Astrocytoma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Differentiating astrocytoma from other Diseases

Diseases		Clinical manifestations								Para-clinical findings				Gold standard	Additional findings
		Symptoms					Physical examination
										Lab Findings	Imaging		Histopathology
		Headache	Seizure	Visual disturbance	Hearing loss	Constitutional	Extraocular movement disorder	Hydrocephalus	Focal neurologic deficit	Endocrine abnormalities	CT scan	MRI
Adult primary brain tumors	Glioblastoma multiform	+	±			−		−	+	−			Astrocyte origin Pleomorphic cell Pseudopalisading appearance GFAP + Necrosis + Hemorrhage + Vascular prolifration +	Biopsy
	Oligodendroglioma	+	±			−		−	+	−			Oligodendrocyte origin Calcification + Fried egg cell appearance	Biopsy
	Meningioma	+	±			−		−	+	−			Arachnoid origin Psammoma bodies Whorled spindle cell pattern	Biopsy
	Hemangioblastoma	+	±			−		−	+	−			Blood vessel origin Capillaries with thin walls	Biopsy	Might secret erythropoietin and cause polycythemia
	Pitutary adenoma	−	−	+ Bitemporal hemianopia		−		−	−	+ Functional adenomas or pressure effect of non-functional adenomas			Endocrine cell hyperplasia	History/physical examination and clinical findings
	Schwannoma	−	−		+	−		−		−			Schwann cell origin S100+	Biopsy
	primary CNS lymphoma	+	±			−		−		−			B cell origin Similar to non hodgkin lymphoma (diffuse large B cell)	Biopsy
Childhood primary brain tumors	Pilocytic astrocytoma	+	±			−		−		−			Glial cell origin Solid and cystic component GFAP +	Biopsy
	Medulloblastoma	+	±			−		+		−			Neuroectoderm origin Homer wright rosettes	Biopsy
	Ependymoma	+	±			−		+		−			Ependymal cell origin Perivascular pseudorosette	Biopsy
	Craniopharyngioma	+	±	+ Bitemporal hemianopia		−		−		+ Pressure effect on pituitary gland			Ectodermal origin (Rathkes pouch) Calcification +	Biopsy
	Pinealoma	+	±			−	+ vertical gaze palsy	−	+	+ B-hCG rise leads to precocious puberty in males			Similar to testicular seminoma	Biopsy
Vascular	AV malformation	+				−		−
	Brain aneurysm	+				−		−
Infectious	Bacterial brain abscess	+				+		−
	Tuberculosis	+				+		−
	Toxoplasmosis	+						−
	Hydatid cyst	+						−
	Fungal	+						−
Other	Brain metastasis	+						−