Astrocytoma differential diagnosis

Astrocytoma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Astrocytoma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-Ray
Echocardiography and Ultrasound
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Study
Case #1
Astrocytoma differential diagnosis On the Web
Most recent articles
cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Astrocytoma differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Astrocytoma differential diagnosis
CDC on Astrocytoma differential diagnosis
Astrocytoma differential diagnosis in the news
Blogs on Astrocytoma differential diagnosis
Directions to Hospitals Treating Astrocytoma
Risk calculators and risk factors for Astrocytoma differential diagnosis

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		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 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	Highest incidence in fifth and sixth decades of life Most of the time, focal neurological deficit is the presenting sign.
	Oligodendroglioma	+	+	+/−	−	−		+	−		Almost always in cerebral hemisphers (frontal lobes) Hypointense on T1 Hyperintense on T2 Calcification Chicken wire capillary pattern	Oligodendrocyte origin Calcification + Fried egg cell appearance	Biopsy	Highest incidence is between 40 and 50 years of age. Most of the time, epileptic seizure is the presenting sign.
	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	Highest incidence is between 40 and 50 years of age. Most of the time, focal neurological deficit and epileptic seizure are the presenting signs. May be associated with NF-2
	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	Biopsy
	Schwannoma	−	−	+/−	+	−			−		Split-fat sign Fascicular sign Often have areas of hemosiderin	Schwann cell origin S100+	Biopsy	May be associated with NF-2 (bilateral schwannomas)
	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	+	+			−
	Brain aneurysm	+				−
Infectious	Bacterial brain abscess	+				+
	Tuberculosis	+				+
	Toxoplasmosis	+									Multifocal masses with ring enhancement
	Hydatid cyst	+
	Fungal	+
Other	Brain metastasis	+									Multifocal			Most common primary tumors that metastasis to brain: Lung cancer Renal cell carcinoma Breast cancer Melanoma Gastrointestinal tract