Pathologic Characteristics of Pediatric Intracranial Pilocytic Astrocytomas and Their Impact on Outcome in 3 Countries

Tihan, Tarık; Erşen, Ayça; Qaddoumi, Ibrahim; Sughayer, Maher A.; Tolunay, Şahsine; Al-Hussaini, Maysa; Phillips, Joanna J.; Gupta, Nalin; Goldhoff, Patricia; Baneerjee, Anu

doi:10.1097/pas.0b013e3182329480

Cited by 42 publications

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References 34 publications

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“…In comparison to the 116 intracranial pilocytic astrocytoma cohort previously reported by our group, 20 pilocytic astrocytoma of the optic nerve showed a significant higher number of affected girls (P ¼ 0.03) but no difference in terms of outcome (P ¼ 0.86), extent of resection (P ¼ 0.7), recurrence (P ¼ 0.37), neurofibromatosis type 1 status (P ¼ 0.92), age of diagnosis (P ¼ 0.11), chemotherapy (P ¼ 0.31), or radiotherapy (P ¼ 0.24).…”

Section: Resultsmentioning

confidence: 86%

“…The latter represented mostly older cases (430 years), where it is well recognized that rates of success for FISH are considerably diminished. Compared with pilocytic astrocytoma of the posterior fossa, 20 the observed frequency of BRAF duplication in pilocytic astrocytoma of the optic nerve was significantly less (P ¼ 0.011; Fischer's exact test). We also used FISH to evaluate for CDKN2A deletions in pilocytic astrocytoma of the optic nerve and found no evidence of CDKN2A alterations.…”

Section: Fish Findingsmentioning

confidence: 82%

“…In addition, existing data were utilized from a recent multi-institutional study of 116 intracranial pilocytic astrocytomas for comparison. 20 Clinical information such as gender, tumor location, type of surgery, and extent of resection was obtained from a review of medical records. Inclusion criteria required that tumors involved only the optic nerve or optic chiasm and that slides were available for review to confirm the diagnosis.…”

Section: Patientsmentioning

confidence: 99%

“…Scoring for cytoplasmic antibodies was carried out using a semiquantitative method described previously. 20 In brief, we determined the ratio of tumor cells staining positive to those staining negative for each antibody without consideration of staining intensity. Cases were semiquantitatively scored as follows (% staining in tumor cells; cytoplasmic staining): (0) no staining (negative); (1) staining in o25%; (2) staining between 25 and 50%; (3) staining between 50 and 75%; and (4) staining in 475%.…”

Section: Immunohistochemistrymentioning

confidence: 99%

“…[20][21][22] For BRAF, we used the RP11-355D18 (KIAA) and RP4-726N20 (BRAF) probes labeled with fluoroisothiocyanate (green) and rhodamine (red), respectively. Nonneoplastic samples were used as controls.…”

Section: Fluorescence In Situ Hybridization Analysismentioning

confidence: 99%

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Pilocytic astrocytomas of the optic nerve and their relation to pilocytic astrocytomas elsewhere in the central nervous system

et al. 2013

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Pilocytic astrocytoma is a low-grade glioma that affects mostly children and young adults and can occur anywhere in the central nervous system. Pilocytic astrocytoma of the optic nerve is an equally indolent subtype that is occasionally associated with neurofibromatosis type 1. In earlier studies, this subtype was considered within the larger category of 'optic pathway glioma,' which included infiltrating astrocytomas and other hypothalamic tumors. However, there have been suggestions that gliomas in the optic nerve, and especially pilocytic astrocytoma of the optic nerve, are biologically different from tumors within the hypothalamus and other parts of the optic tract. Furthermore, the recent discovery of BRAF duplication and fusion with the KIAA1549 gene is reported to be more typical for posterior fossa tumors, and the rate of this aberration is not well known in pilocytic astrocytoma of the optic nerve. To determine the distinction of pilocytic astrocytoma of the optic nerve from pilocytic astrocytoma of the posterior fossa and to investigate the prevalence of BRAF aberrations, we reviewed the clinicopathological and molecular features of all such patients in our institution. Our study demonstrates that BRAF duplication is more frequent in posterior fossa tumors compared with pilocytic astrocytoma of the optic nerve (P ¼ 0.011). However, the rates of phospho-MAPK1 and CDKN2A expression were high in both pilocytic astrocytoma of the optic nerve and posterior fossa pilocytic astrocytoma, suggesting that the MAPK pathway is active in these tumors. Our study supports the notion that BRAF duplication is more typical of posterior fossa pilocytic astrocytoma and that molecular alterations other than KIAA1549 fusion may underlie MAPK pathway activation in pilocytic astrocytoma of the optic nerve.

