differentiation` - an identifiable histological appearance WITHOUT distinct clinical or pathological significance; the rank for things that look different and do not behave differently
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senses[2]0.95the tagger's words
senses`WHO grade` - a `malignancy scale` across all neoplasms rather than a histological grading system, explicitly NOT a requirement for applying the classification, and preliminary for the new entities because their case numbers are small
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senses[3]0.95the tagger's words
claim_relationsextends → the third edition of the WHO Blue Book (Kleihues & Cavenee 2000), which first incorporated genetic profiles as aids to the definition of brain tumours
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claim_relations[0]0.95the tagger's words
claim_relationscritiques → the series' own earlier variant admissions - 'Admittedly, in retrospect, this criterion was not always fulfilled'
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claim_relations[1]0.95the tagger's words
claim_relationscontradicts → the St Anne/Mayo grading of astrocytomas at grade I, which assigns the number to a different tumour
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claim_relations[2]0.95the tagger's words
concept_edgesVariants —part-of→ a previously defined, overarching entity
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the relation itself is separately evidenced · strength of the relation: 0.95 · note: 'VARIANTS WERE DEFINED…' The rank is defined by containment, not by resemblance - and the paper then demotes medullomyoblastoma out of entityhood and parks small cell glioblastoma below varianthood, so all three ranks are exercised in one document · the relation stated: a variant is recognisable and clinically relevant but does not leave its parent entity - which is exactly what separates it from a new entity
concept_edges[0]0.95the tagger's words
concept_edgesa new entity —distinct-from→ an unusual histopathological pattern
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the relation itself is separately evidenced · strength of the relation: 0.95 · note: 'a new entity…' A published statement of what does NOT count, which the corpus has only in the ENCODE blacklist and in bishop2017's exclusionary-criteria section. Note the conjunction: the abstract's rule for VARIANTS uses OR across the same four properties, and this rule for ENTITIES uses AND · the relation stated: an unusual appearance is explicitly insufficient - a new entity needs distinctive morphology AND location AND age distribution AND biologic behaviour
concept_edges[1]0.95the tagger's words
concept_edgesCNS PNET —same-as→ Supratentorial PNET
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the relation itself is separately evidenced · strength of the relation: 0.95 · note: 'THE TERM CNS…' The reason is a cross-field collision: 'tumours AT EXTRACEREBRAL…' A rename that changes nothing about the object and everything about the reader - and the old name keeps the code · the relation stated: the prefixed name is declared synonymous with the existing ICD-O term, so the rename carries no change of extension - only a change of who can be confused
concept_edges[2]0.95the tagger's words
concept_edgesthe WHO system —distinct-from→ the St Anne/Mayo classification
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the relation itself is separately evidenced · strength of the relation: 0.95 · note: 'This system is…' Two systems, one number, different referents, both live - and a grade decides whether a patient gets radiation · the relation stated: the two astrocytoma grading systems agree everywhere except grade I, where they assign the same number to different tumours Audit 2026-09-28: DOUBTFUL - read against its full span and kept, but the span says the WHO system is SIMILAR to the St Anne/Mayo classification with one major difference; distinct-from is loose.
