Anaplastic pilocytic astrocytoma - Revision history

Jensflorian: /* General */ tumor is outdated

2022-10-17T13:52:30Z

General: tumor is outdated

← Older revision		Revision as of 13:52, 17 October 2022
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	==General==		==General==
	*High-grade [[astrocytoma]] - behaviour ~~corresponds~~ to ''WHO Grade III''.		*High-grade [[astrocytoma]] - behaviour corresponded in older classifications to ''WHO Grade III''.
	*Some authors prefered the designation '''pilocytic astrocytoma with anaplastic features'''.		*Some authors prefered the designation '''pilocytic astrocytoma with anaplastic features'''.
	*Less than 2% of all pilocytic astrocytomas.<ref>{{Cite journal \| last1 = Rodriguez \| first1 = FJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Burger \| first3 = PC. \| last4 = Jenkins \| first4 = S. \| last5 = Giannini \| first5 = C. \| title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. \| journal = Am J Surg Pathol \| volume = 34 \| issue = 2 \| pages = 147-60 \| month = Feb \| year = 2010 \| doi = 10.1097/PAS.0b013e3181c75238 \| PMID = 20061938 }}</ref>		*Less than 2% of all pilocytic astrocytomas.<ref>{{Cite journal \| last1 = Rodriguez \| first1 = FJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Burger \| first3 = PC. \| last4 = Jenkins \| first4 = S. \| last5 = Giannini \| first5 = C. \| title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. \| journal = Am J Surg Pathol \| volume = 34 \| issue = 2 \| pages = 147-60 \| month = Feb \| year = 2010 \| doi = 10.1097/PAS.0b013e3181c75238 \| PMID = 20061938 }}</ref>

Jensflorian: Outdated tumor

2022-10-17T13:51:23Z

Outdated tumor

← Older revision		Revision as of 13:51, 17 October 2022
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	~~{{ Infobox diagnosis~~		'''Anaplastic pilocytic astrocytoma''', abbreviated '''APA''', is an outdated tumor terminology. Most of these tumors are now classified either as [[High-grade astrocytoma with piloid features]], [[Pleomorphic xanthoastrocytoma]] or as [[Glioblastoma]], IDH-wildtype.
	~~\| Name = {{PAGENAME}}~~
	~~\| Image = Pilocytic astrocytoma with anaplastic features.jpg~~
	~~\| Width =~~
	~~\| Caption = Anaplastic pilocytic astrocytoma. [[H&E stain]].~~
	~~\| Synonyms =~~
	~~\| Micro =~~
	~~\| Subtypes =~~
	~~\| LMDDx = [[astrocytoma]], [[oligodendroglioma]], [[glioblastoma]]~~
	~~\| Stains = PAS-D +ve (eosinophilic granular bodies)~~
	~~\| IHC = GFAP +ve~~
	~~\| EM =~~
	~~\| Molecular =~~
	~~\| IF =~~
	~~\| Gross = usually cerebellar~~
	~~\| Grossing =~~
	~~\| Site = brain - usu. [[cerebellum]]~~
	~~\| Assdx =~~
	~~\| Syndromes =~~
	~~\| Clinicalhx =~~
	~~\| Signs =~~
	~~\| Symptoms =~~
	~~\| Prevalence = very rare - esp. in children~~
	~~\| Bloodwork =~~
	~~\| Rads =~~
	~~\| Endoscopy =~~
	~~\| Prognosis = poor (analog to WHO Grade III)~~
	~~\| Other =~~
	~~\| ClinDDx =~~
	~~\| Tx =~~
	}}
	'''Anaplastic pilocytic astrocytoma''', abbreviated '''APA''', is ~~a rare high~~-grade [[~~astrocytoma~~]]~~. It can develop from a~~ [[~~pilocytic astrocytoma~~]].

