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==Other Diagnostic Studies== | ==Other Diagnostic Studies== | ||
Biopsy is helpful in the diagnosis of astrocytomas:<ref name="pmid11465400">{{cite journal |vauthors=Jackson RJ, Fuller GN, Abi-Said D, Lang FF, Gokaslan ZL, Shi WM, Wildrick DM, Sawaya R |title=Limitations of stereotactic biopsy in the initial management of gliomas |journal=Neuro-oncology |volume=3 |issue=3 |pages=193–200 |date=July 2001 |pmid=11465400 |pmc=1920616 |doi=10.1093/neuonc/3.3.193 |url=}}</ref><ref name="pmid12748009">{{cite journal |vauthors=McGirt MJ, Villavicencio AT, Bulsara KR, Friedman AH |title=MRI-guided stereotactic biopsy in the diagnosis of glioma: comparison of biopsy and surgical resection specimen |journal=Surg Neurol |volume=59 |issue=4 |pages=277–81; discussion 281–2 |date=April 2003 |pmid=12748009 |doi= |url=}}</ref><ref name="pmid11345717">{{cite journal |vauthors=Son BC, Kim MC, Choi BG, Kim EN, Baik HM, Choe BY, Naruse S, Kang JK |title=Proton magnetic resonance chemical shift imaging (1H CSI)-directed stereotactic biopsy |journal=Acta Neurochir (Wien) |volume=143 |issue=1 |pages=45–9; discussion 49–50 |date=2001 |pmid=11345717 |doi= |url=}}</ref> | [[Biopsy]] is helpful in the diagnosis of astrocytomas:<ref name="pmid11465400">{{cite journal |vauthors=Jackson RJ, Fuller GN, Abi-Said D, Lang FF, Gokaslan ZL, Shi WM, Wildrick DM, Sawaya R |title=Limitations of stereotactic biopsy in the initial management of gliomas |journal=Neuro-oncology |volume=3 |issue=3 |pages=193–200 |date=July 2001 |pmid=11465400 |pmc=1920616 |doi=10.1093/neuonc/3.3.193 |url=}}</ref><ref name="pmid12748009">{{cite journal |vauthors=McGirt MJ, Villavicencio AT, Bulsara KR, Friedman AH |title=MRI-guided stereotactic biopsy in the diagnosis of glioma: comparison of biopsy and surgical resection specimen |journal=Surg Neurol |volume=59 |issue=4 |pages=277–81; discussion 281–2 |date=April 2003 |pmid=12748009 |doi= |url=}}</ref><ref name="pmid11345717">{{cite journal |vauthors=Son BC, Kim MC, Choi BG, Kim EN, Baik HM, Choe BY, Naruse S, Kang JK |title=Proton magnetic resonance chemical shift imaging (1H CSI)-directed stereotactic biopsy |journal=Acta Neurochir (Wien) |volume=143 |issue=1 |pages=45–9; discussion 49–50 |date=2001 |pmid=11345717 |doi= |url=}}</ref> | ||
* Astrocytomas are histologically heterogenous | * Astrocytomas are histologically heterogenous. | ||
* Obtaining small specimen from astrocytomas might lead to false diagnosis. | * Obtaining small specimen from astrocytomas might lead to false diagnosis. | ||
* For lesions with areas of contrast enhancement the specimen should be obtained from those areas. | * For lesions with areas of contrast enhancement the specimen should be obtained from those areas. | ||
* For lesions with no intra-tumor enhancement the specimen should be obtained from the center of the tumor. | * For lesions with no intra-tumor enhancement the specimen should be obtained from the center of the [[tumor]]. | ||
Pathological findings diagnostic of astrocytoma include:<ref name=":0">{{cite book | last = Mattle | first = Heinrich | title = Fundamentals of neurology : an illustrated guide | publisher = Thieme | location = Stuttgart New York | year = 2017 | isbn = 9783131364524 }}</ref><ref>{{cite book | last = Nafussi | first = Awatif | title = Tumor diagnosis : practical approach and pattern analysis | publisher = Arnold Distributed in the U.S.A. by Oxford University Press | location = London New York | year = 2005 | isbn = 0340809442 }}</ref><ref>{{cite book | last = Schniederjan | first = Matthew | title = Biopsy interpretation of