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{{DiseaseDisorder infobox |
__NOTOC__
  Name          = Glioma |
  ICD10          = {{ICD10|C|71||c|69}} |
  ICD9          = {{ICD9|191}} |
  ICDO          = 9380/0-9460/3 |
  Image          = Glioma Gross 3.jpg|
  Caption        = Brain: Glioma: Gross; fixed tissue, horizontal section [[brain stem]] and [[cerebellum]] with obvious gelatinous appearing neoplasm a pontine glioma. [http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]|
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = |
  eMedicineTopic = |
  DiseasesDB    = 31468 |
}}
{{Search infobox}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{CMG}}
{{Glioma}}
__NOTOC__
{{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}},{{Faizan}},{{SC}},{{SR}}
'''Associate Editor-In-Chief:''' {{CZ}}
 
{{Editor Help}}


==Overview==
{{SK}}Gliomas; gliooma; gliome; gliom; glejak; glial tumor; glial neoplasm; neuroglial tumor; neuroglial neoplasm; neoplasm of the neuroglia; neoplasm of neuroglia; tumor of the glial cell; glial cell tumor; astrocytoma; brainstem glioma; optic nerve glioma; mixed gliomas; pilocytic astrocytoma; diffuse astrocytoma; anaplastic astrocytoma; glioblastoma multiforme; oligodendroglioma; anaplastic oligodendroglioma; oligoastrocytoma; anaplastic oligoastrocytoma; ependymoma; anaplastic ependymoma; gliosarcoma; brain tumor


A '''glioma''' is a type of primary [[central nervous system]] (CNS) [[tumor]] that arises from [[glial cell]]s.  The most common site of involvement of gliomas is the brain, but gliomas can also affect the spinal cord or any other part of the CNS, such as the optic nerves.<ref>Mamelak A.N., and Jacoby, D.B. ''[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&list_uids=17335414&cmd=Retrieve&indexed=google Targeted delivery of antitumoral therapy to glioma and other malignancies with synthetic chlorotoxin (TM-601)]'' Expert Opin. Drug Drliv. (2007) '''4'''(2):175-186.</ref>
==[[Glioma overview|Overview]]==


==Classification==
==[[Glioma historical perspective|Historical Perspective]]==
===By type of cell===
Gliomas are named according to the specific type of cell they most closely resemble.  The main types of gliomas are:


* [[Ependymoma]]s — [[ependymal cell]]s
==[[Glioma classification|Classification]]==
* [[Astrocytoma]]s — [[astrocyte]]s
* [[Oligodendroglioma]]s — [[oligodendrocyte]]s
* Mixed gliomas, such as [[oligoastrocytomas]], contain cells from different types of glia.


===By grade===
==[[Glioma pathophysiology|Pathophysiology]]==
Gliomas are further categorized according to their grade, which is determined by [[pathology|pathologic]] evaluation of the tumor. 


* '''Low-grade''' gliomas are well-differentiated (not anaplastic);  these are [[cancer|benign]] and portend a better prognosis for the patient. 
==[[Glioma causes|Causes]]==
* '''High-grade''' gliomas are undifferentiated or [[anaplastic]];  these are [[cancer|malignant]] and carry a worse prognosis. 


Of numerous grading systems in use, the most common is the [[World Health Organization]] (WHO) grading system for astrocytoma.  The WHO system assigns a grade from 1 to 4, with 1 being the least aggressive and 4 being the most aggressive.  Various types of astrocytomas are given corresponding WHO grades.
==[[Glioma differential diagnosis|Differentiating Glioma from other Diseases]]==


:'''WHO grading system for astrocytomas'''
==[[Glioma epidemiology and demographics|Epidemiology and Demographics]]==
:*WHO Grade 1 &mdash; e.g., [[pilocytic astrocytoma]]
:*WHO Grade 2 &mdash; e.g., diffuse or low-grade astrocytoma
:*WHO Grade 3 &mdash; e.g., [[anaplastic]] ([[cancer|malignant]]) astrocytoma
:*WHO Grade 4 &mdash; [[glioblastoma multiforme]] (most common glioma in adults)