	==General==		==General==
	*High-grade [[astrocytoma]] - behaviour corresponds to ''WHO Grade III''.		*High-grade [[astrocytoma]] - behaviour corresponds to ''WHO Grade III''.
	*Some authors ~~prefer~~ the designation '''pilocytic astrocytoma with anaplastic features'''.		*Some authors prefered the designation '''pilocytic astrocytoma with anaplastic features'''.
	*Less than 2% of all pilocytic astrocytomas.<ref>{{Cite journal \| last1 = Rodriguez \| first1 = FJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Burger \| first3 = PC. \| last4 = Jenkins \| first4 = S. \| last5 = Giannini \| first5 = C. \| title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. \| journal = Am J Surg Pathol \| volume = 34 \| issue = 2 \| pages = 147-60 \| month = Feb \| year = 2010 \| doi = 10.1097/PAS.0b013e3181c75238 \| PMID = 20061938 }}</ref>		*Less than 2% of all pilocytic astrocytomas.<ref>{{Cite journal \| last1 = Rodriguez \| first1 = FJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Burger \| first3 = PC. \| last4 = Jenkins \| first4 = S. \| last5 = Giannini \| first5 = C. \| title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. \| journal = Am J Surg Pathol \| volume = 34 \| issue = 2 \| pages = 147-60 \| month = Feb \| year = 2010 \| doi = 10.1097/PAS.0b013e3181c75238 \| PMID = 20061938 }}</ref>
	*De novo cases in the setting of neurofibromatosis 1 reported.		*De novo cases in the setting of neurofibromatosis 1 reported.
	*Many tumors have history of previous radiation.		*Many tumors have history of previous radiation.

	==~~Microscopic~~==		==Old microscopic criteria==
	Features:<ref>{{Cite journal \| last1 = Rodriguez \| first1 = FJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Burger \| first3 = PC. \| last4 = Jenkins \| first4 = S. \| last5 = Giannini \| first5 = C. \| title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. \| journal = Am J Surg Pathol \| volume = 34 \| issue = 2 \| pages = 147-60 \| month = Feb \| year = 2010 \| doi = 10.1097/PAS.0b013e3181c75238 \| PMID = 20061938 }}</ref>		Features:<ref>{{Cite journal \| last1 = Rodriguez \| first1 = FJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Burger \| first3 = PC. \| last4 = Jenkins \| first4 = S. \| last5 = Giannini \| first5 = C. \| title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. \| journal = Am J Surg Pathol \| volume = 34 \| issue = 2 \| pages = 147-60 \| month = Feb \| year = 2010 \| doi = 10.1097/PAS.0b013e3181c75238 \| PMID = 20061938 }}</ref>
	*At least 4 mitoses/10 high power fields - see [[HPFitis]].		*At least 4 mitoses/10 high power fields - see [[HPFitis]].
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	*Epithelioid cells (15%)		*Epithelioid cells (15%)
	*Fibrillary areas resembling [[diffuse astrocytoma]].		*Fibrillary areas resembling [[diffuse astrocytoma]].

	~~DDx of APA (brief):~~
	*[[Ependymoma]]
	*[[Oligodendroglioma]].
	*[[Glioblastoma]] including small-cell GBM (important).


	~~===Images===~~
	~~<gallery>~~
	~~Image:Pilocytic astrocytoma with anaplastic features.jpg \| APA, [[FFPE]] specimen, HE (WC).~~
	~~Image:Pilocytic astrocytoma with anaplastic features mimicking focally a GBM.jpg \| Vacular proliferations and necrosis in APA mimicking [[GBM]] (WC).~~
	~~</gallery>~~

	==IHC==		==IHC==
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	*[[IDH1]] (R132H) -ve.		*[[IDH1]] (R132H) -ve.
	*[[H3F3A]] (K27M) -ve.		*[[H3F3A]] (K27M) -ve.

	~~==Molecular==~~
	*Molecular data is still limited.
	*KIAA1549-BRAF fusion transcripts and [[NF1]] cases reported<ref>{{Cite journal \| last1 = Jones \| first1 = DT. \| last2 = Hutter \| first2 = B. \| last3 = Jäger \| first3 = N. \| last4 = Korshunov \| first4 = A. \| last5 = Kool \| first5 = M. \| last6 = Warnatz \| first6 = HJ. \| last7 = Zichner \| first7 = T. \| last8 = Lambert \| first8 = SR. \| last9 = Ryzhova \| first9 = M. \| title = Recurrent somatic alterations of FGFR1 and NTRK2 in pilocytic astrocytoma. \| journal = Nat Genet \| volume = 45 \| issue = 8 \| pages = 927-32 \| month = Aug \| year = 2013 \| doi = 10.1038/ng.2682 \| PMID = 23817572 }}</ref>


