Astrocytoma other diagnostic studies
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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]
- 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
- Grade 2:
- There might be some atypical cells inside tumor.
- Mitosis rate is relatively slow.
- Diffusely infiltrate neuropil
- Poorly defined cytoplasm
- Grade 3:
- Tumor cells are pleomorphic and malignan
- 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:[6]
| • 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.
- ↑ Ellison, David (2013). Neuropathology : a reference text of CNS pathology. Edinburgh New York: Mosby. ISBN 0723435154.