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Anaplastic Astrocytoma
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Anaplastic astrocytoma (AA)
            • Synonyms

              • Grade III astrocytoma, malignant astrocytoma, high-grade astrocytoma
            • Definitions

              • Diffusely infiltrating malignant astrocytoma with focal or diffuse anaplasia and marked proliferative potential

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. McCrea HJ et al: Sex, Age, Anatomic Location, and Extent of Resection Influence Outcomes in Children With High-grade Glioma. Neurosurgery. ePub, 2015
                                            2. Nayak L et al: Radiotherapy and temozolomide for anaplastic astrocytic gliomas. J Neurooncol. 123(1):129-34, 2015
                                            3. Ogura R et al: Immunohistochemical profiles of IDH1, MGMT and P53: Practical significance for prognostication of patients with diffuse gliomas. Neuropathology. 35(4): 324-35, 2015
                                            4. Reuss DE et al: Adult IDH wild type astrocytomas biologically and clinically resolve into other tumor entities. Acta Neuropathol. ePub, 2015
                                            5. Speirs CK et al: Impact of 1p/19q codeletion and histology on outcomes of anaplastic gliomas treated with radiation therapy and temozolomide. Int J Radiat Oncol Biol Phys. 91(2):268-76, 2015
                                            6. Gempt J et al: Multimodal imaging in cerebral gliomas and its neuropathological correlation. Eur J Radiol. 83(5):829-34, 2014
                                            7. Minniti G et al: IDH1 mutation and MGMT methylation status predict survival in patients with anaplastic astrocytoma treated with temozolomide-based chemoradiotherapy. J Neurooncol. 118(2):377-83, 2014
                                            8. Rusthoven CG et al: The impact of adjuvant radiation therapy for high-grade gliomas by histology in the United States population. Int J Radiat Oncol Biol Phys. 90(4):894-902, 2014
                                            9. Koukourakis GV et al: Temozolomide with radiation therapy in high grade brain gliomas: pharmaceuticals considerations and efficacy; a review article. Molecules. 14(4):1561-77, 2009
                                            10. Attenello FJ et al: Use of Gliadel (BCNU) wafer in the surgical treatment of malignant glioma: a 10-year institutional experience. Ann Surg Oncol. 15(10):2887-93, 2008
                                            11. Hirai T et al: Prognostic value of perfusion MR imaging of high-grade astrocytomas: long-term follow-up study. AJNR Am J Neuroradiol. 29(8):1505-10, 2008
                                            12. Iwamoto FM et al: Clinical relevance of 1p and 19q deletion for patients with WHO grade 2 and 3 gliomas. J Neurooncol. 88(3):293-8, 2008
                                            13. Moulding HD et al: Revisiting anaplastic astrocytomas I: an expansive growth pattern is associated with a better prognosis. J Magn Reson Imaging. 28(6):1311-21, 2008
                                            14. Paulino AC et al: Radiation-induced malignant gliomas: is there a role for reirradiation? Int J Radiat Oncol Biol Phys. 71(5):1381-7, 2008
                                            15. Walid MS et al: Cerebellar anaplastic astrocytoma in a teenager with Ollier Disease. J Neurooncol. 89(1):59-62, 2008
                                            16. Louis DN et al (eds): WHO Classification of Tumours of the Central Nervous System: Anaplastic Astrocytoma. Lyon, France: IARC Press. 30-2, 2007
                                            17. Louis DN et al: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114(2):97-109, 2007; Erratum in: Acta Neuropathol. 114(5):547, 2007
                                            18. Jellison BJ et al: Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns. AJNR Am J Neuroradiol. 25(3):356-69, 2004
                                            19. Tortosa A et al: Prognostic implication of clinical, radiologic, and pathologic features in patients with anaplastic gliomas. Cancer. 97(4): 1063-71, 2003
                                            20. Burger PC et al: Surgical pathology of the nervous system and its coverings: The Brain: Tumors. 4th ed. Philadelphia: Churchill Livingstone. 177-80, 2002
                                            21. Ironside JW et al: Diagnostic pathology of nervous system tumours: Astrocytic tumors. 1st ed. Edinburgh: Churchill Livingstone. 53-120, 2002
                                            22. Mori S et al: Brain white matter anatomy of tumor patients evaluated with diffusion tensor imaging. Ann Neurol. 51(3): 377-80, 2002
                                            23. Nelson SJ et al: Characterization of untreated gliomas by magnetic resonance spectroscopic imaging. Neuroimaging Clin N Am. 12(4):599-613, 2002
                                            24. Provenzale JM et al: Comparison of permeability in high-grade and low-grade brain tumors using dynamic susceptibility contrast MR imaging. AJR Am J Roentgenol. 178(3):711-6, 2002
                                            25. Wong TZ et al: Positron emission tomography imaging of brain tumors. Neuroimaging Clin N Am. 12(4):615-26, 2002
                                            26. Wild-Bode C et al: Molecular determinants of glioma cell migration and invasion. J Neurosurg. 94(6):978-84, 2001
                                            27. Castillo M et al: Correlation of myo-inositol levels and grading of cerebral astrocytomas. AJNR Am J Neuroradiol. 21(9):1645-9, 2000
                                            28. Kleihues P et al: Pathology and genetics of tumours of the nervous system: Anaplastic astrocytoma. Lyon: IARC Press. 27-8, 2000
                                            29. Rutherford GS et al: Contrast enhanced imaging is critical to glioma nosology and grading. IJNR 1:28-38, 1995
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Anaplastic astrocytoma (AA)
                                                      • Synonyms

                                                        • Grade III astrocytoma, malignant astrocytoma, high-grade astrocytoma
                                                      • Definitions

                                                        • Diffusely infiltrating malignant astrocytoma with focal or diffuse anaplasia and marked proliferative potential