the central nervous system | publisher = Wolters Kluwer/Lippincott Williams & Wilkins Health | location = Philadelphia | year = 2011 | isbn = 9780781799935 }}</ref> | Pathological findings diagnostic of astrocytoma include:<ref name=":0">{{cite book | last = Mattle | first = Heinrich | title = Fundamentals of neurology : an illustrated guide | publisher = Thieme | location = Stuttgart New York | year = 2017 | isbn = 9783131364524 }}</ref><ref>{{cite book | last = Nafussi | first = Awatif | title = Tumor diagnosis : practical approach and pattern analysis | publisher = Arnold Distributed in the U.S.A. by Oxford University Press | location = London New York | year = 2005 | isbn = 0340809442 }}</ref><ref>{{cite book | last = Schniederjan | first = Matthew | title = Biopsy interpretation of the central nervous system | publisher = Wolters Kluwer/Lippincott Williams & Wilkins Health | location = Philadelphia | year = 2011 | isbn = 9780781799935 }}</ref> | ||
* Pilocytic: | * [[Pilocytic astrocytoma|Pilocytic]]: | ||
** Cells appearance is normal and growth rate is slow. | ** Cells appearance is normal and growth rate is slow. | ||
** Biphasic pattern (dense fibrillar tissue within loose myxoid tissue | ** Biphasic pattern (dense fibrillar tissue within loose myxoid tissue) | ||
** Calcification | ** [[Calcification]] | ||
** Vascular hyalinization | ** Vascular hyalinization | ||
** Nested fibrotic pattern | ** Nested fibrotic pattern | ||
* Diffuse: | * [[Diffuse astrocytoma|Diffuse]]: | ||
** There might be some atypical cells inside tumor. | ** There might be some [[Atypia|atypical cells]] inside [[tumor]]. | ||
** Mitosis rate is relatively slow. | ** Mitosis rate is relatively slow. | ||
** Diffusely infiltrate neuropil | ** Diffusely infiltrate [[neuropil]] | ||
** Poorly defined cytoplasm | ** Poorly defined [[cytoplasm]] | ||
* Anaplastic: | * [[Anaplastic astrocytoma|Anaplastic]]: | ||
** Tumor cells are pleomorphic and | ** [[Tumor]] cells are [[Pleomorphism|pleomorphic]] and [[malignant]] | ||
** High mitosis rate | ** High [[mitosis]] rate | ||
** Hyperchromatosis | ** Hyperchromatosis | ||
** Prominent small vessels | ** Prominent small [[Blood vessel|vessels]] | ||
* Glioblastoma: | * [[Glioblastoma multiforme|Glioblastoma]]: | ||
** Pleomorphic cells | ** [[Pleomorphism|Pleomorphic]] cells | ||
** Naked nuclei | ** Naked nuclei | ||
** Multi-focal necrosis | ** Multi-focal [[necrosis]] | ||
** Pseudopalisading pattern | ** Pseudopalisading pattern | ||
** Scattered pyknotic nuclear debris in the center | ** Scattered pyknotic nuclear debris in the center | ||
** Micro-vascular proliferation | ** Micro-vascular proliferation | ||
** Vascular thrombi | ** Vascular [[thrombi]] | ||
Molecular findings diagnostic of astrocytoma include:<ref>{{cite book | last = Ellison | first = David | title = Neuropathology : a reference text of CNS pathology | publisher = Mosby | location = Edinburgh New York | year = 2013 | isbn = 0723435154 }}</ref> | Molecular findings diagnostic of astrocytoma include:<ref>{{cite book | last = Ellison | first = David | title = Neuropathology : a reference text of CNS pathology | publisher = Mosby | location = Edinburgh New York | year = 2013 | isbn = 0723435154 }}</ref> | ||
Revision as of 15:09, 14 January 2019
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Astrocytoma other diagnostic studies On the Web |
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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
Other Diagnostic Studies
Biopsy is helpful in the diagnosis of astrocytomas:[1][2][3]
- Astrocytomas are histologically heterogenous.
