Anaplastic astrocytoma - Revision history

Jensflorian: /* Molecular */ update

2018-03-19T09:24:45Z

Molecular: update

← Older revision		Revision as of 09:24, 19 March 2018
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	==Molecular==		==Molecular==
	*TERT promotor mutations in 20-25%<ref>{{Cite journal \| last1 = Lee \| first1 = Y. \| last2 = Koh \| first2 = J. \| last3 = Kim \| first3 = SI. \| last4 = Won \| first4 = JK. \| last5 = Park \| first5 = CK. \| last6 = Choi \| first6 = SH. \| last7 = Park \| first7 = SH. \| title = The frequency and prognostic effect of TERT promoter mutation in diffuse gliomas. \| journal = Acta Neuropathol Commun \| volume = 5 \| issue = 1 \| pages = 62 \| month = Aug \| year = 2017 \| doi = 10.1186/s40478-017-0465-1 \| PMID = 28851427 }}</ref><ref>{{Cite journal \| last1 = Koelsche \| first1 = C. \| last2 = Sahm \| first2 = F. \| last3 = Capper \| first3 = D. \| last4 = Reuss \| first4 = D. \| last5 = Sturm \| first5 = D. \| last6 = Jones \| first6 = DT. \| last7 = Kool \| first7 = M. \| last8 = Northcott \| first8 = PA. \| last9 = Wiestler \| first9 = B. \| title = Distribution of TERT promoter mutations in pediatric and adult tumors of the nervous system. \| journal = Acta Neuropathol \| volume = 126 \| issue = 6 \| pages = 907-15 \| month = Dec \| year = 2013 \| doi = 10.1007/s00401-013-1195-5 \| PMID = 24154961 }}</ref>		*TERT promotor mutations in 20-25%<ref>{{Cite journal \| last1 = Lee \| first1 = Y. \| last2 = Koh \| first2 = J. \| last3 = Kim \| first3 = SI. \| last4 = Won \| first4 = JK. \| last5 = Park \| first5 = CK. \| last6 = Choi \| first6 = SH. \| last7 = Park \| first7 = SH. \| title = The frequency and prognostic effect of TERT promoter mutation in diffuse gliomas. \| journal = Acta Neuropathol Commun \| volume = 5 \| issue = 1 \| pages = 62 \| month = Aug \| year = 2017 \| doi = 10.1186/s40478-017-0465-1 \| PMID = 28851427 }}</ref><ref>{{Cite journal \| last1 = Koelsche \| first1 = C. \| last2 = Sahm \| first2 = F. \| last3 = Capper \| first3 = D. \| last4 = Reuss \| first4 = D. \| last5 = Sturm \| first5 = D. \| last6 = Jones \| first6 = DT. \| last7 = Kool \| first7 = M. \| last8 = Northcott \| first8 = PA. \| last9 = Wiestler \| first9 = B. \| title = Distribution of TERT promoter mutations in pediatric and adult tumors of the nervous system. \| journal = Acta Neuropathol \| volume = 126 \| issue = 6 \| pages = 907-15 \| month = Dec \| year = 2013 \| doi = 10.1007/s00401-013-1195-5 \| PMID = 24154961 }}</ref>
			*Approximately 80 % of IDH wildtype astrocytomas in fact represent underdiagnosed GBM.<ref>{{Cite journal \| last1 = Reuss \| first1 = DE. \| last2 = Kratz \| first2 = A. \| last3 = Sahm \| first3 = F. \| last4 = Capper \| first4 = D. \| last5 = Schrimpf \| first5 = D. \| last6 = Koelsche \| first6 = C. \| last7 = Hovestadt \| first7 = V. \| last8 = Bewerunge-Hudler \| first8 = M. \| last9 = Jones \| first9 = DT. \| title = Adult IDH wild type astrocytomas biologically and clinically resolve into other tumor entities. \| journal = Acta Neuropathol \| volume = 130 \| issue = 3 \| pages = 407-17 \| month = Sep \| year = 2015 \| doi = 10.1007/s00401-015-1454-8 \| PMID = 26087904 }}</ref>

	==DDx==		==DDx==

Jensflorian: /* IHC */ + TERT

2018-03-19T09:20:37Z

IHC: + TERT

← Older revision		Revision as of 09:20, 19 March 2018
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	**'Note:'' This antibody does not detect other rare IDH1/2 mutations.		**'Note:'' This antibody does not detect other rare IDH1/2 mutations.
	*[[ATRX]] nuclear loss in 70%.		*[[ATRX]] nuclear loss in 70%.