	~~==Prognosis==~~
	*Poor, but better than conventional glioblastoma.<ref>{{Cite journal \| last1 = Rodriguez \| first1 = FJ. \| last2 = Scheithauer \| first2 = BW. \| last3 = Burger \| first3 = PC. \| last4 = Jenkins \| first4 = S. \| last5 = Giannini \| first5 = C. \| title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. \| journal = Am J Surg Pathol \| volume = 34 \| issue = 2 \| pages = 147-60 \| month = Feb \| year = 2010 \| doi = 10.1097/PAS.0b013e3181c75238 \| PMID = 20061938 }}</ref>
	*Prognostic unfavourable paramters include: Necrosis, Mitoses and previous radiation.

	==See also==		==See also==

Michael: /* Images */

2017-10-19T13:25:32Z

Images

← Older revision		Revision as of 13:25, 19 October 2017
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	===Images===		===Images===
	<gallery>		<gallery>
	Image:Pilocytic astrocytoma with anaplastic features.jpg \| APA, FFPE specimen, HE (WC).		Image:Pilocytic astrocytoma with anaplastic features.jpg \| APA, [[FFPE]] specimen, HE (WC).
	Image:Pilocytic astrocytoma with anaplastic features mimicking focally a GBM.jpg \| Vacular proliferations and necrosis in APA mimicking [[GBM]] (WC).		Image:Pilocytic astrocytoma with anaplastic features mimicking focally a GBM.jpg \| Vacular proliferations and necrosis in APA mimicking [[GBM]] (WC).
	</gallery>		</gallery>

Jensflorian: exported from pilocytic astrocytoma

2017-04-11T08:14:28Z

exported from pilocytic astrocytoma

New page

{{ Infobox diagnosis
| Name = {{PAGENAME}}
| Image = Pilocytic astrocytoma with anaplastic features.jpg
| Width =
| Caption = Anaplastic pilocytic astrocytoma. [[H&E stain]].
| Synonyms =
| Micro =
| Subtypes =
| LMDDx = [[astrocytoma]], [[oligodendroglioma]], [[glioblastoma]]
| Stains = PAS-D +ve (eosinophilic granular bodies)
| IHC = GFAP +ve
| EM =
| Molecular =
| IF =
| Gross = usually cerebellar
| Grossing =
| Site = brain - usu. [[cerebellum]]
| Assdx =
| Syndromes =
| Clinicalhx =
| Signs =
| Symptoms =
| Prevalence = very rare - esp. in children
| Bloodwork =
| Rads =
| Endoscopy =
| Prognosis = poor (analog to WHO Grade III)
| Other =
| ClinDDx =
| Tx =
}}
'''Anaplastic pilocytic astrocytoma''', abbreviated '''APA''', is a rare high-grade [[astrocytoma]]. It can develop from a [[pilocytic astrocytoma]].

==General==
*High-grade [[astrocytoma]] - behaviour corresponds to ''WHO Grade III''.
*Some authors prefer the designation '''pilocytic astrocytoma with anaplastic features'''.
*Less than 2% of all pilocytic astrocytomas.<ref>{{Cite journal | last1 = Rodriguez | first1 = FJ. | last2 = Scheithauer | first2 = BW. | last3 = Burger | first3 = PC. | last4 = Jenkins | first4 = S. | last5 = Giannini | first5 = C. | title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. | journal = Am J Surg Pathol | volume = 34 | issue = 2 | pages = 147-60 | month = Feb | year = 2010 | doi = 10.1097/PAS.0b013e3181c75238 | PMID = 20061938 }}</ref>
*De novo cases in the setting of neurofibromatosis 1 reported.
*Many tumors have history of previous radiation.

