Changes for page Section 19.1: Astrocytic Tumors

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1		-Section 19.1: Astrocytoma
	1	+Section 19.1: Astrocytic Tumors

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1		-== Astrocytoma ==
	1	+= Astrocytoma =
	2	+==General Characteristics==
	3	+Astrocytomas tend to grow along fiber tracts, versus in brain parenchyma.
2	2
3		-==== Histological appearance ====
	5	+==Diagnosis==
	6	+Diagnosis is made largely from adequate MR imaging of the head. Histological studies may confirm diagnosis.
	7	+===Imaging===
	8	+When malignancy is suspected, the highest priority for imaging is magnetic resonance. CT imaging may assist in the decision to perform a lumbar puncture.
	9	+===Lumbar Puncture===
	10	+Perform only if intracranial pressure is shown to be normal.
	11	+====Histology of CSF====
	12	+Tell me what you'd see in CSF
	13	+====Protein counts of CSF====
	14	+Which proteins would suggest astrocytoma?
	15	+====Volume of CSF====
	16	+Tell me what kind of volume you'd expect.
4	4
5		-===== Pilocytic =====
	18	+==Grades==
	19	+Grade I astrocytic tumors: pilocytic astrocytoma, desmoplastic infantile astrocytoma, and subependymal giant cell astrocytoma
	20	+Grade II astrocytoma: low-grade, diffuse fibrillary astrocytoma (nuclear atypia and no or rare mitoses)
	21	+Grade III astrocytoma: anaplastic astrocytoma (nuclear atypia and marked mitotic activity)
	22	+Grade IV astrocytoma: glioblastoma (atypia, mitoses, and microvascular proliferation or necrosis)
6	6
7		-Pilocytic astrocytomas are relatively common. They are also known as Grade I gliomas. Pilocytic astrocytomas are well differentiated and are essentially just hyperplastic astrocytes.
8	8
9		-===== Desmoplastic =====
	25	+==Grade I astrocytomas==
	26	+In general, grade I astrocytomas are benign and resemble nothing more than an increased mass of astrocytes. They grow somewhere...
10	10
11		-I don't know anything about these.
	28	+====Pilocytic====
	29	+======Definition======
	30	+Pilocytic astrocytomas are relatively common. They are well differentiated and are essentially just hyperplastic astrocytes.
12	12
13		-===== Subependymal Giant Cell Astrocytomas =====
	32	+======Prognosis======
	33	+As compared to [[pediatric medulloblastomas>>]] and [[glioblastomas>>]], prognosis for pilocytic astrocytoma is good. Patients are expected to live in xyz% of cases.
14	14
15		-These are big.
	35	+====Desmoplastic infantile====
	36	+Desmoplastic are different.
16	16
	38	+====Subependymal giant cell====
	39	+These are giant.
17	17
18		-==== Metastasis ====
19	19
20		-Astrocytomas are not likely to metastasize.
	42	+==Grade II astrocytomas==
	43	+====Diffuse fibrillary astrocytoma====
	44	+In contrast to pilocytic astrocytomas, diffuse fibrillary astrocytomas show nuclear atypia. They usually do not show marked mitosis.
21	21
22	22
23		-==== Interventions ====
	47	+==Grade III astrocytomas==
	48	+====Anaplastic====
	49	+======General characteristic of anaplastic neoplasms======
	50	+Anaplastic astrocytomas show significant growth rates (i.e., mitosis). This makes for poorer prognosis and less predictability in terms of their anatomical location.
24	24
25		-As with all brain malignancies, interventions are selected largely upon anatomical location. Surgical and non-surgical interventions are possible.
	52	+======Particular considerations in treatment======
	53	+Due to their high rate of mitotic activity, colchicine and other drugs that prevent microtubule polymerization may be effective.
26	26
27	27
28		-==== Prognosis ====
	56	+==Grade IV astrocytomas: Glioblastoma==
	57	+===Histological characteristics===
	58	+As with lower-grade astrocytomas, glioblastomas show hyperplasia, nuclear atypia, and mitotic activity. Additionally, they exhibit microvascular proliferation, making them capable of metastasis.
	59	+===Prognosis===
	60	+Glioblastomas are bad mothers. Call your family and spend as much time with them as possible.
29	29
30		-As compared to [[pediatric medulloblastomas>>]] and [[glioblastomas>>]], prognosis for pilocytic astrocytoma is good. Patients are expected to live in xyz% of cases.