			==Molecular==
			*TERT promotor mutations in 20-25%<ref>{{Cite journal \| last1 = Lee \| first1 = Y. \| last2 = Koh \| first2 = J. \| last3 = Kim \| first3 = SI. \| last4 = Won \| first4 = JK. \| last5 = Park \| first5 = CK. \| last6 = Choi \| first6 = SH. \| last7 = Park \| first7 = SH. \| title = The frequency and prognostic effect of TERT promoter mutation in diffuse gliomas. \| journal = Acta Neuropathol Commun \| volume = 5 \| issue = 1 \| pages = 62 \| month = Aug \| year = 2017 \| doi = 10.1186/s40478-017-0465-1 \| PMID = 28851427 }}</ref><ref>{{Cite journal \| last1 = Koelsche \| first1 = C. \| last2 = Sahm \| first2 = F. \| last3 = Capper \| first3 = D. \| last4 = Reuss \| first4 = D. \| last5 = Sturm \| first5 = D. \| last6 = Jones \| first6 = DT. \| last7 = Kool \| first7 = M. \| last8 = Northcott \| first8 = PA. \| last9 = Wiestler \| first9 = B. \| title = Distribution of TERT promoter mutations in pediatric and adult tumors of the nervous system. \| journal = Acta Neuropathol \| volume = 126 \| issue = 6 \| pages = 907-15 \| month = Dec \| year = 2013 \| doi = 10.1007/s00401-013-1195-5 \| PMID = 24154961 }}</ref>

	==DDx==		==DDx==

Jensflorian: continued - molecular data is still missing

2016-05-19T14:33:51Z

continued - molecular data is still missing

← Older revision		Revision as of 14:33, 19 May 2016
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	WHO 2016 categorization combines morphology and genetics into following groups:<ref>{{Cite journal \| last1 = Louis \| first1 = DN. \| last2 = Perry \| first2 = A. \| last3 = Reifenberger \| first3 = G. \| last4 = von Deimling \| first4 = A. \| last5 = Figarella-Branger \| first5 = D. \| last6 = Cavenee \| first6 = WK. \| last7 = Ohgaki \| first7 = H. \| last8 = Wiestler \| first8 = OD. \| last9 = Kleihues \| first9 = P. \| title = The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. \| journal = Acta Neuropathol \| volume = 131 \| issue = 6 \| pages = 803-20 \| month = Jun \| year = 2016 \| doi = 10.1007/s00401-016-1545-1 \| PMID = 27157931 }}</ref>		WHO 2016 categorization combines morphology and genetics into following groups:<ref>{{Cite journal \| last1 = Louis \| first1 = DN. \| last2 = Perry \| first2 = A. \| last3 = Reifenberger \| first3 = G. \| last4 = von Deimling \| first4 = A. \| last5 = Figarella-Branger \| first5 = D. \| last6 = Cavenee \| first6 = WK. \| last7 = Ohgaki \| first7 = H. \| last8 = Wiestler \| first8 = OD. \| last9 = Kleihues \| first9 = P. \| title = The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. \| journal = Acta Neuropathol \| volume = 131 \| issue = 6 \| pages = 803-20 \| month = Jun \| year = 2016 \| doi = 10.1007/s00401-016-1545-1 \| PMID = 27157931 }}</ref>
	*Anaplastic astrocytoma, IDH-mutant (ICD-O: 9401/3).		*Anaplastic astrocytoma, IDH-mutant (ICD-O: 9401/3).
	*Anaplastic astrocytoma, IDH-wildtype (ICD-O: ~~9400~~/3).		*Anaplastic astrocytoma, IDH-wildtype (ICD-O: 9401/3).
	*Anaplastic astrocytoma,NOS (ICD-O: ~~9400~~/3) - genetic data missing.		*Anaplastic astrocytoma,NOS (ICD-O: 9401/3) - genetic data missing.

