Astrocytoma pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D., Shivali Marketkar, M.B.B.S. [2], Ammu Susheela, M.D. [3]


The exact pathogenesis of astrocytoma is not completely understood but it is believed that this tumor has a close association with genetic mutations. Microscopic pathologic findings in pilocytic astrocytoma include normal cells with slow growth rate, biphasic pattern (dense fibrillar tissue within loose myxoid tissue), calcification, vascular hyalinization, and nested fibrotic pattern. In diffuse astrocytoma, we may see atypical cells, relatively slow mitosis rate, diffusely infiltrate neuropil and poorly defined cytoplasm. In anaplastic astrocytoma, we may see pleomorphic and malignant cells, high mitosis rate, hyperchromatosis, and prominent small vessels. In glioblastoma multiform, we may see pleomorphic cells, naked nuclei, multi-focal necrosis, pseudopalisading pattern, scattered pyknotic nuclear debris in the center, micro-vascular proliferation, and vascular thrombi.


Associated conditions

  • There are no conditions associated with astrocytoma.


Low-Grade Astrocytomas

High-Grade Astrocytomas

• 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

Gross Pathology

Microscopic Pathology

Pathological findings diagnostic of astrocytoma include:[26][27][28][29]

Histopathological Video




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  6. Korshunov A, Meyer J, Capper D, Christians A, Remke M, Witt H; et al. (2009). "Combined molecular analysis of BRAF and IDH1 distinguishes pilocytic astrocytoma from diffuse astrocytoma". Acta Neuropathol. 118 (3): 401–5. doi:10.1007/s00401-009-0550-z. PMID 19543740.
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  12. Mistry M, Zhukova N, Merico D, Rakopoulos P, Krishnatry R, Shago M; et al. (2015). "BRAF mutation and CDKN2A deletion define a clinically distinct subgroup of childhood secondary high-grade glioma". J Clin Oncol. 33 (9): 1015–22. doi:10.1200/JCO.2014.58.3922. PMC 4356711. PMID 25667294.
  13. Janzarik WG, Kratz CP, Loges NT, Olbrich H, Klein C, Schäfer T; et al. (2007). "Further evidence for a somatic KRAS mutation in a pilocytic astrocytoma". Neuropediatrics. 38 (2): 61–3. doi:10.1055/s-2007-984451. PMID 17712732.
  14. Dahiya S, Haydon DH, Alvarado D, Gurnett CA, Gutmann DH, Leonard JR (2013). "BRAF(V600E) mutation is a negative prognosticator in pediatric ganglioglioma". Acta Neuropathol. 125 (6): 901–10. doi:10.1007/s00401-013-1120-y. PMID 23609006.
  15. Zhang J, Wu G, Miller CP, Tatevossian RG, Dalton JD, Tang B; et al. (2013). "Whole-genome sequencing identifies genetic alterations in pediatric low-grade gliomas". Nat Genet. 45 (6): 602–12. doi:10.1038/ng.2611. PMC 3727232. PMID 23583981.
  16. Paugh BS, Qu C, Jones C, Liu Z, Adamowicz-Brice M, Zhang J; et al. (2010). "Integrated molecular genetic profiling of pediatric high-grade gliomas reveals key differences with the adult disease". J Clin Oncol. 28 (18): 3061–8. doi:10.1200/JCO.2009.26.7252. PMC 2903336. PMID 20479398.
  17. Bax DA, Mackay A, Little SE, Carvalho D, Viana-Pereira M, Tamber N; et al. (2010). "A distinct spectrum of copy number aberrations in pediatric high-grade gliomas". Clin Cancer Res. 16 (13): 3368–77. doi:10.1158/1078-0432.CCR-10-0438. PMC 2896553. PMID 20570930.
  18. Ward SJ, Karakoula K, Phipps KP, Harkness W, Hayward R, Thompson D; et al. (2010). "Cytogenetic analysis of paediatric astrocytoma using comparative genomic hybridisation and fluorescence in-situ hybridisation". J Neurooncol. 98 (3): 305–18. doi:10.1007/s11060-009-0081-4. PMID 20052518.
  19. Pollack IF, Hamilton RL, Sobol RW, Nikiforova MN, Lyons-Weiler MA, LaFramboise WA; et al. (2011). "IDH1 mutations are common in malignant gliomas arising in adolescents: a report from the Children's Oncology Group". Childs Nerv Syst. 27 (1): 87–94. doi:10.1007/s00381-010-1264-1. PMC 3014378. PMID 20725730.
  20. Schwartzentruber J, Korshunov A, Liu XY, Jones DT, Pfaff E, Jacob K; et al. (2012). "Driver mutations in histone H3.3 and chromatin remodelling genes in paediatric glioblastoma". Nature. 482 (7384): 226–31. doi:10.1038/nature10833. PMID 22286061.
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  22. Sturm D, Witt H, Hovestadt V, Khuong-Quang DA, Jones DT, Konermann C; et al. (2012). "Hotspot mutations in H3F3A and IDH1 define distinct epigenetic and biological subgroups of glioblastoma". Cancer Cell. 22 (4): 425–37. doi:10.1016/j.ccr.2012.08.024. PMID 23079654.
  23. Gielen GH, Gessi M, Hammes J, Kramm CM, Waha A, Pietsch T (2013). "H3F3A K27M mutation in pediatric CNS tumors: a marker for diffuse high-grade astrocytomas". Am J Clin Pathol. 139 (3): 345–9. doi:10.1309/AJCPABOHBC33FVMO. PMID 23429371.
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  25. "National Caner Institute Astrocytoma".
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