Difference between revisions of "Astrocytoma"
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An '''astrocytoma''' is a neoplasm derived from an [[neurohistology|astrocyte]]. Astrocytomas are common. This article is a brief introduction them. An overview of CNS tumours is found in the ''[[CNS tumours]]'' article. | An '''astrocytoma''' is a neoplasm derived from an [[neurohistology|astrocyte]]. Astrocytomas are common. This article is a brief introduction them. An overview of CNS tumours is found in the ''[[CNS tumours]]'' article. | ||
=Overview= | |||
{| class="wikitable sortable" | |||
! Name | |||
! Type | |||
! Variants / Patterns | |||
! Image | |||
|- | |||
| Diffuse Astrocytoma, WHO II | |||
| diffuse | |||
| protoplasmatic, fibrillar, gemistocytic | |||
| [[File:Astrocytoma whoII HE.jpg|thumb|center|150px]] | |||
|- | |||
| Anaplastic Astrocytoma, WHO III | |||
| diffuse | |||
| gliomatosis cerebri | |||
| [[File:Anaplastic_astrocytoma_-_very_high_mag.jpg|thumb|center|150px]] | |||
|- | |||
| Glioblastoma, WHO IV | |||
| diffuse | |||
| small cell, epitheloid/rhabdoid, with PNET componet, with granular cell component, giant cell, gliosarcoma | |||
| [[File:Glioblastoma_(1).jpg|thumb|center|150px]] | |||
|- | |||
| Pilocytic astrocytoma, WHO I | |||
| circumscribed | |||
| pilomyxoid astrocytoma, anaplastic pilocytic astrocytoma | |||
| [[File:Rosenthal_HE_40x.jpg|thumb|center|150px]] | |||
|- | |||
| Pleomorphic xanthoastrocytoma, WHO II (PXA) | |||
| circumscribed | |||
| anaplastic PXA | |||
| [[File:PXA_HE_x20.jpg|thumb|center|150px]] | |||
|- | |||
| Subependymal giant cell astrocytoma, WHO I (SEGA) | |||
| circumscribed | |||
| SEGA in tuberous sclerosis | |||
| [[File:SEGA_HE.jpg|thumb|center|150px]] | |||
|} | |||
=Common= | =Common= | ||
==Pilocytic astrocytoma== | ==Pilocytic astrocytoma== | ||
{{Main|Pilocytic astrocytoma}} | {{Main|Pilocytic astrocytoma}} | ||
==Diffuse astrocytoma== | |||
* Grade II and III diffuse astrocytic tumors | |||
* Many of them carry IDH1/2 mutations | |||
==Glioblastoma== | ==Glioblastoma== | ||
| Line 9: | Line 50: | ||
=Uncommon= | =Uncommon= | ||
==Subependymal giant cell astrocytoma== | |||
{{Main|Subependymal giant cell astrocytoma}} | |||
==Pleomorphic xanthroastrocytoma== | ==Pleomorphic xanthroastrocytoma== | ||
*Abbreviated ''PXA''. | *Abbreviated ''PXA''. | ||
| Line 30: | Line 74: | ||
*GFAP +ve -- required for Dx, may be patchy. | *GFAP +ve -- required for Dx, may be patchy. | ||
*S-100 +ve -- cytoplasm, usu. diffuse. | *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 <ref>{{Cite journal | last1 = Khuong-Quang | first1 = DA. | last2 = Buczkowicz | first2 = P. | last3 = Rakopoulos | first3 = P. | last4 = Liu | first4 = XY. | last5 = Fontebasso | first5 = AM. | last6 = Bouffet | first6 = E. | last7 = Bartels | first7 = U. | last8 = Albrecht | first8 = S. | last9 = Schwartzentruber | first9 = J. | title = K27M mutation in histone H3.3 defines clinically and biologically distinct subgroups of pediatric diffuse intrinsic pontine gliomas. | journal = Acta Neuropathol | volume = 124 | issue = 3 | pages = 439-47 | month = Sep | year = 2012 | doi = 10.1007/s00401-012-0998-0 | PMID = 22661320 }}</ref> | |||
==Gliosarcoma== | ==Gliosarcoma== | ||