Astrocytoma differential diagnosis: Difference between revisions

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| rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |Adult primary brain tumors
| rowspan="7" style="background: #DCDCDC; padding: 5px; text-align: center;" |Adult primary brain tumors
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Glioblastoma multiform
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Glioblastoma multiforme
| 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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* Supratentorial
* Irregular ring-nodular enhancing lesions
* Irregular ring-nodular enhancing lesions
* Central [[necrosis]]
* Central [[necrosis]]
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| 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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* Hypointense on T1
* Hyperintense on T2
* [[Calcification]]
* Chicken wire capillary pattern
* Chicken wire capillary pattern
| 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;" | +/−
| 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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* Dural attachement
* Well circumscribed
* Extra-axial mass
 
* Dural attachment
* [[CSF]] [[vascular]] cleft sign
* Sunburst appearance of the [[Vessel|vessels]]
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Arachnoid origin
* Arachnoid origin
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| 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;" |−
| style="background: #F5F5F5; padding: 5px;" |−
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* Infratentorial
* Cystic lesion with a solid enhancing mural nodule
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Blood vessel origin
* Blood vessel origin
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* Isointense to normal pituitary gland in T1
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| style="background: #F5F5F5; padding: 5px;" |
* Endocrine cell hyperplasia
* Endocrine cell hyperplasia
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| 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;" | +
| style="background: #F5F5F5; padding: 5px;" |−
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|-
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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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* Usually deep in the [[white matter]]
* Single mass with ring enhancement
* Single mass with ring enhancement
| 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;" | +/−
| style="background: #F5F5F5; padding: 5px;" |+/−
| style="background: #F5F5F5; padding: 5px;" | +/−
| style="background: #F5F5F5; padding: 5px;" |−
| style="background: #F5F5F5; padding: 5px;" |−
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* Infratentorial
* Solid and cystic component
* Solid and cystic component
* Mostly in posterior fossa
* Mostly in posterior fossa
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| 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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* Infratentorial
* Mostly in cerebellum
* Mostly in cerebellum


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| 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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* Found in 4th ventricle
* Infratentorial
 
* Usually found in 4th ventricle
* Mixed cystic/solid lesion


* Hydrocephalus
* Hydrocephalus
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|-
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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;" | +/−
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* Calcification
* Calcification
* Lobulated contour
* Motor-oil like fluid within tumor
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Ectodermal origin (Rathkes pouch)
* Ectodermal origin (Rathkes pouch)
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| 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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Revision as of 15:47, 18 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 multiforme + +/− +/− − − + −
  • Supratentorial
  • 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 + +/− +/− − − + −
  • Well circumscribed
  • Extra-axial mass
  • 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
Pitutary 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 − − +/− + − −
  • 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 + +/− +/− − − −
  • 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 + + −
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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