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CNS tumor

Astrocytic tumors

Diffuse astrocytoma-general


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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● Also called diffuse infiltrating astrocytoma
● 1015% of all astrocytic brain tumors
● May become more anaplastic over time
● Three histological variants are recognized: fibrillary, gemistocytic and protoplasmic

Age and sex:
● 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
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● Median survival is 6-8 years, but rarely has rapid progression and death
● Treatment: surgery

Grading
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● 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)

Neuroimaging
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● Expanding intra-axial lesion with mass effect, variable peritumoral edema
● Non-enhancing lesions
● Presence of enhancement indicates progression to higher grades

Radiologic images:


   
Diffuse astrocytomas

Gross description
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● Ill defined with blurred margins, may have spongy or gelatinous appearance, microcysts, calcification

Gross images
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Frontal astrocytoma

Micro description
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● 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

Micro images
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Diffuse astrocytoma

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

End of CNS tumor > Astrocytic tumors > Diffuse astrocytoma-general


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