Astrocytoma

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An astrocytoma is a neoplasm derived from an astrocyte. Astrocytomas are common. This article is a brief introduction them. An overview of CNS tumours is found in the CNS tumours article.

Common

Pilocytic astrocytoma

Glioblastoma

Uncommon

Pleomorphic xanthroastrocytoma

  • Abbreviated PXA.

General

  • Kids & young adults.
  • Prognosis usu. good.

Microscopic

Features:

  • Large cells with intracytoplasmic lipid accumulation, i.e. foamy cytoplasm - key features.[1]
    • May not be obvious/one may have to search for this.
  • Focal marked nuclear atypia - including hyperchromasia, marked nuclear enlargement, irregular chromatin.
  • Multinucleation - common.

Images:

IHC

Features:[2]

  • GFAP +ve -- required for Dx, may be patchy.
  • S-100 +ve -- cytoplasm, usu. diffuse.

Gliosarcoma

General

  • Considered to be a variant of glioblastoma by WHO.[3]
  • Rare ~ 200 cases reported in the literature.[3]
  • Definition: gliosarcoma = glioblastoma + sarcomatous component.[4]
  • Usual location (like glioblastoma): temporal lobe.

Microscopic

Features:

  • Glioblastoma.
  • Sarcomatous component (one of the following):[3][4]
    • Fibroblastic.
    • Cartilaginous.
    • Osseous.
    • Smooth muscle.
    • Striated muscle.
    • Adipocyte.

Images

www:

IHC

  • GFAP +ve -- astrocytic component.[5]
    • Spindle cell component -ve.[6]

Gliosarcoma with smooth muscle component (gliomyosarcoma):[7]

  • SMA +ve.
  • Factor VIII +ve.

See also

References

  1. URL: http://moon.ouhsc.edu/kfung/jty1/neurotest/Q14-Ans.htm. Accessed on: 13 January 2011.
  2. URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970469-7. Accessed on: 13 January 2011.
  3. 3.0 3.1 3.2 Han SJ, Yang I, Tihan T, Prados MD, Parsa AT (February 2010). "Primary gliosarcoma: key clinical and pathologic distinctions from glioblastoma with implications as a unique oncologic entity". J. Neurooncol. 96 (3): 313–20. doi:10.1007/s11060-009-9973-6. PMC 2808523. PMID 19618114. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2808523/.
  4. 4.0 4.1 Ayadi L, Charfi S, Khabir A, et al. (March 2010). "[Cerebral gliosarcoma: clinico-pathologic study of 8 cases]" (in French). Tunis Med 88 (3): 142–6. PMID 20415184.
  5. Horiguchi, H.; Hirose, T.; Kannuki, S.; Nagahiro, S.; Sano, T. (Aug 1998). "Gliosarcoma: an immunohistochemical, ultrastructural and fluorescence in situ hybridization study.". Pathol Int 48 (8): 595-602. PMID 9736406.
  6. URL: http://path.upmc.edu/cases/case361.html. Accessed on: 15 January 2012.
  7. Khanna, M.; Siraj, F.; Chopra, P.; Bhalla, S.; Roy, S.. "Gliosarcoma with prominent smooth muscle component (gliomyosarcoma): a report of 10 cases.". Indian J Pathol Microbiol 54 (1): 51-4. doi:10.4103/0377-4929.77324. PMID 21393877.