The prognosis is the worst for grade 4 gliomas, with an average survival time of 12 months. Overall, few patients survive beyond 3 years. [http://www.emedicine.com/NEURO/topic147.htm]
==[[Glioma risk factors|Risk Factors]]==
[http://www.cjns.org/25augtoc/long.html]


===By location===
==[[Glioma screening|Screening]]==
The gliomas can also be roughly classified according to their location:


* infratentorial : mostly in children (70%)
==[[Glioma natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
* [[supratentorial]] : mostly in adults (70%)


==Diagnosis==
==Diagnosis==
 
[[Glioma staging|Staging]] | [[Glioma history and symptoms|History and Symptoms]] | [[Glioma physical examination|Physical Examination]] | [[Glioma laboratory tests|Laboratory Findings]] | [[Glioma x ray|X Ray]] | [[Glioma CT|CT]] | [[Glioma MRI|MRI]] | [[Glioma ultrasound|Ultrasound]] | [[Glioma other imaging findings|Other Imaging Findings]] | [[Glioma other diagnostic studies|Other Diagnostic Studies]]
===Symptoms===
Symptoms of gliomas depend on which part of the central nervous system is affected. A brain glioma can cause [[headaches]], [[nausea]] and [[vomiting]], [[seizures]], and [[cranial nerve]] disorders as a result of increased intracranial pressure. A glioma of the [[optic nerve]] can cause visual loss.  Spinal cord gliomas can cause [[Pain and nociception|pain]], [[weakness]], or [[numbness]] in the extremities. Gliomas do not metastasize by the bloodstream, but they can spread via the [[cerebrospinal fluid]] and cause "drop metastases" to the [[spinal cord]].
 
On May 20th 2008, it was announced that 76 year old Senator Edward Kennedy had a malignant glioma of the left [[parietal lobe]] following a [[seizure]].
 
===MRI===
 
[http://www.peir.net Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Ganglioglioma 1.jpg
Image:Ganglioglioma 2.jpg
</gallery>
</div>
 
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Ganglioglioma 3.jpg
Image:Glioma Optic nerve MRI.jpg
</gallery>
</div>
 
===CT===
 
[http://www.peir.net Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma CT 2.jpg|BRAIN: GLIOMA, OPTICOCHIASMATIC; WITH CONTRAST
Image:Glioma CT 1.jpg|BRAIN: GLIOMA, OPTICOCHIASMATIC; 1 OF 4 WITHOUT CONTRAST
Image:Glioma CT 3.jpg|BRAIN: GLIOMA, OPTICOCHIASMATIC; 2 OF 4 WITH CONTRAST
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma CT 4.jpg|BRAIN: GLIOMA, OPTICOCHIASMATIC; 3 OF 4 WITH CONTRAST
Image:Glioma CT 5.jpg|BRAIN: GLIOMA, OPTICOCHIASMATIC; 4 OF 4 WITH CONTRAST
</gallery>
</div>
 
==Pathology==
High-grade gliomas are highly-[[vascular]] tumors and have a tendency to infiltrate.  They have extensive areas of [[necrosis]] and [[hypoxia (medical)|hypoxia]].  Often tumor growth causes a breakdown of the [[blood-brain barrier]] in the vicinity of the tumor.  As a rule, high-grade gliomas almost always grow back even after complete surgical excision.
 
On the other hand, low-grade gliomas grow slowly, often over many years, and can be followed without treatment unless they grow and cause symptoms.


