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CNS tumor

Astrocytic tumors

Anaplastic astrocytoma


Reviewers: Eman Abdelzaher, M.D. (see Reviewers page)
Revised: 24 March 2012, last major update February 2012
Copyright: (c) 2005-2012, PathologyOutlines.com, Inc.

General
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Grading: WHO grade III
Age and sex: mean age 45 years; male predominance
Site: usually supratentorial, but can be anywhere in CNS; preferred sites are frontal and temporal lobes, brain stem, spinal cord; uncommon in cerebellum
Neuroimaging: usually heterogeneous or patchy enhancement

Radiologic images:



Anaplastic astrocytoma


Clinical features
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● Better clinical response to treatment than glioblastoma (Semin Oncol 2004;31:618)

Case reports
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● 64 year old man with seeding along tract of stereotactic needle (J Neurooncol 2003;61:215)

Gross description
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● Ill-defined with blurred margins, may have spongy or gelatinous appearance, microcysts, calcification
● May have clearer distinction from surrounding brain structures than low grade diffuse astrocytomas

Gross images
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Various images

Micro description
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● Similar to grade II tumors but more cellular, more atypia, and mitoses are seen
● By definition, vascular proliferation and necrosis are absent

Micro images
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Various images


H&E and HAM56+ macrophages


p53


Variable GFAP expression

Cytology images
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Smear

Positive stains
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● GFAP, vimentin

Molecular description
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● deletion of 1q/19q (has prognostic value, Expert Rev Anticancer Ther 2011;11:781); also p53 mutations

Differential diagnosis
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Anaplastic oligodendroglioma: hypercellular with loosely cohesive and single cells, moderate pleomorphism, vacuolated background, mitotic activity
Anaplastic oligoastrocytoma: conspicuous oligodendroglioma and astrocytoma components

End of CNS tumor > Astrocytic tumors > Anaplastic astrocytoma


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