Account-creators
1,040
edits
Difference between revisions of "Diffuse astrocytoma"
Jump to navigation
Jump to search
update
Jensflorian (talk | contribs) (+pic) |
Jensflorian (talk | contribs) (update) |
||
| Line 5: | Line 5: | ||
* Usually shows progression to [[glioblastoma]] sooner or later. | * Usually shows progression to [[glioblastoma]] sooner or later. | ||
Previously categorized as follows:{{Ref WHOCNS|25}} | Previously categorized as follows:<ref name=WHOCNS>{{Ref WHOCNS|25}}</ref> | ||
*Diffuse astrocytoma ICD-O: 9400/3 | *Diffuse astrocytoma ICD-O: 9400/3 | ||
**Fibrillary astrocytoma ICD-O: 9420/3 - most frequent | **Fibrillary astrocytoma ICD-O: 9420/3 - most frequent | ||
| Line 11: | Line 11: | ||
**Protoplasmatic astrocytoma ICD-O:9410/3 - rare | **Protoplasmatic astrocytoma ICD-O:9410/3 - rare | ||
Note: This subtyping is no longer in use! | Note: This subtyping is no longer in use! | ||
==Radiology/Clinic== | |||
*Mass effect. | |||
*Seizures. | |||
*Neurologic decifit. | |||
*Usually not contrast-enhanching, T2 bright. | |||
==Macroscopy== | |||
*No clear demarcation from white matter | |||
*May contain larger cysts | |||
*No necrosis | |||
==Histology== | ==Histology== | ||
Features: <ref name=AFIP2007>{{Ref AFIP2007|34}}</ref> | |||
*Cell density higher than normal brain. | *Cell density higher than normal brain. | ||
*Mild to moderate nuclear pleomorphism. | *Mild to moderate nuclear pleomorphism. | ||
**Monotony of atypical nuclei | **Monotony of atypical nuclei and irregular distribution indicates neoplasm. | ||
**"naked nuclei" without recognizeable processes. | |||
**No prominent nucleolus. | |||
*Cytoplasm highly variable (even within the same tumour). | *Cytoplasm highly variable (even within the same tumour). | ||
**In normal CNS the cytoplasm blends within the neuropil. | **In normal CNS the cytoplasm blends within the neuropil. | ||
*Mitoses absent or very rare. | *Mitoses absent or very rare. | ||
*Microcystic | *Microcystic spaces of the background (none to extensive). | ||
*No necrosis, no vascular proliferations. | *No necrosis, no vascular proliferations. | ||
**Except radiation necrosis. | |||
*Lymphocytic cuffing (mostly in gemistocytic type) | |||
*Abent to few rosenthal fibers. | |||
<gallery> | |||
File:Diffuse_astrocytoma_HE_stain.jpg | Diffuse astrocytoma, [[H&E]] (WC/jensflorian) | |||
File:Image NP T2a 0002.JPG | Diffuse astrocytoma, [[H&E]] (WC/jensflorian) | |||
File:Astrocytoma whoII HE.jpg | Astrocytoma, fibrillary type (WC/jensflorian) | |||
File:Neuropathology case II 02.jpg | Astrocytoma, protoplasmatic type (WC/jensflorian) | |||
</gallery> | |||
==IHC== | ==IHC== | ||
| Line 27: | Line 52: | ||
*Vimentin+ve (often perinuclear). | *Vimentin+ve (often perinuclear). | ||
*S-100+ve. | *S-100+ve. | ||
*p53: Nuclear staining in 30% of the tumours (usually few cells). | |||
*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%. | *[[ATRX]] loss in 70%. | ||
<gallery> | |||
File:GFAP astrocytoma.jpg| GFAP in astrocytoma (WC/jensflorian) | |||
File:Neuropathology case II 04.jpg | ATRX loss in astrocytoma (WC/jensflorian) | |||
</gallery> | |||
==Molecular== | ==Molecular== | ||
| Line 44: | Line 75: | ||
*[[SEGA]] - esp. gemistocytic forms. | *[[SEGA]] - esp. gemistocytic forms. | ||
=See also= | =See also= | ||