Fig. 3: Challenges in interpretation of MTAP immunohistochemistry.

a An IDH-mutant astrocytoma showing positive MTAP staining in fine cytoplasmic processes with weakly positive internal normal controls (arrow head). b Loss of MTAP staining in an IDH-mutant astrocytoma showing weak positivity for the internal normal controls (arrow head). c An IDH-mutant astrocytoma showing loss of MTAP staining with intermixed non-neoplastic reactive astrocytes retaining MTAP positivity. d An IDH-mutant oligodendroglioma, with perinuclear halos that made MTAP interpretation challenging. The case was interpreted as MTAP deficient, although the tumor lacked CDKN2A HD.