==Treatment==
==Treatment==
===Standard therapy===
[[Glioma medical therapy|Medical Therapy]] | [[Glioma surgery|Surgery]] | [[Glioma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Glioma future or investigational therapies|Future or Investigational Therapies]]
Treatment for brain gliomas depends on the location and the grade.  Often, treatment is a combined approach, using surgery, [[radiation therapy]], and [[chemotherapy]].  The radiation therapy is in the form of external beam radiation or the [[stereotactic surgery|stereotactic]] approach using [[radiosurgery]]. Spinal cord tumors can be treated by surgery and radiation. [[Temozolomide]] is a chemotherapeutic drug that is able to cross the [[blood-brain barrier]] effectively and is being used in therapy.
 
===Experimental therapies===
The use of [[oncolytic virus]]es or [[gene therapy]] using prodrug converting retroviruses and [[adenoviruses]] is being studied for the treatment of gliomas.<ref>{{cite journal |author=Gromeier M, Wimmer E |title=Viruses for the treatment of malignant glioma |journal=Curr. Opin. Mol. Ther. |volume=3 |issue=5 |pages=503-8 |year=2001 |pmid=11699896}}</ref><ref>{{cite journal |author=Rainov N, Ren H |title=Gene therapy for human malignant brain tumors |journal=Cancer journal (Sudbury, Mass.) |volume=9 |issue=3 |pages=180-8 |year=2003 |pmid=12952303}}</ref>
 
A small number of low-scale clinical studies have shown possible links between prescription of [[Carphedon]] and improvement in a number of [[encephalopathy|encephalopathic]] conditions, including lesions of cerebral blood pathways and certain types of glioma.
 
American scientists are also studying the effects of ''Leiurus quinquestriatus'' scorpion (Israeli Yellow Scorpion) venom on glioma. They have successfully isolated the [[peptide]] [[chlorotoxin]] from the venom of the ''L. quinquestriatus'' scorpion by means of [[gel filtration chromatography]]. The peptide appears to target glioma-specific chloride ion channels within the cancerous glial cells of the brain, where it binds with a high affinity.
 
In 2006, German physicians reported on a dose-escalation study for the compound AP 12009 (a phosphorothioate antisense oligodeoxynucleotide specific for the mRNA of human transforming growth factor TGF-beta2) in patients with high-grade gliomas. At the time of the report, the median overall survival had not been obtained and the authors hinted at a potential cure.
 
As of 2006, additional research started within the past few years is ongoing. Some of the topics included in this research are:
* efficiency of variations in radiotherapy procedures
* drugs to stop the growth of [[tumor]]s by preventing them to develop blood vessels
* efficiency of combinations of different treatments
* vaccination therapy.
 
Although there have been individual cases of patients receiving an experimental treatment who still showed no signs of tumor 3 years or even more after the first diagnosis, often a new treatment for GBM will already be considered successful if it significantly increases the percentage of survivors after two years.
 
A cancer vaccine "Oncophage" is currently showing great promise in clinical trails, 2007.
 
