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{{Astrocytoma}}
{{Astrocytoma}}
{{CMG}}; {{AE}} {{Ammu}}
{{CMG}}; {{AE}} {{Fs}}
==Overview==
==Overview==
Astrocytoma may be classified according to its [[histology]] into 4 grades: [[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==
 
* 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>
 
{{Family tree/start}}
{{Family tree| | | | | | | | | | | | A01 | | | | | | | | | | | | |A01=Astrocytoma}}
{{Family tree| | | | | |,|-|-|-|-|-|-|^|-|-|-|-|-|.| | | | | | | | | | | | }}
{{Family tree| | | | | D01 | | | | | | | | | | | D02 | | | | | | | | | | |D01=Low grade|D02=High grade}}
{{Family tree| | | |,|-|^|-|.| | | | | | | | |,|-|^|-|.| | | | | | | | | | | | }}
{{Family tree| | | B01 | | B02 | | | | | | | B03 | | B04 | | | | | | | | | | |B01=Pilocyic astrocytoma|B02=Diffuse astrocytoma|B03=Anaplastic astrocytoma|B04=Glioblastomas multiform}}
{{Family tree| |,|-|-|-|v|-|^|-|v|-|-|-|.| | | |,|-|-|^|-|-|.| | | | }}
{{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}}
 
 
 
<br />


==Classification==
* Low-grade astrocytoma may be classified based on tumor spread into four subtypes including:
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]]).


* Various types of astrocytomas are given these WHO grades:
{| class="wikitable"
|-
! WHO Grade
! Astrocytomas
! Description
|-
| I
|
*[[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==
{{familytree/start |summary=Low grade astrocytoma}}
* [[Pilocytic astrocytoma]]
{{familytree | | | | | | | | | | | | | A01| | | | | | | | | | | | | |A01=Low-grade astrocytoma}}
* [[Glioblastoma multiforme]]
{{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]]
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[[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

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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"