Astrocytoma differential diagnosis: Difference between revisions

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Revision as of 15:55, 18 January 2019

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

		Symptoms					Physical examination		Lab Findings	Imaging		Immunohistopathology
Diseases		Clinical manifestations							Para-clinical findings				Gold standard	Additional findings
		Symptoms					Physical examination		Para-clinical findings
		Headache	Seizure	Visual disturbance	Hearing loss	Constitutional	Extraocular movement disorder	Focal neurologic deficit	Endocrine abnormalities	CT scan	MRI	Immunohistopathology
Adult primary brain tumors	Glioblastoma multiforme	+	+/−	+/−	−	−		+	−		Supratentorial Irregular ring-nodular enhancing lesions Central necrosis Surrounding vasogenic edema Cross corpus callosum (butterfly glioma)	Astrocyte origin Pleomorphic cell Pseudopalisading appearance GFAP + Necrosis + Hemorrhage + Vascular prolifration +	Biopsy
	Oligodendroglioma	+	+/−	+/−	−	−		+	−		Hypointense on T1 Hyperintense on T2 Calcification Chicken wire capillary pattern	Oligodendrocyte origin Calcification + Fried egg cell appearance	Biopsy
	Meningioma	+	+/−	+/−	−	−		+	−		Well circumscribed Extra-axial mass Dural attachment CSF vascular cleft sign Sunburst appearance of the vessels	Arachnoid origin Psammoma bodies Whorled spindle cell pattern	Biopsy
	Hemangioblastoma	+	+/−	+/−	−	−		+	−		Infratentorial Cystic lesion with a solid enhancing mural nodule	Blood vessel origin Capillaries with thin walls	Biopsy	Might secret erythropoietin and cause polycythemia May be associated with von hippel-lindau syndrome
	Pituitary adenoma	−	−	+ Bitemporal hemianopia	−	−		−	Endocrine abnormalities as a result of Functional adenomas or pressure effect of non-functional adenomas		Isointense to normal pituitary gland in T1	Endocrine cell hyperplasia	History/physical examination and clinical findings	May be associated with NF-2 (bilateral schwannomas)
	Schwannoma	−	−	+/−	+	−			−		Split-fat sign Fascicular sign Often have areas of hemosiderin	Schwann cell origin S100+	Biopsy
	Primary CNS lymphoma	+	+/−	+/−	−	−			−		Usually deep in the white matter Single mass with ring enhancement	B cell origin Similar to non hodgkin lymphoma (diffuse large B cell)	Biopsy
Childhood primary brain tumors	Pilocytic astrocytoma	+	+/−	+/−	−	−			−		Infratentorial Solid and cystic component Mostly in posterior fossa	Glial cell origin Solid and cystic component GFAP +	Biopsy
	Medulloblastoma	+	+/−	+/−	−	−			−		Infratentorial Mostly in cerebellum Non communicating hydrocephalus	Neuroectoderm origin Homer wright rosettes	Biopsy
	Ependymoma	+	+/−	+/−	−	−			−		Infratentorial Usually found in 4th ventricle Mixed cystic/solid lesion Hydrocephalus	Ependymal cell origin Perivascular pseudorosette	Biopsy
	Craniopharyngioma	+	+/−	+ Bitemporal hemianopia	−	−			Hypopituitarism as a result of pressure effect on pituitary gland		Calcification Lobulated contour Motor-oil like fluid within tumor	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	+	+			−
Vascular	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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@@ Line 33: / Line 33: @@
 |-
 | rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |Adult primary brain tumors
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Glioblastoma multiforme
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Glioblastoma multiforme]]
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +/−
@@ Line 69: / Line 69: @@
 | style="background: #F5F5F5; padding: 5px;" |
 |-
-| 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;" | +/−
@@ Line 95: / Line 95: @@
 | style="background: #F5F5F5; padding: 5px;" |
 |-
-| 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;" | +/−
@@ Line 122: / Line 122: @@
 | style="background: #F5F5F5; padding: 5px;" |
 |-
-| 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;" | +/−
@@ Line 146: / Line 146: @@
 * 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;" |[[Pituitary adenoma]]
 | style="background: #F5F5F5; padding: 5px;" | −
 | style="background: #F5F5F5; padding: 5px;" |−
@@ Line 166: / Line 166: @@
 * 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]]
 | style="background: #F5F5F5; padding: 5px;" | −
 | style="background: #F5F5F5; padding: 5px;" |−
@@ Line 177: / Line 177: @@
 | style="background: #F5F5F5; padding: 5px;" |
 | style="background: #F5F5F5; padding: 5px;" |
+* Split-fat sign
+* Fascicular sign
+* Often have areas of hemosiderin
 | style="background: #F5F5F5; padding: 5px;" |
 * Schwann cell origin
@@ Line 185: / Line 188: @@
 | style="background: #F5F5F5; padding: 5px;" |
 |-
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |Primary CNS lymphoma
+| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Primary central nervous system lymphoma|Primary CNS lymphoma]]
 | style="background: #F5F5F5; padding: 5px;" | +
 | style="background: #F5F5F5; padding: 5px;" | +/−
@@ Line 208: / Line 211: @@
 |-
 | rowspan="5" style="background: #DCDCDC; padding: 5px; text-align: center;" |Childhood primary brain tumors
-| 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;" | +/−
@@ Line 232: / Line 235: @@
 | style="background: #F5F5F5; padding: 5px;" |
 |-
-| 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;" | +/−
@@ Line 256: / Line 259: @@
 | style="background: #F5F5F5; padding: 5px;" |
 |-
-| 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;" | +/−
@@ Line 304: / Line 307: @@
 | style="background: #F5F5F5; padding: 5px;" |
 |-
-| 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;" | +/−

Astrocytoma differential diagnosis: Difference between revisions

Revision as of 15:55, 18 January 2019

Overview

Differentiating astrocytoma from other Diseases

References

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