Astrocytoma

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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

Pilocytic astrocytoma

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

www:

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.