Astrocytoma classification: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
 
(23 intermediate revisions by 6 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Astrocytoma}}
{{Astrocytoma}}
{{CMG}}; {{AE}} {{Ammu}}
{{CMG}}; {{AE}} {{Fs}}
==Overview==
==Overview==
Astrocytoma may be classified according to [[histology]] into 4 [[grade]]s: [[pilocytic astrocytoma]], [[diffuse astrocytoma]], anaplastic astrocytoma and [[glioblastoma multiforme]].
Astrocytoma may be classified according to its [[histology]] into 4 grades: [[pilocytic astrocytoma]], [[diffuse astrocytoma]], [[anaplastic astrocytoma]] and [[glioblastoma multiforme]].
==Classification==
==Classification==
Within the astrocytomas, there are two broad classes recognized in literature, those with:
* Narrow zones of [[infiltration]] (mostly invasive [[tumor]]s; e.g., [[pilocytic astrocytoma]], subependymal giant cell astrocytoma, pleomorphic xanthoastrocytoma), that often are clearly outlined on diagnostic images
* Diffuse zones of [[infiltration]] (e.g., low-grade astrocytoma, anaplastic astrocytoma, [[glioblastoma]]), that share various features, including the ability to arise at any location in the [[CNS]], but with a preference for the [[cerebral hemispheres]]; they occur usually in adults; and an intrinsic tendency to progress to more advanced grades.<ref> http://emedicine.medscape.com/article/283453-overview </ref>
* There is no standard staging system for childhood astrocytoma.
===Grading===
Astrocytomas have great variation in their presentation. The [[World Health Organization]] acknowledges the following grading system for astrocytomas:
* '''Grade 1''' — [[pilocytic astrocytoma]] - primarily pediatric tumor, with median age at diagnosis of 12
* '''Grade 2''' — [[diffuse astrocytoma]]
* '''Grade 3''' — anaplastic ([[malignant]]) astrocytoma
* '''Grade 4''' — [[glioblastoma multiforme]] (most common)


* The WHO-grading scheme is based on the appearance of certain characteristics: [[atypia]], [[mitosis]], [[endothelial proliferation]], and [[necrosis]]. These features reflect the [[malignant]] potential of the [[tumor]] in terms of invasion and growth rate. [[Tumors]] without any of these features are grade I, and those with one of these features (usually atypia) are grade II. [[Tumors]] with 2 criteria and [[tumor]]s with 3 or 4 criteria are WHO grades III and IV, respectively. Thus, the low-grade group of astrocytomas are grades I and II. According to the WHO data the lowest grade astrocytomas (grade I) make up only 2% of recorded astrocytomas, grade II 8%, and the higher grade anaplastic astrocytomas (grade III) 20%. The highest graded astrocytoma (grade IV GBM) is the most common primary [[nervous system neoplasm|nervous system cancer]] and second most frequent [[brain tumor]] after [[brain]] [[metastasis]]. Despite the low incidence of astrocytomas compared to other human [[cancer]]s, mortality is significant, as the higher grades (III & IV) present high mortality rates (mainly due to late detection of the [[neoplasm]]).
* Astrocytoma may be classified according to its histology into 4 grades:<ref name="pmid3179928">{{cite journal |vauthors=Daumas-Duport C, Scheithauer B, O'Fallon J, Kelly P |title=Grading of astrocytomas. A simple and reproducible method |journal=Cancer |volume=62 |issue=10 |pages=2152–65 |date=November 1988 |pmid=3179928 |doi= |url=}}</ref><ref name="pmid27157931">{{cite journal |vauthors=Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW |title=The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary |journal=Acta Neuropathol. |volume=131 |issue=6 |pages=803–20 |date=June 2016 |pmid=27157931 |doi=10.1007/s00401-016-1545-1 |url=}}</ref>


