Gemistocytic astrocytoma

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Synonyms and keywords: Gemistocytic astrocytomas; Diffuse astrocytoma; Low grade astrocytoma

Overview

Gemistocytic astrocytoma is a histologic subtype of low grade astrocytoma, with a poorer prognosis than other matched WHO grade II tumors, and with no specific imaging features.[1]

Pathophysiology

Pathogenesis

  • Gemistocytic astrocytoma is characterized by a significant gemistocyte population, which are large cells with their cytoplasm filled with eosinophilic material displacing the nucleus eccentrically.[2]
  • It is important to note that other gliomas (e.g. fibrillary astrocytoma and oligodendroglioma) can have occasional gemistocytes, without being designated a gemistocytic astrocytoma. A cut off of 20% of the tumor cells being gemistocytes may be used before designating it as a gemistocytic astrocytoma.

Differentiating Fibrillary Astrocytoma from other Diseases

  • Gemistocytic astrocytoma must be differentiated from:[3]

Epidemiology and Demographics

Prevalence

Age

  • Gemistocytic astrocytoma is a rare disease that tends to affect the children and young adult population.[4]
  • The peak age at which gemistocytic astrocytoma is diagnosed ranges between 20-40 years.
  • The mean age at diagnosis is 35 years.

Gender

  • Males are more commonly affected with gemistocytic astrocytoma than females. The male to female ratio is approximately 1.5 to 1.[4]

History and Symptoms

History

  • When evaluating a patient for gemistocytic astrocytoma, you should take a detailed history of the presenting symptom (onset, duration, and progression), other associated symptoms, and a thorough family and past medical history review.

Symptoms

  • Symptoms of gemistocytic astrocytoma include:[5]

References

  1. Gemistocytic astrocytoma. Dr Henry Knipe and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/gemistocytic-astrocytoma. Accessed on January 8, 2016
  2. Pathology of gemistocytic astrocytoma. Dr Henry Knipe and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/gemistocytic-astrocytoma. Accessed on January 8, 2016
  3. Differential diagnosis of low grade infiltrative astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 5, 2016
  4. 4.0 4.1 Epidemiology of gemistocytic astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 8, 2016
  5. Clinical presentation of low grade infiltrative astrocytoma. Dr Ahmed Abd Rabou and A.Prof Frank Gaillard et al. Radiopaedia 2016. http://radiopaedia.org/articles/low-grade-infiltrative-astrocytoma. Accessed on January 8, 2016

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