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Nuclear Medicine Findings

                                                              • Imaging Recommendations

                                                                DIFFERENTIAL DIAGNOSIS

                                                                  PATHOLOGY

                                                                  • General Features

                                                                    • Staging, Grading, & Classification

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. McCrea HJ et al: Sex, Age, Anatomic Location, and Extent of Resection Influence Outcomes in Children With High-grade Glioma. Neurosurgery. ePub, 2015
                                                                                      2. Nayak L et al: Radiotherapy and temozolomide for anaplastic astrocytic gliomas. J Neurooncol. 123(1):129-34, 2015
                                                                                      3. Ogura R et al: Immunohistochemical profiles of IDH1, MGMT and P53: Practical significance for prognostication of patients with diffuse gliomas. Neuropathology. 35(4): 324-35, 2015
                                                                                      4. Reuss DE et al: Adult IDH wild type astrocytomas biologically and clinically resolve into other tumor entities. Acta Neuropathol. ePub, 2015
                                                                                      5. Speirs CK et al: Impact of 1p/19q codeletion and histology on outcomes of anaplastic gliomas treated with radiation therapy and temozolomide. Int J Radiat Oncol Biol Phys. 91(2):268-76, 2015
                                                                                      6. Gempt J et al: Multimodal imaging in cerebral gliomas and its neuropathological correlation. Eur J Radiol. 83(5):829-34, 2014
                                                                                      7. Minniti G et al: IDH1 mutation and MGMT methylation status predict survival in patients with anaplastic astrocytoma treated with temozolomide-based chemoradiotherapy. J Neurooncol. 118(2):377-83, 2014
                                                                                      8. Rusthoven CG et al: The impact of adjuvant radiation therapy for high-grade gliomas by histology in the United States population. Int J Radiat Oncol Biol Phys. 90(4):894-902, 2014
                                                                                      9. Koukourakis GV et al: Temozolomide with radiation therapy in high grade brain gliomas: pharmaceuticals considerations and efficacy; a review article. Molecules. 14(4):1561-77, 2009
                                                                                      10. Attenello FJ et al: Use of Gliadel (BCNU) wafer in the surgical treatment of malignant glioma: a 10-year institutional experience. Ann Surg Oncol. 15(10):2887-93, 2008
                                                                                      11. Hirai T et al: Prognostic value of perfusion MR imaging of high-grade astrocytomas: long-term follow-up study. AJNR Am J Neuroradiol. 29(8):1505-10, 2008
                                                                                      12. Iwamoto FM et al: Clinical relevance of 1p and 19q deletion for patients with WHO grade 2 and 3 gliomas. J Neurooncol. 88(3):293-8, 2008
                                                                                      13. Moulding HD et al: Revisiting anaplastic astrocytomas I: an expansive growth pattern is associated with a better prognosis. J Magn Reson Imaging. 28(6):1311-21, 2008
                                                                                      14. Paulino AC et al: Radiation-induced malignant gliomas: is there a role for reirradiation? Int J Radiat Oncol Biol Phys. 71(5):1381-7, 2008
                                                                                      15. Walid MS et al: Cerebellar anaplastic astrocytoma in a teenager with Ollier Disease. J Neurooncol. 89(1):59-62, 2008
                                                                                      16. Louis DN et al (eds): WHO Classification of Tumours of the Central Nervous System: Anaplastic Astrocytoma. Lyon, France: IARC Press. 30-2, 2007
                                                                                      17. Louis DN et al: The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 114(2):97-109, 2007; Erratum in: Acta Neuropathol. 114(5):547, 2007
                                                                                      18. Jellison BJ et al: Diffusion tensor imaging of cerebral white matter: a pictorial review of physics, fiber tract anatomy, and tumor imaging patterns. AJNR Am J Neuroradiol. 25(3):356-69, 2004
                                                                                      19. Tortosa A et al: Prognostic implication of clinical, radiologic, and pathologic features in patients with anaplastic gliomas. Cancer. 97(4): 1063-71, 2003
                                                                                      20. Burger PC et al: Surgical pathology of the nervous system and its coverings: The Brain: Tumors. 4th ed. Philadelphia: Churchill Livingstone. 177-80, 2002
                                                                                      21. Ironside JW et al: Diagnostic pathology of nervous system tumours: Astrocytic tumors. 1st ed. Edinburgh: Churchill Livingstone. 53-120, 2002
                                                                                      22. Mori S et al: Brain white matter anatomy of tumor patients evaluated with diffusion tensor imaging. Ann Neurol. 51(3): 377-80, 2002
                                                                                      23. Nelson SJ et al: Characterization of untreated gliomas by magnetic resonance spectroscopic imaging. Neuroimaging Clin N Am. 12(4):599-613, 2002
                                                                                      24. Provenzale JM et al: Comparison of permeability in high-grade and low-grade brain tumors using dynamic susceptibility contrast MR imaging. AJR Am J Roentgenol. 178(3):711-6, 2002
                                                                                      25. Wong TZ et al: Positron emission tomography imaging of brain tumors. Neuroimaging Clin N Am. 12(4):615-26, 2002
                                                                                      26. Wild-Bode C et al: Molecular determinants of glioma cell migration and invasion. J Neurosurg. 94(6):978-84, 2001
                                                                                      27. Castillo M et al: Correlation of myo-inositol levels and grading of cerebral astrocytomas. AJNR Am J Neuroradiol. 21(9):1645-9, 2000
                                                                                      28. Kleihues P et al: Pathology and genetics of tumours of the nervous system: Anaplastic astrocytoma. Lyon: IARC Press. 27-8, 2000
                                                                                      29. Rutherford GS et al: Contrast enhanced imaging is critical to glioma nosology and grading. IJNR 1:28-38, 1995