==Pathological Findings==
 
===Microscopic Images===
[http://www.peir.net Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
<br>
<div align="left">
<gallery heights="225" widths="225">
Image:Pilocytic astrocytoma 1.jpg|CNS: [[Pilocytic astrocytoma]]: variations in histologic appearance. As illustrated, many lesions are composed largely of spongy tissue rich in microcysts. Characteristic of [[pilocytic astrocytoma]]s in general, the lesion is largely a solid mass of neoplastic cells without an obvious background of infiltrated brain.
Image:Pilocytic astrocytoma 2.jpg|CNS: [[Pilocytic astrocytoma]]: variations in histologic appearance. The perivascular radiating processes in some lesions can create a likeness to an [[ependymoma]]. Note the spongy background unusual for [[ependymoma]]s.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Pilocytic astrocytoma 3.jpg|CNS: [[Pilocytic astrocytoma]]: variations in histologic appearance. Other [[pilocytic astrocytoma]]s are solid, rather than microcystic, and may be lobular.
Image:Pilocytic astrocytoma 4.jpg|CNS: [[Pilocytic astrocytoma]]: variations in histologic appearance. Rosenthal fibers, usually confined to the solid rather than spongy regions are found in many pilocytic [[astrocytoma]]s, but are not requisite for the diagnosis.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Pilocytic astrocytoma 15.jpg|CNS: [[Pilocytic astrocytoma]]: variations in histologic appearance. Rosenthal fibers are extremely abundant in some lesions. Particularly in the [[cerebellum]], it can be difficult to distinguish such solid, paucicellular, highly fibrillar [[pilocytic astrocytoma]]s from reactive gliosis with abundant Rosenthal fiber formation.
Image:Pilocytic astrocytoma 16.jpg|CNS: [[Pilocytic astrocytoma]]: variations in histologic appearance. A loose array of polar cells creates an additional variant of pilocytic [[astrocytoma]].
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Pilocytic astrocytoma 7.jpg|CNS: [[Pilocytic astrocytoma]]: variations in histologic appearance. Some pilocytic [[astrocytoma]]s are traversed by prominent collagenous septa.
Image:Pilocytic astrocytoma 8.jpg|CNS: [[Pilocytic astrocytoma]]: variations in histologic appearance. Unusual pilocytic [[astrocytoma]]s have an extensive mucinous background without microcysts.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Comparison.jpg|CNS: Comparison of normal [[optic nerve]] and [[pilocytic astrocytoma]] of the [[optic nerve]]. These two figures compare, at the same magnification, the normal [[optic nerve]] (left) with one containing a [[pilocytic astrocytoma]] (right). The [[neoplasm]] enlarges the compartments of the [[nerve]] and extends in collar-like fashion into the [[subarachnoid]] space.
Image:Pilocytic astrocytoma 9.jpg|CNS: [[Pilocytic astrocytoma]]; The "hair cells" for which this lesion is named are readily seen.
</gallery>
</div>
 
