Difference between revisions of "Astrocytoma"

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*GFAP +ve -- astrocytic component.<ref name=pmid9736406>{{Cite journal  | last1 = Horiguchi | first1 = H. | last2 = Hirose | first2 = T. | last3 = Kannuki | first3 = S. | last4 = Nagahiro | first4 = S. | last5 = Sano | first5 = T. | title = Gliosarcoma: an immunohistochemical, ultrastructural and fluorescence in situ hybridization study. | journal = Pathol Int | volume = 48 | issue = 8 | pages = 595-602 | month = Aug | year = 1998 | doi =  | PMID = 9736406 }}</ref>
*GFAP +ve -- astrocytic component.<ref name=pmid9736406>{{Cite journal  | last1 = Horiguchi | first1 = H. | last2 = Hirose | first2 = T. | last3 = Kannuki | first3 = S. | last4 = Nagahiro | first4 = S. | last5 = Sano | first5 = T. | title = Gliosarcoma: an immunohistochemical, ultrastructural and fluorescence in situ hybridization study. | journal = Pathol Int | volume = 48 | issue = 8 | pages = 595-602 | month = Aug | year = 1998 | doi =  | PMID = 9736406 }}</ref>
**Spindle cell component -ve.<ref>URL: [http://path.upmc.edu/cases/case361.html http://path.upmc.edu/cases/case361.html]. Accessed on: 15 January 2012.</ref>
**Spindle cell component -ve.<ref>URL: [http://path.upmc.edu/cases/case361.html http://path.upmc.edu/cases/case361.html]. Accessed on: 15 January 2012.</ref>
Gliosarcoma with smooth muscle component (gliomyosarcoma):<ref name=pmid21393877>{{Cite journal  | last1 = Khanna | first1 = M. | last2 = Siraj | first2 = F. | last3 = Chopra | first3 = P. | last4 = Bhalla | first4 = S. | last5 = Roy | first5 = S. | title = Gliosarcoma with prominent smooth muscle component (gliomyosarcoma): a report of 10 cases. | journal = Indian J Pathol Microbiol | volume = 54 | issue = 1 | pages = 51-4 | month =  | year =  | doi = 10.4103/0377-4929.77324 | PMID = 21393877 }}</ref>
*SMA +ve.
*Factor VIII +ve.


=See also=
=See also=

Revision as of 19:48, 12 June 2012

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:

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:

IHC

  • GFAP +ve -- astrocytic component.[7]
    • Spindle cell component -ve.[8]

Gliosarcoma with smooth muscle component (gliomyosarcoma):[9]

  • SMA +ve.
  • Factor VIII +ve.

See also

References

  1. 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.
  2. 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.
  3. URL: http://moon.ouhsc.edu/kfung/jty1/neurotest/Q14-Ans.htm. Accessed on: 13 January 2011.
  4. URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970469-7. Accessed on: 13 January 2011.
  5. 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. 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.
  7. 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.
  8. URL: http://path.upmc.edu/cases/case361.html. Accessed on: 15 January 2012.
  9. 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.