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Pediatrics
Diagnosis
Brain
Cysts and Neoplasms
Pilocytic Astrocytoma
Pilocytic Astrocytoma
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Pilocytic astrocytoma (PA)

            • Definitions

              • Low-grade (WHO grade1) astrocytic tumor characterized by densely fibrillated regions containing Rosenthal fibers at microscopy

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Campion T et al: Surveillance imaging of grade 1 astrocytomas in children: can duration and frequency of follow-up imaging and the use of contrast agents be reduced? Neuroradiology. 63(6):953-8, 2021
                                            2. Sathyakumar K et al: Neuroimaging of pediatric infratentorial tumors and the value of diffusion-weighted imaging (DWI) in determining tumor grade. Acta Radiol. 62(4):533-40, 2021
                                            3. McAuley E et al: The benefit of surveillance imaging for paediatric cerebellar pilocytic astrocytoma. Childs Nerv Syst. 35(5):801-5, 2019
                                            4. Tabash MA: Characteristics, survival and incidence rates and trends of pilocytic astrocytoma in children in the United States; SEER-based analysis. J Neurol Sci. 400:148-52, 2019
                                            5. Gaudino S et al: MR imaging of brain pilocytic astrocytoma: beyond the stereotype of benign astrocytoma. Childs Nerv Syst. 33(1):35-54, 2017
                                            6. Alkonyi B et al: Differential imaging characteristics and dissemination potential of pilomyxoid astrocytomas versus pilocytic astrocytomas. Neuroradiology. 57(6):625-38, 2015
                                            7. Collins VP et al: Pilocytic astrocytoma: pathology, molecular mechanisms and markers. Acta Neuropathol. 129(6):775-88, 2015
                                            8. Nabavizadeh SA et al: High accuracy of arterial spin labeling perfusion imaging in differentiation of pilomyxoid from pilocytic astrocytoma. Neuroradiology. 57(5):527-33, 2015
                                            9. Chourmouzi D et al: Manifestations of pilocytic astrocytoma: a pictorial review. Insights Imaging. 5(3):387-402, 2014
                                            10. de Fatima Vasco Aragao M et al: Comparison of perfusion, diffusion, and MR spectroscopy between low-grade enhancing pilocytic astrocytomas and high-grade astrocytomas. AJNR Am J Neuroradiol. 35(8):1495-502, 2014
                                            11. Ostrom QT et al: CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro Oncol. 16 Suppl 4:iv1-63, 2014
                                            12. Rodriguez Gutierrez D et al: Metrics and textural features of MRI diffusion to improve classification of pediatric posterior fossa tumors. AJNR Am J Neuroradiol. 35(5):1009-15, 2014
                                            13. Forbes JA et al: Pediatric cerebellar pilomyxoid-spectrum astrocytomas. J Neurosurg Pediatr. 8(1):90-6, 2011
                                            14. Foroughi M et al: Spontaneous regression of septum pellucidum/forniceal pilocytic astrocytomas--possible role of Cannabis inhalation. Childs Nerv Syst. 27(4):671-9, 2011
                                            15. Dorward IG et al: Postoperative imaging surveillance in pediatric pilocytic astrocytomas. J Neurosurg Pediatr. 6(4):346-52, 2010
                                            16. Kumar VA et al: Magnetic resonance dynamic susceptibility-weighted contrast-enhanced perfusion imaging in the diagnosis of posterior fossa hemangioblastomas and pilocytic astrocytomas: initial results. J Comput Assist Tomogr. 34(6):825-9, 2010
                                            17. Porto L et al: Proton magnetic resonance spectroscopic imaging in pediatric low-grade gliomas. Brain Tumor Pathol. 27(2):65-70, 2010
                                            18. Linscott LL et al: Pilomyxoid astrocytoma: expanding the imaging spectrum. AJNR Am J Neuroradiol. 29(10):1861-6, 2008
                                            19. Koeller KK et al: From the archives of the AFIP: pilocytic astrocytoma: radiologic-pathologic correlation. Radiographics. 24(6):1693-708, 2004
                                            20. Arslanoglu A et al: MR imaging characteristics of pilomyxoid astrocytomas. AJNR Am J Neuroradiol. 24(9):1906-8, 2003
                                            21. Fernandez C et al: Pilocytic astrocytomas in children: prognostic factors--a retrospective study of 80 cases. Neurosurgery. 53(3):544-53; discussion 554-5, 2003
                                            22. Kaschten B et al: Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med. 39(5):778-85, 1998
                                            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

                                                        • Pilocytic astrocytoma (PA)

