A8TROCYT A8TROCYT MA MA A8TROCYT A8TROCYT MA MA

Ernie G. Bautista , RN Ernie G. Bautista , RN

FEU FEU- -NRMF nstitute of Medicine NRMF nstitute of Medicine
A8TROCYTOMA
A Lype of neoplasm of Lhe braln
CrlglnaLe ln a parLlcular klnd of
gllalcells sLarshaped braln cells ln
Lhe cerebrum called asLrocyLes
usually found ln Lhe cerebral
hemlspheres
MosL ofLen ln Lhe 46
Lh
decades
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
Etiology: Etiology:
All All grades have been assoclaLed grades have been assoclaLed
wlLh cranlal LherapeuLlc lrradlaLlon wlLh cranlal LherapeuLlc lrradlaLlon
exposure Lo pesLlcldes exposure Lo pesLlcldes nn nlLroso nlLroso
compounds compounds
Lndogenous Lndogenous muLaLlons caused by muLaLlons caused by
Lhese agenLs or oLher causes acL Lo Lhese agenLs or oLher causes acL Lo
produce produce asLrocyLomas asLrocyLomas
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
JC gradlng scheme
W W Crade l Crade l llocyLlc asLrocyLoma
W W Crade ll Crade ll Lowgrade (dlffuse)
asLrocyLoma
W W CCrade lll rade lll AnaplasLlc asLrocyLoma
W W Crade lv Crade lv ClloblasLoma
mulLlforme (C8M)
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
GRADE I: GRADE I:
W lowgrowlng benlgn wlLh
longLerm survlval
W Macro exam CfLen cysLlc lf
solld ls a well clrcumscrlbed
or less lnfllLraLlve
W M|cro exam JlLh blpolar
cells wlLh long Lhln halrllke"
processes LhaL are ClA
poslLlve form dense
flbrlllary meshworks
8osenLhal flbers and
eoslnophlllc granular bodles
are ofLen presenL
W (+) surglcal removal
radlaLlon
GRADE I: GRADE I:
W lowgrowlng benlgn wlLh
longLerm survlval
W Macro exam CfLen cysLlc lf
solld ls a well clrcumscrlbed
or less lnfllLraLlve
W M|cro exam JlLh blpolar
cells wlLh long Lhln halrllke"
processes LhaL are ClA
poslLlve form dense
flbrlllary meshworks
8osenLhal flbers and
eoslnophlllc granular bodles
are ofLen presenL
W (+) surglcal removal
radlaLlon
GRADE II: GRADE II:
W lowgrowlng usually benlgn
someLlmes evolve lnLo more
mallgnanL or hlghergrade
Lumors
W 1umor cells peneLraLe lnLo Lhe
surroundlng normal braln
W Mlld Lo moderaLe lncrease ln
gllal cellularlLy varlable
nuclear pleomorphlsm an
lnLervenlng felLwork of flne
ClAposlLlve asLrocyLlc
processes LhaL glve Lhe
background a flbrlllary
appearance
GRADE II: GRADE II:
W lowgrowlng usually benlgn
someLlmes evolve lnLo more
mallgnanL or hlghergrade
Lumors
W 1umor cells peneLraLe lnLo Lhe
surroundlng normal braln
W Mlld Lo moderaLe lncrease ln
gllal cellularlLy varlable
nuclear pleomorphlsm an
lnLervenlng felLwork of flne
ClAposlLlve asLrocyLlc
processes LhaL glve Lhe
background a flbrlllary
appearance
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
GRADE III: GRADE III:
W More densely cellular have
greaLer nuclear
pleomorphlsm marked
mlLoLlc flgures
W CfLen relaLed Lo selzures
neurologlc deflclLs
headaches or changes ln
menLal sLaLus
W Landard lnlLlal LreaLmenL
8emove as much of Lhe Lumor
as posslble wlLhouL worsenlng
neurologlc deflclLs
GRADE III: GRADE III:
W More densely cellular have
greaLer nuclear
pleomorphlsm marked
mlLoLlc flgures
W CfLen relaLed Lo selzures
neurologlc deflclLs
headaches or changes ln
menLal sLaLus
W Landard lnlLlal LreaLmenL
8emove as much of Lhe Lumor
as posslble wlLhouL worsenlng
neurologlc deflclLs
GRADE IV: GRADE IV:
W lmllar Lo anaplasLlc
asLrocyLoma wlLh Lhe
addlLlonal feaLures of necros|s
vascu|ar or endothe||a| ce||
pro||ferat|on
W necrosls ln glloblasLoma ofLen
occurs ln a serpenLlne paLLern
ln areas of hypercellularlLy
W 1umor cells collecL along Lhe
edges of Lhe necroLlc reglons
produclng a hlsLologlc paLLern
referred Lo as pseudo
pa||sad|ng
GRADE IV: GRADE IV:
W lmllar Lo anaplasLlc
asLrocyLoma wlLh Lhe
addlLlonal feaLures of necros|s
vascu|ar or endothe||a| ce||
pro||ferat|on
W necrosls ln glloblasLoma ofLen
occurs ln a serpenLlne paLLern
ln areas of hypercellularlLy
W 1umor cells collecL along Lhe
edges of Lhe necroLlc reglons
produclng a hlsLologlc paLLern
referred Lo as pseudo
pa||sad|ng
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
Molecular Molecular Pathogenesis: Pathogenesis:
MuLaLlons ln p33 overexpresslon of
uClA mosL common alLeraLlons ln
Lhe lowgrade asLrocyLoma
1umor suppressor genes (k8
p16/cukNoA) Lumor suppressor on
chromosome 19q are assoclaLed wlLh
Lhe hlgher grade asLrocyLoma
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
Molecular Pathogenesis: Molecular Pathogenesis:
ClloblasLoma occur ln one of Lwo
cllnlcal seLLlngs
r|mary g||ob|astoma Secondary g||ob|astoma
MosL commonly as new
onseL dlsease
1yplcally ln older lndlvlduals
ave ampllflcaLlon of
MuM2 (gene LhaL encodes
an lnhlblLor of p33)
ave ampllfled (LCl8) genes
JlLh a pasL hlsLory of lower
grade asLrocyLoma
ln younger paLlenLs
ave p33 muLaLlons
ave lncreased slgnallng
Lhrough Lhe uClA recepLor
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s
Clinical course: Clinical course:
W MosL common presenLlng slgns and sympLoms
selzures headaches focal neurologlc deflclLs
relaLed Lo Lhe anaLomlc slLe of lnvolvemenL
W Crade ll Lhe mean survlval ls 3 years
W 34 wlLhouL LreaLmenL
W 70 wlLh radlaLlon Lherapy
W Crade lll 18 monLhs wlLh LreaLmenL (radlaLlon
and chemoLherapy)
W oor prognosls for glloblasLoma
W 17wks wlLhouL LreaLmenL
W 37wks wlLh LreaLmenL
Introduct|on Lt|o|ogy Grad|ng scheme Morpho|ogy C||n|ca| course athogenes|s