 
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<gallery heights="225" widths="225">
Image:Pilocytic astrocytoma 10.jpg|CNS: [[Pilocytic astrocytoma]]; Nuclear hyperchromasia and [[pleomorphism]] are common. Note the typical cellular elongation, and, at the center of the illustration, the [[eosinophil]]ic granular body that populates [[pilocytic astrocytoma]]s and certain other slowly growing gliomas.
Image:Pilocytic astrocytoma 11.jpg|CNS: [[Pilocytic astrocytoma]]; Intracytoplasmic Rosenthal fibers are prominent in some pilocytic [[neoplasm]]s.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Malignant ependymoma.jpg|Brain: [[Malignant]] [[ependymoma]]: Micro med mag H&E tumor cells.
Image:Oligodendroglioma 2.jpg|CNS: [[Oligodendroglioma]]; Occasional [[oligodendroglioma]]s contain cells with minute, refractile [[eosinophil]]ic bodies representing miniature Rosenthal fibers.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Oligodendroglioma 1.jpg|CNS: [[Oligodendroglioma]]; The cells of some [[oligodendroglioma]]s acquire sufficient [[cytoplasm]] and process formation to become decidedly astrocytic, but their nuclei retain the roundness, uniformity, and chromatin distribution typical of [[oligodendroglioma]].
Image:Anaplastic oligodendroglioma.jpg|[[Anaplastic]] [[oligodendroglioma]]: [[Anaplastic]] [[oligodendroglioma]]s are highly cellular and associated with vascular proliferation.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Oligodendroglioma frozen.jpg|CNS: [[Oligodendroglioma]] (frozen section); [[Oligodendroglioma]]s in frozen sections lack the distinctive halos so often seen in permanent sections. Cellular monomorphism and infiltration of [[cerebral cortex]] with perineuronal satellitosis suggest the correct diagnosis.
Image:Clear cell ependymoma.jpg|CNS: Clear cell [[ependymoma]]; Perinuclear clearing similar to that seen in [[oligodendroglioma]]s is a prominent feature of the clear cell variant. Note the vague perivascular pseudorosettes. The lesion was a discrete occipital intraventricular mass.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioblastoma multiforme 1.jpg|CNS: [[Glioblastoma multiforme]]; Brain: [[Glioblastoma multiforme]]. Grade I-Ii: Micro med mag with H&E, [[tumor]] well shown
Image:Glioblastoma multiforme 2.jpg|CNS: [[Glioblastoma multiforme]] arising in an [[astrocytoma]]. At higher magnification, gemistocytic [[astrocytoma]] with microcystic change is apparent at the bottom of the illustration and cellular nodules of [[glioblastoma multiforme]] are seen at the top. The 6-year history of symptoms attested to the initially low-grade nature of this astrocytic tumor.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioblastoma multiforme 103.jpg|CNS: [[Glioblastoma multiforme]]; Characteristic of most [[glioblastoma]]s are small cells with elongated nuclei and bipolar processes. As here, the [[chromatin]] is generally not markedly dense nor are nucleoli usually prominent.
Image:Glioblastoma multiforme 104.jpg|CNS: [[Glioblastoma multiforme]]; Vascular proliferation, a common feature of glioblastoma, produces tufts which often grow directionally. Here, as is often the case, they are oriented toward a focus of necrosis (top right).
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioblastoma multiforme 105.jpg|CNS: [[Glioblastoma multiforme]]; At high magnification, the neovascular tuft is a mass which, as can be confirmed by immunohistochemistry, is formed of both endothelial cells and smooth muscle cells (pericytes).
Image:Glioblastoma multiforme 106.jpg|CNS: [[Glioblastoma multiforme]]; In many instances, [[necrosis]] is surrounded by a distinctive collar of cells, which are often smaller than those in surrounding neoplastic tissue. The phenomenon is referred to as pseudopalisading.
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Cerebrospinal dissemination of glioblastoma multiforme 1.jpg|CNS: Cerebrospinal dissemination of glioblastoma multiforme; As seen at low (left) and high (right) magnification, the small undifferentiated-appearing cells of this glioblastoma are drop metastases colonizing the nerve roots of the cauda equina.
Image:Cerebrospinal dissemination of glioblastoma multiforme 2.jpg|CNS: Cerebrospinal dissemination of glioblastoma multiforme; As seen at low (left) and high (right) magnification, the small undifferentiated-appearing cells of this glioblastoma are drop metastases colonizing the nerve roots of the cauda equina.
</gallery>
</div>


==Case Studies==
[[Glioma case study one|Case#1]]


<div align="left">
==Related chapters==
<gallery heights="225" widths="225">
* [[Brain Stem Gliomas]]
Image:Glioblastoma multiforme 116.jpg|CNS: [[Glioblastoma multiforme]]; Higher magnification reveals the small cell nature of such tumors.
* [[Astrocytoma]]
Image:Glioblastoma multiforme 117.jpg|CNS: [[Glioblastoma multiforme]]; Some glioblastomas are especially infiltrative of the cerebral cortex where subpial, perivascular, and perineuronal accumulations are prominent.
* [[Ependymomas]]
</gallery>
* [[Oligodendrogliomas]]
</div>
* [[Oligoastrocytomas]]
 
* [[Glioblastoma multiforme]]
 
