CNS tumor
Astrocytic tumors
OLD Diffuse astrocytoma - general

Author: Eman Abdelzaher, M.D., Ph.D. (see Authors page)

Revised: 25 August 2017, last major update February 2012

Copyright: (c) 2002-2017,, Inc.

PubMed Search: Diffuse astrocytoma [title]

Topic Completed: 1 February 2012

Minor changes: 14 December 2019

Eman Abdelzaher, M.D., Ph.D.
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Cite this page: Abdelzaher, E. OLD Diffuse astrocytoma - general. website. Accessed September 26th, 2020.
Definition / general
  • 10 - 15% of all astrocytic brain tumors
  • May become more anaplastic over time
  • Three histological variants are recognized: fibrillary, gemistocytic and protoplasmic
  • Also called diffuse infiltrating astrocytoma
  • Young adults, most commonly arise during the 3rd and 4th decades
  • Male predominance
  • Site usually supratentorial but can be anywhere in CNS
  • Preferred sites: frontal and temporal lobes, brain stem, spinal cord
  • Uncommon in cerebellum
Clinical features
  • Median survival is 6 - 8 years but rarely has rapid progression and death
  • WHO grade II
  • Gemistocytic variant may progress to higher grades but NOT recommended to give it a WHO grade III (J Neurooncol 2006;76:175)
Radiology description
  • Expanding intra-axial lesion with mass effect, variable peritumoral edema
  • Nonenhancing lesions
  • Presence of enhancement indicates progression to higher grades
Radiology images

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Diffuse astrocytomas

  • Surgery
Gross description
  • Ill defined with blurred margins, may have spongy or gelatinous appearance, microcysts, calcification
Microscopic (histologic) description
  • Appears as hypercellular area as compared to the normal white matter, which merges imperceptibly with the surrounding brain; background is fibrillary
  • Atypia is typical yet variable
  • May have microcysts, calcification
  • No mitotic figures (a single mitosis in a large biopsy is accepted), no vascular proliferation and no necrosis
  • Secondary structures of Scherer may be seen
Microscopic (histologic) images

Images hosted on other servers:

Diffuse astrocytoma

Positive stains
  • GFAP (variable, weak in protoplasmic astrocytoma), vimentin
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