Difference between revisions of "Astrocytoma"

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(→‎Glioblastoma: split out)
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=Common=
=Common=
==Glioblastoma==
==Glioblastoma==
*Previously known as ''glioblastoma multiforme'' (abbreviated ''GBM'').
{{Main|Glioblastoma}}
===General===
*Median survival is measured in months.<ref>{{Cite journal  | last1 = Jubelirer | first1 = SJ. | title = A review of the treatment and survival rates of 138 patients with glioblastoma multiforme. | journal = W V Med J | volume = 92 | issue = 4 | pages = 186-90 | month =  | year =  | doi =  | PMID = 8772403 }}</ref>
*Only about 5% can expect to survive more than three years.<ref name=pmid17785346>{{Cite journal  | last1 = Krex | first1 = D. | last2 = Klink | first2 = B. | last3 = Hartmann | first3 = C. | last4 = von Deimling | first4 = A. | last5 = Pietsch | first5 = T. | last6 = Simon | first6 = M. | last7 = Sabel | first7 = M. | last8 = Steinbach | first8 = JP. | last9 = Heese | first9 = O. | title = Long-term survival with glioblastoma multiforme. | journal = Brain | volume = 130 | issue = Pt 10 | pages = 2596-606 | month = Oct | year = 2007 | doi = 10.1093/brain/awm204 | PMID = 17785346 }}</ref>
 
===Microscopic===
Features:
*Astrocytic tumour with:
**Nuclear atypia.
**Necrosis.
**Endothelial proliferation (AKA microvascular proliferation).
**+/-"Pseudopalisading necrosis" - tumour cells lined-up like a picket fence around necrotic areas.
 
Images:
*www:
**[http://moon.ouhsc.edu/kfung/jty1/OPAQ/PathQuiz/PQ-Images/N0A002-1.gif Microvascular proliferation in a GBM (ouhsc.edu)].
**[http://cancerres.aacrjournals.org/content/64/3/920/F7.expansion.html Pseudopalisading necrosis in GBM (aacrjournals.org)].
*[[WC]]:
**[http://commons.wikimedia.org/wiki/File:Glioblastoma_with_extreme_nuclear_enlargement_-_very_high_mag.jpg Extreme nuclear enlargement in a GBM - very high mag. (WC)].
**[http://commons.wikimedia.org/wiki/File:Glioblastoma_-_high_mag.jpg GBM juxtaposed with near normal white matter - high mag. (WC)].
 
===IHC===
*GFAP +ve (cytoplasm).
*IDH-1 -ve.
**+ve if developed from lower grade astrocytoma. (???)


=Uncommon=
=Uncommon=

Revision as of 23:23, 23 July 2013

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

Common

Glioblastoma

Main article: 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:

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.
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