Gemistocytic astrocytoma: Difference between revisions
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==Overview== | ==Overview== | ||
Gemistocytic astrocytoma is a histologic subtype of [[low grade astrocytoma]], with a poorer prognosis than other matched WHO grade II tumors, and with no specific imaging features.<ref name=overviewga1>Gemistocytic astrocytoma. Dr Henry Knipe and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/gemistocytic-astrocytoma. Accessed on January 8, 2016</ref> | Gemistocytic astrocytoma is a histologic subtype of [[low grade astrocytoma]], with a poorer prognosis than other matched WHO grade II astrocytic tumors, and with no specific imaging features.<ref name=overviewga1>Gemistocytic astrocytoma. Dr Henry Knipe and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/gemistocytic-astrocytoma. Accessed on January 8, 2016</ref> | ||
==Pathophysiology== | ==Pathophysiology== | ||
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===Gender=== | ===Gender=== | ||
*Males are more commonly affected with gemistocytic astrocytoma than females. The male to female ratio is approximately 1.5 to 1.<ref name=epidemiologyga1>Epidemiology of gemistocytic astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 8, 2016</ref> | *Males are more commonly affected with gemistocytic astrocytoma than females. The male to female ratio is approximately 1.5 to 1.<ref name=epidemiologyga1>Epidemiology of gemistocytic astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 8, 2016</ref> | ||
==Natural History, Complications and Prognosis== | |||
===Natural History=== | |||
*If left untreated, patients with gemistocytic astrocytoma may progress to develop [[seizures]], focal neurological deficits, and [[hydrocephalus]].<ref name=symptomsga1>Clinical presentation of low grade infiltrative astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 8, 2016</ref> | |||
===Complications=== | |||
*Common complications of gemistocytic astrocytoma include:<ref name=symptomsga1>Clinical presentation of low grade infiltrative astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 8, 2016</ref> | |||
:*[[Hydrocephalus]] | |||
:*Side-effects of neurosurgery | |||
===Prognosis=== | |||
*Gemistocytic astrocytoma has a poorer prognosis than the other matched WHO grade II astrocytic tumors ([[fibrillary astrocytoma, protoplasmic astrocytoma, and [[oligoastrocytoma]]).<ref name=overviewga1>Gemistocytic astrocytoma. Dr Henry Knipe and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/gemistocytic-astrocytoma. Accessed on January 8, 2016</ref> | |||
==History and Symptoms== | ==History and Symptoms== | ||
Revision as of 15:36, 8 January 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]
Synonyms and keywords: Gemistocytic astrocytomas; Diffuse astrocytoma; Low grade astrocytoma
Overview
Gemistocytic astrocytoma is a histologic subtype of low grade astrocytoma, with a poorer prognosis than other matched WHO grade II astrocytic tumors, and with no specific imaging features.[1]
Pathophysiology
Pathogenesis
- Gemistocytic astrocytoma is characterized by a significant gemistocyte population, which are large cells with their cytoplasm filled with eosinophilic material displacing the nucleus eccentrically.[2]
- It is important to note that other gliomas (e.g. fibrillary astrocytoma and oligodendroglioma) can have occasional gemistocytes, without being designated a gemistocytic astrocytoma. A cut off of 20% of the tumor cells being gemistocytes may be used before designating it as a gemistocytic astrocytoma.
Differentiating Fibrillary Astrocytoma from other Diseases
- Gemistocytic astrocytoma must be differentiated from:[3]
- Fibrillary astrocytoma
- Protoplasmic astrocytoma
- Oligoastrocytoma
- Stroke
- Cerebritis
- Encephalitis (herpes simplex encephalitis)
- Anaplastic astrocytoma
- Oligodendroglioma
- Angiocentric glioma
Epidemiology and Demographics
Prevalence
Age
- Gemistocytic astrocytoma is a rare disease that tends to affect the children and young adult population.[4]
- The peak age at which gemistocytic astrocytoma is diagnosed ranges between 20-40 years.
- The mean age at diagnosis is 35 years.
Gender
- Males are more commonly affected with gemistocytic astrocytoma than females. The male to female ratio is approximately 1.5 to 1.[4]
Natural History, Complications and Prognosis
Natural History
- If left untreated, patients with gemistocytic astrocytoma may progress to develop seizures, focal neurological deficits, and hydrocephalus.[5]
Complications
- Common complications of gemistocytic astrocytoma include:[5]
- Hydrocephalus
- Side-effects of neurosurgery
Prognosis
- Gemistocytic astrocytoma has a poorer prognosis than the other matched WHO grade II astrocytic tumors ([[fibrillary astrocytoma, protoplasmic astrocytoma, and oligoastrocytoma).[1]
History and Symptoms
History
- When evaluating a patient for gemistocytic astrocytoma, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough family and past medical history review.
Symptoms
- Symptoms of gemistocytic astrocytoma include:[5]
References
- ↑ 1.0 1.1 Gemistocytic astrocytoma. Dr Henry Knipe and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/gemistocytic-astrocytoma. Accessed on January 8, 2016
- ↑ Pathology of gemistocytic astrocytoma. Dr Henry Knipe and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/gemistocytic-astrocytoma. Accessed on January 8, 2016
- ↑ Differential diagnosis of low grade infiltrative astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 5, 2016
- ↑ 4.0 4.1 Epidemiology of gemistocytic astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 8, 2016
- ↑ 5.0 5.1 5.2 Clinical presentation of low grade infiltrative astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 8, 2016