concept_edges[3]0.95the tagger's words
concept_edgestumour grade —causes→ the choice of therapies
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the relation itself is separately evidenced · strength of the relation: 0.95 · note: 'Histological grading is…' Read against two other sentences in the same paper: the scale is 'NOT A REQUIREMENT…', and for the new entities 'THE ASSIGNMENT…'. An optional, provisional label with a treatment attached · the relation stated: the grade is a key factor in choosing therapy, and in particular in deciding adjuvant radiation and chemotherapy protocols
concept_edges[4]0.95the tagger's words
content_tagsA CLASSIFICATION THAT PUBLISHES ITS ADMISSION RULES: `two or more reports from different institutions were considered mandatory ... and not simply by an unusual histopathological pattern`
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content_tags.findings[0]0.95the tagger's words
content_tagsAND SAYS ITS OWN PAST ADMISSIONS FAILED THEM: `Admittedly, in retrospect, this criterion was not always fulfilled`
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content_tags.findings[1]0.95the tagger's words
content_tagsAND AN ENTITY DEMOTED TO A DESCRIPTIVE PHRASE: medullomyoblastoma is `no longer considered a distinct entity` and its cases take the medulloblastoma code
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content_tags.findings[2]0.95the tagger's words
content_tagsAND A CLASS PARKED WITH ITS PROMOTION CRITERION PRE-REGISTERED: `If future clinical trials show a difference in prognosis and/or response to therapy, the small cell glioblastoma may be reconsidered as a variant`
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content_tags.findings[3]0.95the tagger's words
content_tagsAND ONE GRADE LABEL SPANS DEATH WITHIN A YEAR AND 80% FIVE-YEAR SURVIVAL: glioblastoma against medulloblastoma and germinoma, `both WHO grade IV lesions`
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content_tags.findings[4]0.95the tagger's words
content_tagsAND TWO GRADING SYSTEMS USE ONE NUMBER FOR DIFFERENT TUMOURS: `the only major difference being grade I ... whereas the St Anne/Mayo classification assigns grade 1 to an exceedingly rare diffuse astrocytoma without atypia`
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content_tags.findings[5]0.95the tagger's words
content_tagsRGNT, WHO grade I, shares the new ICD-O code 9509/1 with PGNT
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content_tags.findings[6]0.95the tagger's words
content_tagsthe term extraventricular neurocytoma is recommended, with an ICD-O code identical to central neurocytoma's (9506/1)
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content_tags.findings[7]0.95the tagger's words
content_tagsatypical choroid plexus papilloma shares the choroid plexus code but with the /1 extension (9390/1)
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content_tags.findings[8]0.95the tagger's words
content_tags`a `MALIGNANCY SCALE` ranging across a wide variety of neoplasms rather than a strict histological grading system ... not a requirement for the application of the WHO classification`
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also in: WHO grade
content_tags.definitions[1]0.95the tagger's words
content_tags`two or more reports from different institutions were considered mandatory ... a new entity had to be characterized by distinctive morphology, location, age distribution and biologic behaviour, and not simply by an unusual histopathological pattern. Variants ... still being part of a previously defined, overarching entity. ... patterns ... did not have a distinct clinical or pathological significance`
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content_tags.definitions[2]0.95the tagger's words
content_tags`two or more reports from different institutions were considered mandatory ... a new entity had to be characterized by distinctive morphology, location, age distribution and biologic behaviour, and not simply by an unusual histopathological pattern. Variants ... still being part of a previously defined, overarching entity. ... patterns ... did not have a distinct clinical or pathological significance`
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content_tags.definitions[3]0.95the tagger's words
content_tags`two or more reports from different institutions were considered mandatory ... a new entity had to be characterized by distinctive morphology, location, age distribution and biologic behaviour, and not simply by an unusual histopathological pattern. Variants ... still being part of a previously defined, overarching entity. ... patterns ... did not have a distinct clinical or pathological significance`
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content_tags.definitions[4]0.95the tagger's words
content_tagsplus distinctive morphology, location, age distribution and biologic behaviour
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content_tags.quantities[0]0.95the tagger's words
content_tagsno voting rule, agreement threshold or dissent count is reported
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content_tags.quantities[1]0.95the tagger's words
content_tagsand grade II typically survive more than 5 years, grade III 2-3 years
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content_tags.quantities[2]0.95the tagger's words
content_tags`patients with WHO grade II tumours typically survive more than 5 years and those with grade III tumours survive 2-3 years` - an ordered scale - and then grade IV contains both `succumb ... within a year` and `5-year survival rates exceeding 60 and 80%`. The scale is monotone until its last step, where it stops being a scale at all
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content_tags.statistics[0]0.95the tagger's words
content_tagsthe property that decides rank at every level - it separates an entity from a pattern, a variant from a pattern, and it is what a grade is meant to predict. And it is the one property that cannot be read off the slide, which is why two of the new categories are parked pending clinical follow-up
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content_tags.variables[0]0.95the tagger's words

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