- Obtaining small specimen from astrocytomas might lead to false diagnosis.
- For lesions with areas of contrast enhancement the specimen should be obtained from those areas.
- For lesions with no intra-tumor enhancement the specimen should be obtained from the center of the tumor.
Pathological findings diagnostic of astrocytoma include:[4][5][6]
- Pilocytic:
- Cells appearance is normal and growth rate is slow.
- Biphasic pattern (dense fibrillar tissue within loose myxoid tissue)
- Calcification
- Vascular hyalinization
- Nested fibrotic pattern
- Diffuse:
- There might be some atypical cells inside tumor.
- Mitosis rate is relatively slow.
- Diffusely infiltrate neuropil
- Poorly defined cytoplasm
- Anaplastic:
- Tumor cells are pleomorphic and malignant
- High mitosis rate
- Hyperchromatosis
- Prominent small vessels
- Glioblastoma:
- Pleomorphic cells
- Naked nuclei
- Multi-focal necrosis
- Pseudopalisading pattern
- Scattered pyknotic nuclear debris in the center
- Micro-vascular proliferation
- Vascular thrombi
Molecular findings diagnostic of astrocytoma include:[7]
• Stem cell • Precursor cell • Glial cell | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
IDH1 mutation | • 10q loss • PTEN mutation • EGFR overexpression • MDM2 overexpression | • KIAA1549-BRAF fusion • MAPK/ERK abnormalities | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
• p53 mutation • PDGF/PDGFRA overexpression | Primary glioblastoma grade IV | Pilocytic astrocytoma grade I | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Diffuse astrocytoma grade II | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Chr 19q loss | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Anaplastic astocytoma grade III | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
10q loss | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Glioblastoma (secondary) grade IV | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Jackson RJ, Fuller GN, Abi-Said D, Lang FF, Gokaslan ZL, Shi WM, Wildrick DM, Sawaya R (July 2001). "Limitations of stereotactic biopsy in the initial management of gliomas". Neuro-oncology. 3 (3): 193–200. doi:10.1093/neuonc/3.3.193. PMC 1920616. PMID 11465400.
- ↑ McGirt MJ, Villavicencio AT, Bulsara KR, Friedman AH (April 2003). "MRI-guided stereotactic biopsy in the diagnosis of glioma: comparison of biopsy and surgical resection specimen". Surg Neurol. 59 (4): 277–81, discussion 281–2. PMID 12748009.
- ↑ Son BC, Kim MC, Choi BG, Kim EN, Baik HM, Choe BY, Naruse S, Kang JK (2001). "Proton magnetic resonance chemical shift imaging (1H CSI)-directed stereotactic biopsy". Acta Neurochir (Wien). 143 (1): 45–9, discussion 49–50. PMID 11345717.
- ↑ Mattle, Heinrich (2017). Fundamentals of neurology : an illustrated guide. Stuttgart New York: Thieme. ISBN 9783131364524.
- ↑ Nafussi, Awatif (2005). Tumor diagnosis : practical approach and pattern analysis. London New York: Arnold Distributed in the U.S.A. by Oxford University Press. ISBN 0340809442.
- ↑ Schniederjan, Matthew (2011). Biopsy interpretation of the central nervous system. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. ISBN 9780781799935.
- ↑ Ellison, David (2013). Neuropathology : a reference text of CNS pathology. Edinburgh New York: Mosby. ISBN 0723435154.