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Section: Resultsmentioning

confidence: 86%

Section: Fish Findingsmentioning

confidence: 82%

Section: Patientsmentioning

confidence: 99%

Section: Immunohistochemistrymentioning

confidence: 99%

Section: Fluorescence In Situ Hybridization Analysismentioning

confidence: 99%

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Pilocytic astrocytomas of the optic nerve and their relation to pilocytic astrocytomas elsewhere in the central nervous system

et al. 2013

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Tumors of the Central Nervous System

Fung

Petropoulou

2014

Pediatric Malignancies: Pathology and Imaging

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Knowledge of normal neuroanatomy and neurodevelopment is critical to proper diagnosis. A few normal structures may be mistaken as tumor particularly on frozen sections.The external granular layer (Fig. 6.1a ) is a layer of small neurons that covers the external surface of fetal/infant cerebellum. It is quite prominent at the time of birth but is almost completely regressed by the ninth postnatal month. It should not be misinterpreted as medulloblastoma or lymphocytic infi ltration in younger infants. The internal granular layer is also composed of small neurons. Without a size comparison, these cells may be mistaken for medulloblastoma or other small blue cell tumors in minute specimens or cytologic preparations. Conversely medulloblastoma cells, particularly those with smaller nuclei, can be mistaken as internal granular cells. Purkinje cells are rather large and should not be mistaken as rhabdoid cells (Fig. 6.1b ). Other normal structures that can be mistaken for neoplastic tissue include the posterior pituitary and the pineal gland which may be mistaken as glial neoplasm and normal choroid plexus being mistaken as choroid plexus papilloma. These misinterpretations are likely to be committed when the specimen is minute and communication between the pathologist and the neurosurgeon is poor. Overview and Classifi cationTumor of the CNS is not uncommon in the pediatric age group and some of these entities occur only rarely in adults (Table 6.1 ). While meningiomas are very common in adults, it is uncommon in children and almost nonexistent in infants. The most common pediatric tumors in descending order of frequency are pilocytic astrocytoma, diffuse astrocytomas, medulloblastomas, and craniopharyngiomas. Ependymal neoplasms and schwannomas are the most frequent infratentorial tumors. Most tumors occur in the brain with a supratentorial-to-infratentorial ratio of approximately 2-to-1. Malignant CNS neoplasms represent 16.6 % of all malignancies in the pediatric age group. In general, the incidence is higher in males than females and among white compared to black children. The incidence is 36.2 per million between infancy and 7 years of age and 21.0 per million between 7 and 10 years of age. As a group, they are the second most frequent malignancy and most common solid tumor in pediatric patients. About 2,200 new cases are diagnosed annually in the United States. Among CNS malignancies, astrocytic tumors account for 52 %, while medulloblastoma and primitive neuroectodermal tumor (PNET), other gliomas, and ependymomas accounted for 21, 15, and 9 %, respectively [ 2 ].In contrast to adults, there is a high occurrence of malignancies in the cerebellum and brain stem in young children. About 40 % of all thalamic tumors arise in patients under 18 years old and account for 2-5 % of all intracranial tumors in children [ 3 ]. About two third or pediatric thalamic tumors are high grade in histology [ 4 ]. Tumor of the spinal cord represents about 9.9 % and extramedullary tumors are slightly more common than intramedullary...

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Circumscribed Astrocytic Gliomas

Lacruz

2023

Central Nervous System Tumors

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Pathologic Characteristics of Pediatric Intracranial Pilocytic Astrocytomas and Their Impact on Outcome in 3 Countries

Cited by 42 publications

References 34 publications

Pilocytic astrocytomas of the optic nerve and their relation to pilocytic astrocytomas elsewhere in the central nervous system

Pilocytic astrocytomas of the optic nerve and their relation to pilocytic astrocytomas elsewhere in the central nervous system

Tumors of the Central Nervous System

Circumscribed Astrocytic Gliomas

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