Astrocytoma
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.
Overview
| Name | Type | Variants / Patterns | Image |
|---|---|---|---|
| Diffuse Astrocytoma, WHO II | diffuse | protoplasmatic, fibrillar, gemistocytic | |
| Anaplastic Astrocytoma, WHO III | diffuse | gliomatosis cerebri | |
| Glioblastoma, WHO IV | diffuse | small cell, epitheloid/rhabdoid, with PNET componet, with granular cell component, giant cell, gliosarcoma | |
| Pilocytic astrocytoma, WHO I | circumscribed | pilomyxoid astrocytoma, anaplastic pilocytic astrocytoma | |
| Pleomorphic xanthoastrocytoma, WHO II (PXA) | circumscribed | anaplastic PXA | |
| Subependymal giant cell astrocytoma, WHO I (SEGA) | circumscribed | SEGA in tuberous sclerosis |
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Common
Pilocytic astrocytoma
Main article: Pilocytic astrocytoma
Diffuse astrocytoma
- Grade II and III diffuse astrocytic tumors
- Many of them carry IDH1/2 mutations
Glioblastoma
Main article: Glioblastoma
Uncommon
Subependymal giant cell astrocytoma
Main article: Subependymal giant cell astrocytoma
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.
Gliomatosis cerebri
- Extensively diffusely growing astrocytic neoplasm.
- Currently considered a pattern of diffuse glioma infiltration.
- More than 3 lobes have to be involved, us. bilateral (radiology).
- biologic behaviour corresponds to WHO III (ICD-O: 9381/3)
H3.3 K27M mutated glioma of the midline
- High-grade astrocytic neoplasm associated with midline structures
- Mostly in children and adolescents
- Includes diffuse intrinsic pontine gliomas (DPIG)
- Will become provisonal variant in upcoming WHO 2016 classification
- Distinct biological and clinical group with poor prognosis [3]
Gliosarcoma
General
- Considered to be a variant of glioblastoma by WHO.[4]
- Rare ~ 200 cases reported in the literature.[4]
- Definition: gliosarcoma = glioblastoma + sarcomatous component.[5]
- Usual location (like glioblastoma): temporal lobe.
Microscopic
Features:
- Glioblastoma.
- Sarcomatous component (one of the following):[4][5]
- Fibroblastic.
- Cartilaginous.
- Osseous.
- Smooth muscle.
- Striated muscle.
- Adipocyte.
Images
Gliosarcoma - elastic von Giesson. (WC)
www:
- Gliosarcoma - several images (upmc.edu).
- Gliosarcoma - case 2 - several images (upmc.edu).
- Gliosarcoma - case 3 - several images (upmc.edu).
IHC
Gliosarcoma with smooth muscle component (gliomyosarcoma):[8]
- SMA +ve.
- Factor VIII +ve.
See also
References
- ↑ URL: http://moon.ouhsc.edu/kfung/jty1/neurotest/Q14-Ans.htm. Accessed on: 13 January 2011.
- ↑ URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970469-7. Accessed on: 13 January 2011.
- ↑ Khuong-Quang, DA.; Buczkowicz, P.; Rakopoulos, P.; Liu, XY.; Fontebasso, AM.; Bouffet, E.; Bartels, U.; Albrecht, S. et al. (Sep 2012). "K27M mutation in histone H3.3 defines clinically and biologically distinct subgroups of pediatric diffuse intrinsic pontine gliomas.". Acta Neuropathol 124 (3): 439-47. doi:10.1007/s00401-012-0998-0. PMID 22661320.
- ↑ 4.0 4.1 4.2 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/.
- ↑ 5.0 5.1 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.
- ↑ 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.
- ↑ URL: http://path.upmc.edu/cases/case361.html. Accessed on: 15 January 2012.
- ↑ 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.