Magnetic resonance imaging features of gemistocytic astrocytoma

Simkin, Paul; Yang, Natalie; Tsui, Alpha; Fitt, Greg; Gaillard, Frank

doi:10.1111/1754-9485.12550

Cited by 8 publications

(5 citation statements)

References 22 publications

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“…In comparison, most IDH mutant Astrocytomas are found in the frontal lobes. Simkin et al [ 23 ] describe rare Astrocytomas with Gemistocytic differentiation occurring within the brainstem and spinal cord, but we did not encounter any such case in our study. The IDH mutant GA showed a Male to Female ratio of 2.5 to 1 in contrast to the 1.3:1 for IDH mutant Astrocytomas.…”

Section: Discussionmentioning

confidence: 53%

Gemistocytic Differentiation in Isocitrate Dehydrogenase Mutant Astrocytomas: A Histopathological and Survival Analysis

Hassan¹,

Amer²,

Hussain³

et al. 2023

Cureus

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Gemistocytic differentiation is a rare histological feature seen in IDH mutant Astrocytomas. The 2021 World Health Organization (WHO) retains the diagnosis of IDH mutant Astrocytoma with its classical histology and tumors with the rare histological pattern of gemistocytic differentiation. Gemistocytic differentiation has historically been associated with a worse prognosis and shorter survival, and this prognostic difference has not been investigated in detail in our population.A population-based retrospective study included 56 patients with IDH mutant Astrocytoma with Gemistocytic differentiation and IDH mutant Astrocytoma diagnosed between 2010 and 2018 in our hospital. Demographic, histopathological, and clinical parameters were compared between the two groups. Gemistocyte percentage, perivascular lymphoid infiltrates, and Ki-67 proliferation index were also analyzed. A Kaplan-Meier analysis was done to analyze any prognostic difference in the overall survival time between the two groups.Patients with an IDH mutant Astrocytoma having gemistocytic differentiation had an average survival period of 2 years, while patients diagnosed with an IDH mutant Astrocytoma had an average survival time of approximately 6 years. There was a statistically significant decrease in survival time (p = 0.005) for patients with tumors with gemistocytic differentiation. The percentage of gemistocytes and the presence of perivascular lymphoid aggregates did not correlate with survival time (p = 0.303 and 0.602, respectively). Tumors with gemistocytic morphology had a higher mean Ki-67 proliferation index (4.4%) than IDH mutant Astrocytoma (2.0%, p = 0.005).Our data suggest that IDH mutant Astrocytoma with Gemistocytic differentiation is an aggressive variant of IDH mutant Astrocytoma associated with a shorter survival time and an overall worse prognosis. This data might be helpful to clinicians in the future management of IDH mutant Astrocytoma with Gesmistocytic differentiation as an aggressive tumor.

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Section: Discussionmentioning

confidence: 53%

Gemistocytic Differentiation in Isocitrate Dehydrogenase Mutant Astrocytomas: A Histopathological and Survival Analysis

Hassan¹,

Amer²,

Hussain³

et al. 2023

Cureus

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“…Per a 1991 study by Krouwer et al [106], as low as a 5% gemistocytic component within a patient's astrocytoma is sufficient to negatively impact prognosis. In 2016, Simkin et al [107] described the use of MRI in diagnosing gemistocytic astrocytomas. Specifically, gemistocytic astrocytoma evaluation should be considered in patients with heterogeneous cystic lesions that display contrast enhancement and partial FLAIR suppression [107].…”

Section: Diagnostic Imagingmentioning

confidence: 99%

“…In 2016, Simkin et al [107] described the use of MRI in diagnosing gemistocytic astrocytomas. Specifically, gemistocytic astrocytoma evaluation should be considered in patients with heterogeneous cystic lesions that display contrast enhancement and partial FLAIR suppression [107]. Recent literature has emerged on the use of MRI to predict tumor grade in IDH-mutant astrocytomas and oligodendrogliomas [108].…”

Section: Diagnostic Imagingmentioning

confidence: 99%

Update for astrocytomas: medical and surgical management considerations

Willman

Figg

et al. 2023

Explor Neurosci

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Astrocytomas include a wide range of tumors with unique mutations and varying grades of malignancy. These tumors all originate from the astrocyte, a star-shaped glial cell that plays a major role in supporting functions of the central nervous system (CNS), including blood-brain barrier (BBB) development and maintenance, water and ion regulation, influencing neuronal synaptogenesis, and stimulating the immunological response. In terms of epidemiology, glioblastoma (GB), the most common and malignant astrocytoma, generally occur with higher rates in Australia, Western Europe, and Canada, with the lowest rates in Southeast Asia. Additionally, significantly higher rates of GB are observed in males and non-Hispanic whites. It has been suggested that higher levels of testosterone observed in biological males may account for the increased rates of GB. Hereditary syndromes such as Cowden, Lynch, Turcot, Li-Fraumeni, and neurofibromatosis type 1 have been linked to increased rates of astrocytoma development. While there are a number of specific gene mutations that may influence malignancy or be targeted in astrocytoma treatment, O6-methylguanine-DNA methyltransferase (MGMT) gene function is an important predictor of astrocytoma response to chemotherapeutic agent temozolomide (TMZ). TMZ for primary and bevacizumab in the setting of recurrent tumor formation are two of the main chemotherapeutic agents currently approved in the treatment of astrocytomas. While stereotactic radiosurgery (SRS) has debatable implications for increased survival in comparison to whole-brain radiotherapy (WBRT), SRS demonstrates increased precision with reduced radiation toxicity. When considering surgical resection of astrocytoma, the extent of resection (EoR) is taken into consideration. Subtotal resection (STR) spares the margins of the T1 enhanced magnetic resonance imaging (MRI) region, gross total resection (GTR) includes the margins, and supramaximal resection (SMR) extends beyond the margin of the T1 and into the T2 region. Surgical resection, radiation, and chemotherapy are integral components of astrocytoma treatment.

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“…В литературе можно встретить лишь небольшое количество работ, которые освещают непосред-ственно ГА [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. По сравнению с диффузными астроцитомами GII они характеризуются более агрессивным биологическим поведением, что проявляется более короткой общей выживаемо-стью пациентов (38-49 мес и 69-89 мес.…”

Section: онкология / Oncologyunclassified

“…В. А. Алмазова» Минздрава России, Санкт-Петербург, Россия 2 Федеральное государственное бюджетное образовательное учреждение высшего образования «Северо-Западный государственный медицинский университет им. И. И. Мечникова» Минздрава России, Санкт-Петербург, Россия 3 Государственное бюджетное учреждение здравоохранения «Санкт-Петербургский клинический научно-практический центр специализированных видов медицинской помощи (онкологический)», Санкт-Петербург, Россия 4 Санкт-Петербургский Государственный Университет, Санкт-Петербург, Россия 5 Частное образовательное учреждение высшего образования «Санкт-Петербургский медико-социальный институт», Санкт-Петербург, Россия 6 Федеральное государственное бюджетное учреждение «Национальный медицинский исследовательский центр онкологии им. Н.Н.…”

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