* [[Mixed gliomas]]
<div align="left">
<gallery heights="225" widths="225">
Image:Glioblastoma multiforme 126.jpg|CNS: [[Glioblastoma multiforme]]; Although this densely cellular and largely undifferentiated lesion technically merits a diagnosis of [[anaplastic]] [[astrocytoma]], it is, for practical purposes, a glioblastoma.
Image:Glioblastoma multiforme malignant astrocytoma 1.jpg|Brain: [[Glioblastoma multiforme]] [[malignant]] [[astrocytoma]]
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioblastoma multiforme pallisading.jpg|Brain: [[Glioblastoma multiforme]]; pallisading
Image:Glioblastoma multiforme vascular proliferation.jpg|Brain: [[Glioblastoma multiforme]]; vascular proliferation
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioblastoma multiforme extravasated blood.jpg|Brain: [[Glioblastoma multiforme]]; Plump and juicy [[endothelial cell]]s, extravasated blood
Image:Glioblastoma multiforme perivascular lymphocytes.jpg|Brain: [[Glioblastoma multiforme]]; perivascular [[lymphocyte]]s
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioblastoma multiforme thrombosed vessel.jpg|Brain: [[Glioblastoma multiforme]]; thrombosed vessel
Image:Hemosiderin in glioblastoma.jpg|Brain: [[Glioblastoma multiforme]]; [[Hemosiderin]] in glioblastoma
</gallery>
</div>
 
===Gross Images===
[http://www.peir.net Images shown below are courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology]
<br>
 