==Microscopic==
Features:<ref>{{Cite journal | last1 = Rodriguez | first1 = FJ. | last2 = Scheithauer | first2 = BW. | last3 = Burger | first3 = PC. | last4 = Jenkins | first4 = S. | last5 = Giannini | first5 = C. | title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. | journal = Am J Surg Pathol | volume = 34 | issue = 2 | pages = 147-60 | month = Feb | year = 2010 | doi = 10.1097/PAS.0b013e3181c75238 | PMID = 20061938 }}</ref>
*At least 4 mitoses/10 high power fields - see [[HPFitis]].
*Hypercellularity.
*Necrosis +/-.
*Pilocytic like (biphasic) - most common.
*#Eosinophilic granular bodies +/-.
*Small cell (32%)
*Epithelioid cells (15%)
*Fibrillary areas resembling [[diffuse astrocytoma]].

DDx of APA (brief):
*[[Ependymoma]]
*[[Oligodendroglioma]].
*[[Glioblastoma]] including small-cell GBM (important).

===Images===
<gallery>
Image:Pilocytic astrocytoma with anaplastic features.jpg | APA, FFPE specimen, HE (WC).
Image:Pilocytic astrocytoma with anaplastic features mimicking focally a GBM.jpg | Vacular proliferations and necrosis in APA mimicking [[GBM]] (WC).
</gallery>

==IHC==
Features:<ref>{{Cite journal | last1 = Rodriguez | first1 = FJ. | last2 = Scheithauer | first2 = BW. | last3 = Burger | first3 = PC. | last4 = Jenkins | first4 = S. | last5 = Giannini | first5 = C. | title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. | journal = Am J Surg Pathol | volume = 34 | issue = 2 | pages = 147-60 | month = Feb | year = 2010 | doi = 10.1097/PAS.0b013e3181c75238 | PMID = 20061938 }}</ref>
*GFAP +ve (fibres).
*p53: +ve.
*KI-67: high 25%.
*[[ATRX]] loss may be present.<ref>{{Cite journal | last1 = Ebrahimi | first1 = A. | last2 = Skardelly | first2 = M. | last3 = Bonzheim | first3 = I. | last4 = Ott | first4 = I. | last5 = Mühleisen | first5 = H. | last6 = Eckert | first6 = F. | last7 = Tabatabai | first7 = G. | last8 = Schittenhelm | first8 = J. | title = ATRX immunostaining predicts IDH and H3F3A status in gliomas. | journal = Acta Neuropathol Commun | volume = 4 | issue = 1 | pages = 60 | month = Jun | year = 2016 | doi = 10.1186/s40478-016-0331-6 | PMID = 27311324 }}</ref>
*[[IDH1]] (R132H) -ve.
*[[H3F3A]] (K27M) -ve.

==Molecular==
*Molecular data is still limited.
*KIAA1549-BRAF fusion transcripts and [[NF1]] cases reported<ref>{{Cite journal | last1 = Jones | first1 = DT. | last2 = Hutter | first2 = B. | last3 = Jäger | first3 = N. | last4 = Korshunov | first4 = A. | last5 = Kool | first5 = M. | last6 = Warnatz | first6 = HJ. | last7 = Zichner | first7 = T. | last8 = Lambert | first8 = SR. | last9 = Ryzhova | first9 = M. | title = Recurrent somatic alterations of FGFR1 and NTRK2 in pilocytic astrocytoma. | journal = Nat Genet | volume = 45 | issue = 8 | pages = 927-32 | month = Aug | year = 2013 | doi = 10.1038/ng.2682 | PMID = 23817572 }}</ref>

==Prognosis==
*Poor, but better than conventional glioblastoma.<ref>{{Cite journal | last1 = Rodriguez | first1 = FJ. | last2 = Scheithauer | first2 = BW. | last3 = Burger | first3 = PC. | last4 = Jenkins | first4 = S. | last5 = Giannini | first5 = C. | title = Anaplasia in pilocytic astrocytoma predicts aggressive behavior. | journal = Am J Surg Pathol | volume = 34 | issue = 2 | pages = 147-60 | month = Feb | year = 2010 | doi = 10.1097/PAS.0b013e3181c75238 | PMID = 20061938 }}</ref>
*Prognostic unfavourable paramters include: Necrosis, Mitoses and previous radiation.

==See also==
*[[Neuropathology tumours]].
*[[Pilocytic Astrocytoma]].

==References==
{{Reflist|2}}

[[Category:Diagnosis]]
[[Category:Neuropathology tumours]]