Difference between revisions of "Astrocytoma"
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An '''astrocytoma''' is a neoplasm derived from an [[neurohistology|astrocyte]]. Astrocytomas are common. This article deals with | An '''astrocytoma''' is a neoplasm derived from an [[neurohistology|astrocyte]]. Astrocytomas are common. This article deals with them. An overview of CNS tumours is found in the ''[[CNS tumours]]'' article. | ||
= | =Common= | ||
==Glioblastoma== | |||
*Previously known as ''glioblastoma multiforme'' (abbreviated ''GBM''). | |||
===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)]. | |||
*[[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)]. | |||
=Uncommon= | |||
==Pleomorphic xanthroastrocytoma== | ==Pleomorphic xanthroastrocytoma== | ||
*Abbreviated ''PXA''. | *Abbreviated ''PXA''. | ||
| Line 24: | Line 46: | ||
*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. | ||
==Gliosarcoma== | ==Gliosarcoma== | ||
Revision as of 04:22, 17 December 2011
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
- Previously known as glioblastoma multiforme (abbreviated GBM).
General
- Median survival is measured in months.[1]
- Only about 5% can expect to survive more than three years.[2]
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:
- WC:
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.[3]
- 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:[4]
- 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.[5]
- Rare ~ 200 cases reported in the literature.[5]
- Definition: gliosarcoma = glioblastoma + sarcomatous component.[6]
- Usual location (like glioblastoma): temporal lobe.
Microscopic
Features:
- Glioblastoma.
- Sarcomatous component (one of the following):[5][6]
- Fibroblastic.
- Cartilaginous.
- Osseous.
- Smooth muscle.
- Striated muscle.
- Adipocyte.
Image: Gliosarcoma - elastic von Gieson (WC).
See also
References
- ↑ Jubelirer, SJ.. "A review of the treatment and survival rates of 138 patients with glioblastoma multiforme.". W V Med J 92 (4): 186-90. PMID 8772403.
- ↑ Krex, D.; Klink, B.; Hartmann, C.; von Deimling, A.; Pietsch, T.; Simon, M.; Sabel, M.; Steinbach, JP. et al. (Oct 2007). "Long-term survival with glioblastoma multiforme.". Brain 130 (Pt 10): 2596-606. doi:10.1093/brain/awm204. PMID 17785346.
- ↑ 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.
- ↑ 5.0 5.1 5.2 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/.
- ↑ 6.0 6.1 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.