<div align="left">
<gallery heights="175" widths="175">
Image:Glioma Gross 1.jpg|Brain: Pontine Glioma: Gross; fixed tissue, anterior view of [[brain stem]] and [[cerebellum]] with bosselated tumor adjacent to [[basilar artery]]
Image:Glioma Gross 2.jpg|Brain: Pontine Glioma: Gross; fixed tissue, sagittal section [[brain stem]] and [[cerebellum]]
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 3.jpg|Brain: Glioma: Gross; fixed tissue, horizontal section [[brain stem]] and [[cerebellum]] with obvious gelatinous appearing neoplasm a pontine glioma
Image:Glioma Gross 4.jpg|Brain: Oligodendroglioma: Gross; natural color, large, well circumscribed lesion in left [[frontal lobe]]
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 5.jpg|Brain: Glioma: Gross; fixed tissue, horizontal sections [[brain stem]] and [[cerebellum]] showing large pontine glioma
Image:Glioma Gross 6.jpg|Brain: Pontine Glioma and Diffuse Meningeal Gliomatosis: Gross; fixed tissue, view of cerebral hemispheres from inferior with [[brain stem]] and [[cerebellum]] removed. Pontine asymmetry is easily seen due to low grade [[astrocytoma]] and meningeal gliomatosis is easily seen over [[frontal lobe]]s
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 7.jpg|Brain: Pontine Glioma and Diffuse Meningeal Gliomatosis in 7 yo boy: Gross; fixed tissue, view of cerebral hemispheres from vertex meningeal gliomatosis.
Image:Glioma Gross 8.jpg|Brain: Pontine Glioma and Diffuse Meningeal Gliomatosis: Gross; in situ dural nodule
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 9.jpg|Brain: Oligodendroglioma: Gross; fixed tissue, multiple coronal sections, cerebral hemispheres with large tumor and hemorrhage into tumor
Image:Glioma Gross 10.jpg|Brain: Oligodendroglioma: Gross; fixed tissue, coronal section, cerebral hemispheres, large hemorrhagic lesion in one hemisphere
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 11.jpg|Brain: Oligodendroglioma: Gross; fixed tissue, ischemic tissue, anterior to tumor mass
Image:Glioma Gross 12.jpg|Brain: Oligodendroglioma: Gross; natural color, coronal section, cerebral hemispheres, large lesion, left parieto occipital white matter
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 13.jpg|Brain: Gliomatosis Cerebri: Gross; fixed tissue, coronal sections, cerebral hemispheres, lesion is in temporal lobes and hypothalamus
Image:Glioma Gross 14.jpg|Brain: Ventriculitis: Gross; fixed tissue, case of glioma with meningitis, a nice view of ventriculitis in one lateral ventricle
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 15.jpg|Brain: Glioma Thalamic Grade Ii-Iii: Gross; fixed tissue, four coronal sections, cerebral hemispheres, very large hemorrhagic lesion
Image:Glioma Gross 16.jpg|Brain: Glioma Thalamic Grade Ii-Iii: Gross; fixed tissue, coronal section, cerebral hemispheres with large hemorrhagic lesion
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 17.jpg|Brain: Glioma Thalamic Grade Ii-Iii: Gross fixed tissue coronal section cerebral hemispheres lesions appears to be in choroid plexus of lateral ventricle in this picture. There is blood in fourth ventricle
Image:Glioma Gross 18.jpg|Brain: Cerebral Sarcoma or Microglioma: Gross; fixed tissue, coronal section, cerebral hemispheres (58 yo man)
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 19.jpg|Brain: Cerebral Sarcoma or Microglioma: Gross; fixed tissue, coronal section, cerebral hemispheres
Image:Glioma Gross 20.jpg|Brain: Cerebral Sarcoma or Microglioma: Gross; fixed tissue, coronal section, cerebral hemispheres
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 21.jpg|Brain: Infarct Subcortical: Gross; fixed tissue, close-up view of old small subcortical infarct, a case of microglioma
Image:Glioma Gross 22.jpg|Brain: Microglioma: Gross; fixed tissue; [[cerebellum]] and fourth ventricle with periventricular tumor invasion
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 23.jpg|Brain: Microglioma: Gross fixed tissue horizontal sections cerebellum and brain stem with periventricular neoplastic infiltrate
Image:Glioma Gross 24.jpg|Brain: Microglioma: Gross fixed tissue horizontal section midbrain and cerebellum at mid pons level periventricular tumor infiltration
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 25.jpg|Brain: Microglioma: Gross fixed tissue horizontal section rostral pons and cerebellum
Image:Glioma Gross 26.jpg|Brain: Microglioma: Gross fixed tissue horizontal section rostral pons and cerebellum periventricular tumor invasion
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 27.jpg|Brain: Microglioma: Gross fixed tissue coronal section cerebral hemispheres with mild ventricular dilation
Image:Glioma Gross 28.jpg|Glioma: Optic Nerve
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 29.jpg|Brain: Oligodendroglioma, Frontal Lobe
Image:Glioma Gross 30.jpg|Brain: Oligodendroglioma, Mixed Astrocytoma & Oligodendroglioma
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 31.jpg|Brain: Oligodendroglioma
Image:Glioma Gross 32.jpg|Brain: Oligodendroglioma
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 33.jpg|Brain: Oligodendroglioma; Ventricular Cobblestone Effect
Image:Glioma Gross 34.jpg|Eye: Neurofibromatosis; Glaucoma; Glioma
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 36.jpg|Brain: Glioma, Grade II Anaplastic
Image:Glioma Gross 37.jpg|Brain: Glioma, [[Brain stem]], Low Grade
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 38.jpg|Fundoscopy: Eye; Optic Nerve Glioma, Optic Nerve
Image:Glioma Gross 41.jpg|Brain: Glioma, Hypothalamic, Circle Around Region of Tumor
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 39.jpg|CNS: Pilocytic Astrocytoma of the Spinal Cord. The fusiform expansion of the spinal cord produced by this pilocytic astrocytoma is not, on external examination alone, distinguishable from that produced by a nonresectable diffuse glioma.
Image:Glioma Gross 42.jpg|Brain: Glioma, Pontine
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 43.jpg|Brain: [[Glioblastoma Multiforme]]: Gross fixed tissue close-up large necrotic tumor mass in septum pellucidum
Image:Glioma Gross 44.jpg|Brain: [[Glioblastoma Multiforme]]: Gross fixed tissue coronal section of the brain with a large necrotic tumor mass in septum pellucidum diagnosed as astrocytoma grade III
</gallery>
</div>
 