	==Radiology/Clinic==		==Radiology/Clinic==
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	*The majority are contrast-enhanching, T2 bright.		*The majority are contrast-enhanching, T2 bright.

			==Prognosis==
			*Overall prognosis is rather poor (average survival 2-3 years).
			*IDH-mutant tumors share a similiar prognosis to grade II IDH-mutant tumors.<ref>{{Cite journal \| last1 = Reuss \| first1 = DE. \| last2 = Mamatjan \| first2 = Y. \| last3 = Schrimpf \| first3 = D. \| last4 = Capper \| first4 = D. \| last5 = Hovestadt \| first5 = V. \| last6 = Kratz \| first6 = A. \| last7 = Sahm \| first7 = F. \| last8 = Koelsche \| first8 = C. \| last9 = Korshunov \| first9 = A. \| title = IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO. \| journal = Acta Neuropathol \| volume = 129 \| issue = 6 \| pages = 867-73 \| month = Jun \| year = 2015 \| doi = 10.1007/s00401-015-1438-8 \| PMID = 25962792 }}</ref>
			*Anaplastic astrocytoma, IDH-wildtype perform worse than glioblastoma, IDH-mutant despite grading differences.<ref>{{Cite journal \| last1 = Hartmann \| first1 = C. \| last2 = Hentschel \| first2 = B. \| last3 = Wick \| first3 = W. \| last4 = Capper \| first4 = D. \| last5 = Felsberg \| first5 = J. \| last6 = Simon \| first6 = M. \| last7 = Westphal \| first7 = M. \| last8 = Schackert \| first8 = G. \| last9 = Meyermann \| first9 = R. \| title = Patients with IDH1 wild type anaplastic astrocytomas exhibit worse prognosis than IDH1-mutated glioblastomas, and IDH1 mutation status accounts for the unfavorable prognostic effect of higher age: implications for classification of gliomas. \| journal = Acta Neuropathol \| volume = 120 \| issue = 6 \| pages = 707-18 \| month = Dec \| year = 2010 \| doi = 10.1007/s00401-010-0781-z \| PMID = 21088844 }}</ref>

	==Macroscopy==		==Macroscopy==
	*No clear demarcation from white matter.		*No clear demarcation from white matter.
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	*Softer consistency and opacity.		*Softer consistency and opacity.
	*No necrosis.		*No necrosis.

			==Histology==
			Features: <ref name=AFIP2007>{{Ref AFIP2007\|34}}</ref>
			*Increased cellularity (compared to [[Diffuse Astrocytoma]]).
			**Specimens with low cellularity but plenty mitoses are also considered anaplastic.
			*Distinct nuclear atypia and pleomorphism.
			**May include multinucleated cells.
			*Cytoplasm highly variable (even within the same tumour).
			*Mitoses present (a single mitosis in a small specimen indicates a high-grade tumor).
			*Microcystic spaces of the background (none to extensive).
			*No necrosis, no vascular proliferations.
			**Except radiation necrosis after pretreatment.
			*Lymphocytic cuffing (mostly in gemistocytic type).
			*Rosenthal fibers usu. absent.

			<gallery>
			File:Mitoses_astro_III.jpg \| Marked mitotic activity in anaplastic astrocytoma (WC/jensflorian).
			File:405551M-ANAPLASTIC_ASTROCYTOMA.jpg \| Marked nuclear pleomorphism (AFIP).
			</gallery>

			==IHC==
			*[[GFAP]]+ve.
			*[[MAP2]]+ve (especially in cell processes).
			*Vimentin+ve (often perinuclear).
			*S-100+ve.
			*MIB-1: usu. 5-10& (overlaps with grade II tumors).
			*[[IDH-1]] (R132H)+ve in 60-70%.
			**'Note:'' This antibody does not detect other rare IDH1/2 mutations.
			*[[ATRX]] nuclear loss in 70%.

