For a general discussion of clinical presentation, epidemiology, treatment please refer to the article on low grade astrocytomas.
Gemistocytic astrocytomas are characterised by a significant gemistocytes population, which are large cells with their cytoplasm filled with eosinophilic material displacing the nucleus eccentrically 1.
It is important to note that other gliomas (e.g. fibrillary astrocytoma and oligodendrogliomas) can have occasional gemistocytes, without being designated a gemistocytic astrocytoma. Some authors use a cut off of 20% of the tumour cells being gemistocytes before designating it as a gemistocytic astrocytoma 1-2.
Although there are no specific features which allow pre-biopsy diagnosis, gemistocytic astrocytomas are almost always supratentorial and usually located in the frontal lobes 4.
Treatment and prognosis
In general gemistocytic astrocytomas, although often still considered WHO II tumours, have a more aggressive behaviour compared to fibrillary astrocytomas 1-3. Some authors suggest that they should be considered WHO III tumours 2.
The median with treatment is only 2.5 years, with a 5-year survival rate of 30% which is significantly worse than other low grade gliomas 4. Older age at presentation appears to be a poor prognostic sign 4.
Given the generally worse prognosis, most clinicians would favour a more aggressive approach to treatment.
- 1. Prayson RA, M.d. BK, Cohen MD. Brain Tumors. Demos Medical Publishing. (2009) ISBN:1933864699. Read it at Google Books - Find it at Amazon
- 2. Tonn J, Westphal M. Neuro-oncology of CNS tumors. Springer Verlag. (2006) ISBN:3540258337. Read it at Google Books - Find it at Amazon
- 3. Tonn J, Westphal M, Rutka JT. Oncology of CNS Tumors. Springer Verlag. (2009) ISBN:364202873X. Read it at Google Books - Find it at Amazon
- 4. Raghavan D. Textbook of uncommon cancer. John Wiley & Sons Inc. (2006) ISBN:0470012021. Read it at Google Books - Find it at Amazon
- WHO classification of CNS tumours
- WHO grading of CNS tumours
- VASARI MRI feature set
- diffuse astrocytoma grading
- grade I:
- grade II:
- grade III
- grade IV:
- glioblastoma vs cerebral metastasis
- radiation-induced gliomas
- gliomatosis cerebri (growth pattern)
- specific locations
- treatment response
- Stupp protocol
- glioma treatment response assessment in clinical trials
- multicentric glioblastoma
- multifocal glioblastoma
- prognostic genetic markers