 
<div align="left">
<gallery heights="225" widths="225">
Image:Glioma Gross 45.jpg|Brain: [[Glioblastoma Multiforme]]: Gross natural color large hemorrhagic lesion in right centrum semiovale
Image:Pilocytic astrocytoma gross.jpg|CNS: Malignant pilocytic astrocytoma: A 29-year-old woman died 2 years after a diagnosis of "atypical pilocytic astrocytoma" of the pineal region. At autopsy, multiple tumor implants were present in the craniospinal subarachnoid spaces.
</gallery>
</div>
 
==References==
{{reflist|2}}
 
==Recent Publications==
<small>
<div style="-moz-column-count:2; column-count:2;">
*Su Y, Zhang X, Gu J, Zhang C, Tian Z, Zhang J. JSI-124 Inhibits Glioblastoma Multiforme Cell Proliferation through G2/M Cell Cycle Arrest and Apoptosis Augment. Cancer Biol Ther. 2008 May 10;7(8). [Epub ahead of print] PMID 18487947 [PubMed - as supplied by publisher]
*Emblem KE, Nedregaard B, Nome T, Due-Tonnessen P, Hald JK, Scheie D, Borota OC, Cvancarova M, Bjornerud A. Glioma grading by using histogram analysis of blood volume heterogeneity from MR-derived cerebral blood volume maps. Radiology. 2008 Jun;247(3):808-17. PMID 18487536 [PubMed - in process]
*Capuani S, Porcari P, Fasano F, Campanella R, Maraviglia B. (10) B-editing (1) H-detection and (19) F MRI strategies to optimize boron neutron capture therapy. Magn Reson Imaging. 2008 May 15. [Epub ahead of print] PMID 18486394 [PubMed - as supplied by publisher]
*Chung IS, Son YI, Ko YJ, Baek CH, Cho JK, Jeong HS. Peritumor injections of purified tumstatin delay tumor growth and lymphatic metastasis in an orthotopic oral squamous cell carcinoma model. Oral Oncol. 2008 May 15. [Epub ahead of print] PMID 18485794 [PubMed - as supplied by publisher]
*Ahmed AE, Jacob S, Nagy AA, Abdel-Naim AB. Dibromoacetonitrile-induced protein oxidation and inhibition of proteasomal activity in rat glioma cells. Toxicol Lett. 2008 Apr 8. [Epub ahead of print] PMID 18485629 [PubMed - as supplied by publisher]
</div>
</small>
 
==External links==
* {{GPnotebook|-2147090429}}
* [http://virtualtrials.com/pdf/williams2007.pdf Treatment Options for Glioblastoma and other Gliomas (.pdf format)]
* [http://www.hirntumorhilfe.de German Brain Tumor Association]
* [http://rad.usuhs.mil/rad/who/who-index.html WHO Classification]
* [http://www.sciencedaily.com/releases/2007/08/070830155859.htm Experimental Anti-cancer Drug Kills Brain Tumor Stem Cells (Science Daily)]
* [http://www.medicalnewstoday.com/articles/61156.php Statin Plus Cancer Drug Deliver Combo Punch to Brain Cancer Cells (Medical News Today, Jan 2007)]
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Latest revision as of 23:37, 26 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2],Faizan Sheraz, M.D. [3],Shanshan Cen, M.D. [4],Sujit Routray, M.D. [5]

Synonyms and keywords:Gliomas; gliooma; gliome; gliom; glejak; glial tumor; glial neoplasm; neuroglial tumor; neuroglial neoplasm; neoplasm of the neuroglia; neoplasm of neuroglia; tumor of the glial cell; glial cell tumor; astrocytoma; brainstem glioma; optic nerve glioma; mixed gliomas; pilocytic astrocytoma; diffuse astrocytoma; anaplastic astrocytoma; glioblastoma multiforme; oligodendroglioma; anaplastic oligodendroglioma; oligoastrocytoma; anaplastic oligoastrocytoma; ependymoma; anaplastic ependymoma; gliosarcoma; brain tumor

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