Astrocytoma differential diagnosis: Difference between revisions

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Line 35: Line 35:
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Glioblastoma multiform
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Glioblastoma multiform
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Oligodendroglioma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Oligodendroglioma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Meningioma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Meningioma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hemangioblastoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Hemangioblastoma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Might secret [[erythropoietin]] and cause [[polycythemia]]
* Might secret [[erythropoietin]] and cause [[polycythemia]]
* Can be associated with von hippel-lindau syndrome
* May be associated with von hippel-lindau syndrome
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pitutary adenoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pitutary adenoma
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* History/physical examination and clinical findings
* History/physical examination and clinical findings
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* May be associated with NF-2 (bilateral schwannomas)
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Schwannoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Schwannoma
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |primary CNS lymphoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |primary CNS lymphoma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pilocytic astrocytoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pilocytic astrocytoma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Solid and cystic component
* Mostly in posterior fossa
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Glial cell origin
* Glial cell origin
 
*Solid and cystic component
* Solid and cystic component


* GFAP +
* GFAP +
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Medulloblastoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Medulloblastoma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Hydrocephalus
* Mostly in cerebellum
 
* Non communicating hydrocephalus
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Neuroectoderm origin
* Neuroectoderm origin
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Ependymoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Ependymoma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Found in 4th ventricle
* Hydrocephalus
* Hydrocephalus
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Craniopharyngioma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Craniopharyngioma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" | + Bitemporal hemianopia
| style="background: #F5F5F5; padding: 5px;" | + Bitemporal hemianopia
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Calcification
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Ectodermal origin (Rathkes pouch)
* Ectodermal origin (Rathkes pouch)
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pinealoma
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pinealoma
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |±
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Hydrochepalus (compression of cerebral aqueduct)
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Similar to testicular seminoma
* Similar to testicular seminoma
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |AV malformation
| style="background: #DCDCDC; padding: 5px; text-align: center;" |AV malformation
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |+
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |

Revision as of 17:00, 17 January 2019

Astrocytoma Microchapters

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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

Differentiating astrocytoma from other Diseases

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Immunohistopathology
Headache Seizure Visual disturbance Hearing loss Constitutional Extraocular movement disorder Focal neurologic deficit Endocrine abnormalities CT scan MRI
Adult primary brain tumors Glioblastoma multiform + +/− − + −
  • Cross corpus callosum (butterfly glioma)
  • Astrocyte origin
  • Pleomorphic cell
  • Pseudopalisading appearance
  • GFAP +
  • Necrosis +
  • Hemorrhage +
  • Vascular prolifration +
  • Biopsy
Oligodendroglioma + +/− − + −
  • Chicken wire capillary pattern
  • Oligodendrocyte origin
  • Calcification +
  • Fried egg cell appearance
  • Biopsy
Meningioma + +/− − + −
  • Dural attachement
  • Arachnoid origin
  • Psammoma bodies
  • Whorled spindle cell pattern
  • Biopsy
Hemangioblastoma + +/− − + −
  • Blood vessel origin
  • Capillaries with thin walls
  • Biopsy
Pitutary adenoma − − + Bitemporal hemianopia − −
  • + Functional adenomas or pressure effect of non-functional adenomas
  • Endocrine cell hyperplasia
  • History/physical examination and clinical findings
  • May be associated with NF-2 (bilateral schwannomas)
Schwannoma − − + − −
  • Schwann cell origin
  • S100+
  • Biopsy
primary CNS lymphoma + +/− − −
  • Single mass with ring enhancement
  • B cell origin
  • Similar to non hodgkin lymphoma (diffuse large B cell)
  • Biopsy
Childhood primary brain tumors Pilocytic astrocytoma + +/− − −
  • Solid and cystic component
  • Mostly in posterior fossa
  • Glial cell origin
  • Solid and cystic component
  • GFAP +
  • Biopsy
Medulloblastoma + +/− − −
  • Mostly in cerebellum
  • Non communicating hydrocephalus
  • Neuroectoderm origin
  • Homer wright rosettes
  • Biopsy
Ependymoma + +/− − −
  • Found in 4th ventricle
  • Hydrocephalus
  • Ependymal cell origin
  • Perivascular pseudorosette
  • Biopsy
Craniopharyngioma + +/− + Bitemporal hemianopia −
  • + Pressure effect on pituitary gland
  • Calcification
  • Ectodermal origin (Rathkes pouch)
  • Calcification +
  • Biopsy
Pinealoma + +/− − + vertical gaze palsy +
  • + B-hCG rise leads to precocious puberty in males
  • Hydrochepalus (compression of cerebral aqueduct)
  • Similar to testicular seminoma
  • Biopsy
Vascular AV malformation + + −
Brain aneurysm + −
Infectious Bacterial brain abscess + +
Tuberculosis + +
Toxoplasmosis +
  • Multifocal masses with ring enhancement
Hydatid cyst +
Fungal +
Other Brain metastasis +
  • Multifocal

References

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