Astroblastoma: A Case Report

Kim, Dong Sug; Park, So Yoon; Lee, Sang Pyung

doi:10.3346/jkms.2004.19.5.772

Cited by 24 publications

(20 citation statements)

References 13 publications

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“…In the present tumor, nearly all of the tumor cells were positive for EMA. EMA expression has been noted in many astroblastomas; however, it is generally a focal phenomenon . Focal cytokeratin (CAM5.2) expression has also been reported in some astroblastomas …”

Section: Discussionmentioning

confidence: 99%

Cerebral astroblastoma in an adult: An immunohistochemical, ultrastructural and genetic study

Fu¹,

Taniguchi²,

Takeuchi³

et al. 2012

Neuropathology

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Astroblastoma is a rare glial tumor of unknown origin, usually affecting the cerebral hemispheres of children and young adults. Here we report an unusual cerebral tumor in a 60-year-old woman. On MRI, the tumor appeared as a well circumscribed lesion in the left frontal lobe. Histopathologically, it was composed of rounded eosinophilic cells, and was divisible into two areas. One area was characterized by a collection of GFAP-positive cells around sclerotic blood vessels (astroblastic pseudorosettes and perivascular hyalinization), and had a Ki-67 labeling index of 2.8%. However, the other area was highly cellular, showing many GFAP-negative cells often with a rhabdoid appearance, mitoses and a Ki-67 index of 15.7%. Thus, a final diagnosis of malignant astroblastoma was made. In both areas of the tumor, nearly all the cells were positive for epithelial membrane antigen, and many were positive for oligodendrocyte transcription factor 2 (Olig2). Focal expression of cytokeratin was also evident. With regard to genetic markers, the tumor cells were positive for INI1 and negative for mutant IDH1. The p53 labeling index was <1%. Ultrastructurally, the presence of intra- and intercellular lumina with microvilli was a feature. DNA examination of IDH1/2 and TP53 showed no mutations. In conclusion, although ependymal features were evident ultrastructurally in the present tumor, the immunohistochemical expression pattern of Olig2 was that of diffuse astrocytoma. On the other hand, the absence of mutations in both IDH1/2 and TP53 suggested that the present tumor was not a purely astrocytic neoplasm. Further studies, including molecular and genetic analyses, will provide insight into the histogenesis of astroblastoma.

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Section: Discussionmentioning

confidence: 99%

Cerebral astroblastoma in an adult: An immunohistochemical, ultrastructural and genetic study

Fu¹,

Taniguchi²,

Takeuchi³

et al. 2012

Neuropathology

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“…Central areas of necrosis, or hemorrhage into cystic cavities may be seen. Tumors may display prominent perivascular hyalinization and regional hyaline changes (Brat et al 2000;Kim et al 2004). Microscopically, astroblastomas have a characteristic appearance.…”

Section: Pathologymentioning

confidence: 99%

Uncommon glial tumors

Chen¹,

Elder²,

González-Gómez³

et al. 2012

Brain Tumors

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“…The low-grade type includes astroblastomas with uniform perivascular arrangement of pseudorosettes, low to moderate number of mitotic figures, little cellular atypia, minimal or no vascular endothelial proliferation, and predominant sclerosis of the vascular walls. High-grade astroblastomas show high cytological atypia, increased mitotic figures, compact cellularity, perivascular cells with high mitotic rates, and hypertrophy of vascular endothelium without hyalinization (5,12,21). This has prognostic value, as patients with a low-grade astroblastoma survive for a longer time than those with the anaplastic form.…”

Section: █ Case Reportmentioning

confidence: 96%

“…Gross total resection may result in long-term survival. An anaplastic histology has been associated with recurrence and progression, suggesting that more aggressive treatment, including radiotherapy, is necessary for high-grade lesions (5,7,21,25,29,34,38). Combination chemotherapy has had encouraging success regarding the prognosis (30).…”

Section: █ Case Reportmentioning

confidence: 99%

“…3) Rarefied spaces between pseudorosettes, 4) Absence of abundant fibrillary pattern, 5) Difference in nuclear characteristics (9,12,21,22,33) Pathological grading of astroblastoma is classified into low and high grade. The low-grade type includes astroblastomas with uniform perivascular arrangement of pseudorosettes, low to moderate number of mitotic figures, little cellular atypia, minimal or no vascular endothelial proliferation, and predominant sclerosis of the vascular walls.…”

Section: █ Case Reportmentioning

confidence: 99%

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Astroblastoma; case report and review of literature

Barakat

Ammar²,

Salama³

et al. 2014

Turkish Neurosurgery

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ABSTRACTa gradual progressive course for the last two weeks. He presented with recurrent attacks of vomiting and confusion that rapidly worsened. Neurologically, the patient was confused and uncooperative with recurrent attacks of vomiting and bradycardia but no other neurological symptoms or signs. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a well-demarcated enhancing spaceoccupying lesion, that was partially cystic, partially calcified in the subependymal area of the left frontal lobe partially projecting into the frontal horn of the lateral ventricle and causing obstructive hydrocephalus (Figure 1). We managed the patient as an urgent case in our intensive care unit (ICU) and performed urgent external ventricular drainage to manage the increased intracranial pressure (ICP). About one week later, we performed surgery for tumor resection by left frontal craniotomy. The tumor was pink-yellow in color, highly vascular, soft in consistency in parts and firm and calcified in other parts and was partially succable and well circumscribed which allowed total resection of the tumor. After the surgery, the patient ws transported routinely to the ICU for 3 days. Follow-up CT showed gross total resection (GTR) with mild postoperative brain edema at the site of surgery. The patient was followed up periodically every month for the first 3 months and then every 6 months without postoperative chemotherapy or radiotherapy and without recurrence. After one year, he showed a recurrent mass at the same site as the primary lesion in the follow-up MRI that was managed █ INTRODUCTION A stroblastoma is a rare glial tumor of the brain. It is estimated to account for 0.45-2.8% of all primary cerebral gliomas (1,30,31). Astroblastomas are initially described by Bailey and Cushing (3) and further characterized by Bailey and Bucy (2). However, much confusion has arisen regarding criteria for their diagnosis in the following years. Moreover, the origin of these tumors has been debated, because they share common histological characteristics with ependymomas and astrocytomas. Recent studies suggested that astroblastoma is a distinct histological and genetic entity (6,7,31,39). It has a distinctive characteristic of perivascular pseudorosettes with frequent vascular hyalinization. Perivascular pseudorosettes in astroblastoma have short and thick cytoplasmic processes and blunt-ended foot plates (30).We introduced a case of astroblastoma and reviewed all relevant literature of astroblastoma in order to discuss astroblastoma from the clinical, pathological, management, and prognostic view points. We tried to discover more secrets of astroblastoma and to introduce a standard approach to its diagnosis and management. █ CASE REPORTA forty-year old male patient complained of headache, nausea, vomiting, and deterioration of conscious level with Astroblastoma is a rare and distinct type of aggressive glial tumor for which there is much confusion regarding the diagnostic criteria. We present a case of astroblastoma and review...

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Astroblastoma: A Case Report

Cited by 24 publications

References 13 publications

Cerebral astroblastoma in an adult: An immunohistochemical, ultrastructural and genetic study

Cerebral astroblastoma in an adult: An immunohistochemical, ultrastructural and genetic study

Uncommon glial tumors

Astroblastoma; case report and review of literature

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