* Various types of astrocytomas are given these WHO grades:
{{Family tree/start}}
{| class="wikitable"
{{Family tree| | | | | | | | | | | | A01 | | | | | | | | | | | | |A01=Astrocytoma}}
|-
{{Family tree| | | | | |,|-|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | | | }}
! WHO Grade
{{Family tree| | | | | D01 | | | | | | | | | | | D02 | | | | | | | | | | |D01=Low grade|D02=High grade}}
! Astrocytomas
{{Family tree| | | |,|-|^|-|.| | | | | | | | |,|-|^|-|.| | | | | | | | | | | | }}
! Description
{{Family tree| | | B01 | | B02 | | | | | | | B03 | | B04 | | | | | | | | | | |B01=Pilocyic astrocytoma|B02=Diffuse astrocytoma|B03=Anaplastic astrocytoma|B04=Glioblastomas multiform}}
|-
{{Family tree| |,|-|-|-|v|-|^|-|v|-|-|-|.| | | |,|-|-|^|-|-|.| | | | }}
| I
{{Family tree| C01 | | C02 | | C03 | | C04 | | | C05 | | | | C06 | | |C01=[[Fibrillary astrocytoma]]|C02=[[Gemistocytic astrocytoma]]|C03=[[Protoplasmic astrocytoma]]|C04=[[Oligoastrocytoma]]|C05=Primary glioblastoma multiforme|C06=Secondary glioblastoma multiforme}}
|  
{{Family tree/end}}
*[[Pilocytic astrocytoma]]
* Pleomorphic xanthoastrocytoma
*[[Subependymal giant cell astrocytoma]]
* Subependymoma
| Consist of slow growing astrocytomas, benign, and associated with long-term survival. Individuals with very slow growing [[tumor]]s where complete surgical removal by [[stereotactic surgery]] is possible may experience total [[remission]].<ref name=mdguidelines>[http://www.mdguidelines.com/astrocytoma mdguidelines.com > Astrocytoma] Retrieved on Mars 26, 2010</ref> Even if the surgeon is not able to remove the entire [[tumor]], it may remain inactive or be successfully treated with [[radiation]].
|-
| II
|
* Low-grade (fibrillary astrocytoma) astrocytoma
* Mixed oligoastrocytoma
| Consist of relatively slow-growing astrocytomas, usually considered [[benign]] that sometimes evolve into more [[malignant]] or as higher grade [[tumors]].
|-
| III
| [[Anaplastic astrocytoma]]
|  
|-
| IV
| [[Glioblastoma multiforme]] (GBM)
| Consists of [[glioblastoma multiforme]] (GBM), which is the most common and most [[malignant]] primary [[brain tumor]]. <ref name="mainstay">quoted from http://www.mayoclinic.org/glioma/glioblastoma.html{{full}}</ref> Less than 10% form more slowly following degeneration of low-grade astrocytoma or anaplastic astrocytoma. These are called secondary [[glioblastoma multiforme]].
|}


==See Also==
 
{{main|pilocytic astrocytoma|glioblastoma multiforme}}
 
<br />
 
* Low-grade astrocytoma may be classified based on tumor spread into four subtypes including:
 
 
 
