Radiopaedia 2021 UPDATE Conference-only registration is now closed. Late registration for All-Access Pass and Free Country Pass holders ends this Friday - LEARN MORE

Gemistocytic astrocytoma

Dr Bruno Di Muzio and Assoc Prof Frank Gaillard et al.

Gemistocytic astrocytoma is a histologic subtype of low grade astrocytoma, with a poorer prognosis than other matched WHO grade tumors, 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 characterized 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 tumor 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 tumors, have a more aggressive behavior compared to fibrillary astrocytomas 1-3. Some authors suggest that they should be considered WHO III tumors 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 favor a more aggressive approach to treatment. 

Astrocytic tumour

Article information

rID: 14597
Synonyms or Alternate Spellings:
  • Gemistocytic astrocytomas

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Figure 1: gemistocytic cells with eosinophilic cytoplasm
    Drag here to reorder.
  • Case 1
    Drag here to reorder.
  • Case 2
    Drag here to reorder.
  • Case 3: anaplastic
    Drag here to reorder.
  • Case 4
    Drag here to reorder.
  • Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.