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===Overview=== | ===Overview=== | ||
*Low-grade (diffuse) astrocytomas (Grade II). | *Low-grade (diffuse) astrocytomas (Grade II). | ||
*Anaplastic astrocytomas (Grade III). | *Anaplastic astrocytomas (Grade III). | ||
*Glioblastoma (Grade IV). | *Glioblastoma (Grade IV). | ||
Notes: | |||
*Non-infiltrative gliomas: | |||
**Pilocytic astrocytomas (WHO Grade I). | |||
**Dysembryoplastic neuroepithelial tumour (DNT), (WHO Grade I). | |||
===Microscopic=== | ===Microscopic=== | ||
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*Glial processes - '''key feature'''. | *Glial processes - '''key feature'''. | ||
**Thin stringy cytoplasmic processes - best seen at high power in less cellular areas. | **Thin stringy cytoplasmic processes - best seen at high power in less cellular areas. | ||
*No Rosenthal fibres within the tumour itself. | |||
Images: | Images: | ||
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**Glial: "blends into brain"/gradual transition to non-tumour brain. | **Glial: "blends into brain"/gradual transition to non-tumour brain. | ||
**Non-glial: no glial processes. | **Non-glial: no glial processes. | ||
*Rosenthal fibres within the tumour... make it into a [[pilocytic astrocytoma]]. | |||
**Rosenthal fibres may be seen around a (very) slow growing tumour and represent a reactive process. | |||
* | |||
* | |||
====Grading==== | ====Grading==== | ||
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**[http://commons.wikimedia.org/wiki/File:Anaplastic_astrocytoma_-_very_high_mag_-_cropped.jpg Anaplastic astrocytoma - very high mag. (WC)]. | **[http://commons.wikimedia.org/wiki/File:Anaplastic_astrocytoma_-_very_high_mag_-_cropped.jpg Anaplastic astrocytoma - very high mag. (WC)]. | ||
**[http://commons.wikimedia.org/wiki/File:Anaplastic_astrocytoma_-_gfap_-_very_high_mag.jpg Anaplastic astrocytoma - GFAP - very high mag. (WC)]. | **[http://commons.wikimedia.org/wiki/File:Anaplastic_astrocytoma_-_gfap_-_very_high_mag.jpg Anaplastic astrocytoma - GFAP - very high mag. (WC)]. | ||
=====Table of common gliomas - grading===== | |||
Histomorphologic comparison of common gliomas: | |||
{| class="wikitable" | |||
|'''Entity''' || '''Rosenthal <br>fibres / EGBs''' ||'''Nuclear atypia''' ||'''Mitoses''' || '''Necrosis or MVP''' || '''Infiltrative''' || '''Image''' | |||
|- | |||
|Pilocytic astrocytoma || yes || usu. no || usu. no || usu. no || no || [http://commons.wikimedia.org/wiki/File:Rosenthal_HE_40x.jpg] | |||
|- | |||
|Low-grade astrocytoma || no || yes || no || no || yes || image? | |||
|- | |||
|Anaplastic astrocytoma || no || yes || yes || no || yes || [http://commons.wikimedia.org/wiki/File:Anaplastic_astrocytoma_-_high_mag.jpg] | |||
|- | |||
|Glioblastoma || no || yes || yes || yes || yes || [http://commons.wikimedia.org/wiki/File:Glioblastoma_-_high_mag.jpg] | |||
|} | |||
Notes: | |||
*''MVP'' = microvascular proliferation. | |||
*''EGBs'' = eosinophilic granular bodies. | |||
===IHC=== | ===IHC=== |
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