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Difference between revisions of "Diffuse astrocytoma"
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WHO 2016 update
Jensflorian (talk | contribs) (update) |
Jensflorian (talk | contribs) (WHO 2016 update) |
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* Usually shows progression to [[glioblastoma]] sooner or later. | * Usually shows progression to [[glioblastoma]] sooner or later. | ||
WHO 2016 categorization combines morphology and genetics into following groups:<ref>{{Cite journal | last1 = Louis | first1 = DN. | last2 = Perry | first2 = A. | last3 = Reifenberger | first3 = G. | last4 = von Deimling | first4 = A. | last5 = Figarella-Branger | first5 = D. | last6 = Cavenee | first6 = WK. | last7 = Ohgaki | first7 = H. | last8 = Wiestler | first8 = OD. | last9 = Kleihues | first9 = P. | title = The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. | journal = Acta Neuropathol | volume = 131 | issue = 6 | pages = 803-20 | month = Jun | year = 2016 | doi = 10.1007/s00401-016-1545-1 | PMID = 27157931 }}</ref> | |||
*Diffuse astrocytoma ICD-O: 9400/3 | *Diffuse astrocytoma, IDH-mutant ICD-O: 9400/3 - most frequent. | ||
** | **Gemistocytic astrocytoma, IDH-mutant ICD-O:9411/3 | ||
* | *Diffuse astrocytoma, IDH-wildtype ICD-O: 9400/3 | ||
* | *Diffuse astrocytoma,NOS ICD-O: 9400/3 - genetic data missing. | ||
Note: This subtyping is no longer in use | |||
''Note:'' Older terminologies included Fibrillary astrocytoma (ICD-O: 9420/3) and Protoplasmatic astrocytoma (ICD-O:9410/3)<ref name=WHOCNS>{{Ref WHOCNS|25}}</ref> This subtyping is no longer in use. These tumors are now classified according their IDH mutation status. | |||
==Radiology/Clinic== | ==Radiology/Clinic== | ||
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File:Astrocytoma whoII HE.jpg | Astrocytoma, fibrillary type (WC/jensflorian) | File:Astrocytoma whoII HE.jpg | Astrocytoma, fibrillary type (WC/jensflorian) | ||
File:Neuropathology case II 02.jpg | Astrocytoma, protoplasmatic type (WC/jensflorian) | File:Neuropathology case II 02.jpg | Astrocytoma, protoplasmatic type (WC/jensflorian) | ||
File:Gemistocytic astrocytoma.jpg | Gemistocytic astrocytoma (WC/jensflorian) | |||
</gallery> | </gallery> | ||
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*MIB-1: 0-5% (mean: 2%). | *MIB-1: 0-5% (mean: 2%). | ||
*[[IDH-1]] (R132H)+ve in 60-70%. | *[[IDH-1]] (R132H)+ve in 60-70%. | ||
*[[ATRX]] loss in 70%. | **'Note:'' This antibody does not detect other rare IDH1/2 mutations. | ||
*[[ATRX]] nuclear loss in 70%. | |||
<gallery> | <gallery> | ||
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==Molecular== | ==Molecular== | ||
*IDH1 R132- or IDH2 R172-point mutations classify the tumors as Diffuse astrocytoma, IDH-mutant. | |||
*Absence of LOH 1p/19q. | *Absence of LOH 1p/19q. | ||
*Tp53 mutations in approx. 60% (80-90% in gemistocytic, 50% in fibrillary types). | *Tp53 mutations in approx. 60% (80-90% in gemistocytic, 50% in fibrillary types). | ||
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*Reactive astrocytosis. | *Reactive astrocytosis. | ||
*Demyelinisation. | *Demyelinisation. | ||
*[[Anaplastic astrocytoma]] | *[[Anaplastic astrocytoma]] - increased mitotic activity. | ||
*[[Oligoastrocytoma]] | *[[Oligoastrocytoma]], NOS - esp. when genetic data on IDH and LOH 1p/19q are lacking. | ||
*[[Oligodendroglioma]] - esp. protoplasmatic forms. | *[[Oligodendroglioma]] - esp. protoplasmatic forms. LOH 1p/19q testing required. | ||
*[[SEGA]] - esp. gemistocytic forms. | *[[SEGA]] - esp. gemistocytic forms. | ||