{{familytree/start |summary=Low grade astrocytoma}}
{{familytree | | | | | | | | | | | | | A01| | | | | | | | | | | | | |A01=Low-grade astrocytoma}}
{{familytree | | | | | | | |,|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | |}}
{{familytree | | | | | | | B01 | | | | | | | | | | B02 | | | | | | | | |B01=[[Localized low-grade astrocytoma]]|B02=Low-grade infiltrative astrocytoma<br>Diffuse astrocytoma}}
{{familytree | | | | | | | F01 | | | | | | | | | | F02 | | | | | | | | |F01=WHO grade I / II|F02=WHO grade II}}
{{familytree | | | | | | | |!| | |,|-|-|-|v|-|-|-|v|^|-|.| | | | | | | |}}
{{familytree | | | | | | | |!| | C01 | | C02 | | C03 | | C04 | | | | | |C01=[[Fibrillary astrocytoma]]|C02=[[Gemistocytic astrocytoma]]|C03=[[Protoplasmic astrocytoma]]|C04=[[Oligoastrocytoma]]}}
{{familytree | |,|-|-|-|v|-|^|-|v|-|-|-|.| | | | | | | | | | | | | | |}}
{{familytree | D01 | | D02 | | D03 | | D04 | | | | | | | | | | | | | | |D01=[[Pilocytic astrocytoma]]|D02=Pilomyxoid astrocytoma|D03=[[Subependymal giant cell astrocytoma]]|D04=[[Pleomorphic xanthoastrocytoma]]}}
{{familytree | E01 | | E02 | | E03 | | E04 | | | | | | | | | | | | | |E01=WHO grade I|E02=WHO grade II|E03=WHO grade I|E04=WHO grade II}}
{{familytree/end}}


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}


[[Category:Disease]]
[[Category:Disease]]
Line 62: Line 46:
[[Category:Pathology]]
[[Category:Pathology]]
[[Category:Neurosurgery]]
[[Category:Neurosurgery]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]

Latest revision as of 14:38, 25 October 2019

Astrocytoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Astrocytoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-Ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Study

Case #1

Astrocytoma classification On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Astrocytoma classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Astrocytoma classification

CDC on Astrocytoma classification

Astrocytoma classification in the news

Blogs on Astrocytoma classification

Directions to Hospitals Treating Astrocytoma

Risk calculators and risk factors for Astrocytoma classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Astrocytoma may be classified according to its histology into 4 grades: pilocytic astrocytoma, diffuse astrocytoma, anaplastic astrocytoma and glioblastoma multiforme.

Classification

  • Astrocytoma may be classified according to its histology into 4 grades:[1][2]
 
 
 
 
 
 
 
 
 
 
 
Astrocytoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Low grade
 
 
 
 
 
 
 
 
 
 
High grade
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pilocyic astrocytoma
 
Diffuse astrocytoma
 
 
 
 
 
 
Anaplastic astrocytoma
 
Glioblastomas multiform
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fibrillary astrocytoma
 
Gemistocytic astrocytoma
 
Protoplasmic astrocytoma
 
Oligoastrocytoma
 
 
Primary glioblastoma multiforme
 
 
 
Secondary glioblastoma multiforme
 
 



  • Low-grade astrocytoma may be classified based on tumor spread into four subtypes including:


 
 
 
 
 
 
 
 
 
 
 
 
Low-grade astrocytoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Localized low-grade astrocytoma
 
 
 
 
 
 
 
 
 
Low-grade infiltrative astrocytoma
Diffuse astrocytoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
WHO grade I / II
 
 
 
 
 
 
 
 
 
WHO grade II
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Fibrillary astrocytoma
 
Gemistocytic astrocytoma
 
Protoplasmic astrocytoma
 
Oligoastrocytoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pilocytic astrocytoma
 
Pilomyxoid astrocytoma
 
Subependymal giant cell astrocytoma
 
Pleomorphic xanthoastrocytoma
 
 
 
 
 
 
 
 
 
 
 
 
 
 
WHO grade I
 
WHO grade II
 
WHO grade I
 
WHO grade II
 
 
 
 
 
 
 
 
 
 
 
 
 

References

  1. ↑ Daumas-Duport C, Scheithauer B, O'Fallon J, Kelly P (November 1988). "Grading of astrocytomas. A simple and reproducible method". Cancer. 62 (10): 2152–65. PMID 3179928.
  2. ↑ Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (June 2016). "The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary". Acta Neuropathol. 131 (6): 803–20. doi:10.1007/s00401-016-1545-1. PMID 27157931.
Retrieved from "https://www.wikidoc.org/index.php?title=Astrocytoma_classification&oldid=1585824"