                                                      • Definitions

                                                        • Low-grade (WHO grade1) astrocytic tumor characterized by densely fibrillated regions containing Rosenthal fibers at microscopy

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Campion T et al: Surveillance imaging of grade 1 astrocytomas in children: can duration and frequency of follow-up imaging and the use of contrast agents be reduced? Neuroradiology. 63(6):953-8, 2021
                                                                                      2. Sathyakumar K et al: Neuroimaging of pediatric infratentorial tumors and the value of diffusion-weighted imaging (DWI) in determining tumor grade. Acta Radiol. 62(4):533-40, 2021
                                                                                      3. McAuley E et al: The benefit of surveillance imaging for paediatric cerebellar pilocytic astrocytoma. Childs Nerv Syst. 35(5):801-5, 2019
                                                                                      4. Tabash MA: Characteristics, survival and incidence rates and trends of pilocytic astrocytoma in children in the United States; SEER-based analysis. J Neurol Sci. 400:148-52, 2019
                                                                                      5. Gaudino S et al: MR imaging of brain pilocytic astrocytoma: beyond the stereotype of benign astrocytoma. Childs Nerv Syst. 33(1):35-54, 2017
                                                                                      6. Alkonyi B et al: Differential imaging characteristics and dissemination potential of pilomyxoid astrocytomas versus pilocytic astrocytomas. Neuroradiology. 57(6):625-38, 2015
                                                                                      7. Collins VP et al: Pilocytic astrocytoma: pathology, molecular mechanisms and markers. Acta Neuropathol. 129(6):775-88, 2015
                                                                                      8. Nabavizadeh SA et al: High accuracy of arterial spin labeling perfusion imaging in differentiation of pilomyxoid from pilocytic astrocytoma. Neuroradiology. 57(5):527-33, 2015
                                                                                      9. Chourmouzi D et al: Manifestations of pilocytic astrocytoma: a pictorial review. Insights Imaging. 5(3):387-402, 2014
                                                                                      10. de Fatima Vasco Aragao M et al: Comparison of perfusion, diffusion, and MR spectroscopy between low-grade enhancing pilocytic astrocytomas and high-grade astrocytomas. AJNR Am J Neuroradiol. 35(8):1495-502, 2014
                                                                                      11. Ostrom QT et al: CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2007-2011. Neuro Oncol. 16 Suppl 4:iv1-63, 2014
                                                                                      12. Rodriguez Gutierrez D et al: Metrics and textural features of MRI diffusion to improve classification of pediatric posterior fossa tumors. AJNR Am J Neuroradiol. 35(5):1009-15, 2014
                                                                                      13. Forbes JA et al: Pediatric cerebellar pilomyxoid-spectrum astrocytomas. J Neurosurg Pediatr. 8(1):90-6, 2011
                                                                                      14. Foroughi M et al: Spontaneous regression of septum pellucidum/forniceal pilocytic astrocytomas--possible role of Cannabis inhalation. Childs Nerv Syst. 27(4):671-9, 2011
                                                                                      15. Dorward IG et al: Postoperative imaging surveillance in pediatric pilocytic astrocytomas. J Neurosurg Pediatr. 6(4):346-52, 2010
                                                                                      16. Kumar VA et al: Magnetic resonance dynamic susceptibility-weighted contrast-enhanced perfusion imaging in the diagnosis of posterior fossa hemangioblastomas and pilocytic astrocytomas: initial results. J Comput Assist Tomogr. 34(6):825-9, 2010
                                                                                      17. Porto L et al: Proton magnetic resonance spectroscopic imaging in pediatric low-grade gliomas. Brain Tumor Pathol. 27(2):65-70, 2010
                                                                                      18. Linscott LL et al: Pilomyxoid astrocytoma: expanding the imaging spectrum. AJNR Am J Neuroradiol. 29(10):1861-6, 2008
                                                                                      19. Koeller KK et al: From the archives of the AFIP: pilocytic astrocytoma: radiologic-pathologic correlation. Radiographics. 24(6):1693-708, 2004
                                                                                      20. Arslanoglu A et al: MR imaging characteristics of pilomyxoid astrocytomas. AJNR Am J Neuroradiol. 24(9):1906-8, 2003
                                                                                      21. Fernandez C et al: Pilocytic astrocytomas in children: prognostic factors--a retrospective study of 80 cases. Neurosurgery. 53(3):544-53; discussion 554-5, 2003
                                                                                      22. Kaschten B et al: Preoperative evaluation of 54 gliomas by PET with fluorine-18-fluorodeoxyglucose and/or carbon-11-methionine. J Nucl Med. 39(5):778-85, 1998