Astrocytoma
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:
IHC
- GFAP +ve (cytoplasm).
- IDH-1 -ve.
- +ve if developed from lower grade astrocytoma. (???)
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.
Images:
- Gliosarcoma - elastic von Gieson (WC).
- Gliosarcoma - several images (upmc.edu).
- Gliosarcoma - case 3 - several images (upmc.edu).
IHC
- GFAP +ve.
- Spindle cell component -ve.[7]
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.
- ↑ URL: http://path.upmc.edu/cases/case361.html. Accessed on: 15 January 2012.