			==DDx==
			*[[Diffuse astrocytoma]] - absent or very low mitotic activity.
			*Anaplastic [[Oligoastrocytoma]], NOS - esp. when genetic data on IDH and LOH 1p/19q are lacking.
			*Anaplastic [[Oligodendroglioma]], when LOH 1p/19q is present.
			*[[Glioblastoma]] - vascular proliferations and / or necrosis.

Jensflorian: to be continued

2016-05-19T08:27:21Z

to be continued

← Older revision		Revision as of 08:27, 19 May 2016
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			'''Anaplastic astrocytoma''' (AKA: ''high-grade astrocytoma'') is a infiltrating neoplasm of the diffuse astrocytic and oligodendroglial tumor group occurring in the CNS white matter.

			* Most common grade III WHO glioma in adults (peaks between 40-50 years).
			* Approx 5% of all [[glioma]]s.<ref>{{Cite journal \| last1 = Ohgaki \| first1 = H. \| last2 = Kleihues \| first2 = P. \| title = Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. \| journal = J Neuropathol Exp Neurol \| volume = 64 \| issue = 6 \| pages = 479-89 \| month = Jun \| year = 2005 \| doi = \| PMID = 15977639 }}</ref>
			* Usually shows progression to [[glioblastoma]] sooner or later.

			WHO 2016 categorization combines morphology and genetics into following groups:<ref>{{Cite journal \| last1 = Louis \| first1 = DN. \| last2 = Perry \| first2 = A. \| last3 = Reifenberger \| first3 = G. \| last4 = von Deimling \| first4 = A. \| last5 = Figarella-Branger \| first5 = D. \| last6 = Cavenee \| first6 = WK. \| last7 = Ohgaki \| first7 = H. \| last8 = Wiestler \| first8 = OD. \| last9 = Kleihues \| first9 = P. \| title = The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. \| journal = Acta Neuropathol \| volume = 131 \| issue = 6 \| pages = 803-20 \| month = Jun \| year = 2016 \| doi = 10.1007/s00401-016-1545-1 \| PMID = 27157931 }}</ref>
			*Anaplastic astrocytoma, IDH-mutant (ICD-O: 9401/3).
			*Anaplastic astrocytoma, IDH-wildtype (ICD-O: 9400/3).
			*Anaplastic astrocytoma,NOS (ICD-O: 9400/3) - genetic data missing.

			==Radiology/Clinic==
			*Mass effect.
			*Seizures.
			*Neurologic decifit.
			*The majority are contrast-enhanching, T2 bright.

			==Macroscopy==
			*No clear demarcation from white matter.
			*Invaded structures may appear enlarged.
			*Softer consistency and opacity.
			*No necrosis.


	#redirect [[Neuropathology_tumours#Infiltrative_astrocytomas]]		#redirect [[Neuropathology_tumours#Infiltrative_astrocytomas]]
	[[Category:Diagnosis]]		[[Category:Diagnosis]]
	[[Category:Neuropathology tumours]]		[[Category:Neuropathology tumours]]
	[[Category:WHO grade III tumours]]		[[Category:WHO grade III tumours]]

Jensflorian: cat

2015-10-16T06:34:35Z

cat

← Older revision		Revision as of 06:34, 16 October 2015
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	#redirect [[Neuropathology_tumours#Infiltrative_astrocytomas]]		#redirect [[Neuropathology_tumours#Infiltrative_astrocytomas]]
	[[Category:Diagnosis]]		[[Category:Diagnosis]]
			[[Category:Neuropathology tumours]]
			[[Category:WHO grade III tumours]]

Michael: redirect

2012-02-07T05:40:08Z

redirect

New page

#redirect [[Neuropathology_tumours#Infiltrative_astrocytomas]]
[[Category:Diagnosis]]