Gemistocytic astrocytoma

Gemistocytic astrocytoma is a histologic subtype of low grade astrocytoma, with a poorer prognosis than other matched WHO grade tumours, and with no specific imaging features. 

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

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. 


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Article Information

rID: 14597
Section: Pathology
Synonyms or Alternate Spellings:
  • Gemistocytic astrocytomas

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    Figure 1: gemistocytic cells with eosinophilic cytoplasm
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    Case 2
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    Case 3: anaplastic
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