Protoplasmic astrocytoma

Case contributed by Dr Jeremy Jones

Presentation

Headaches and first seizure.

Patient Data

Age: 14 years
Gender: Male
Modality: MRI

Large tumour centered on the left middle frontal gyrus. It is T2 bright with areas of T2 hyperintensity that suppress on FLAIR.  Rim-like diffusion restriction and virtually no contrast enhancement.

MICROSCOPIC FINDINGS

Two specimens submitted for analysis:

1. Section shows a moderately cellular tumour comprising astrocytes showing hyperchromatic nuclei, moderate nuclear pleomorphism and ill-defined eosinophilic cytoplasm.  Mitotic activity is not seen.  Rosenthal fibres or eosinophilic granular bodies are not identified.  There is no necrosis or microvascular proliferation.

2. Section shows one fragment of cortex with infiltration by a tumour with appearances similar to those seen in specimen 1.  A Ki-67 stain shows a proliferative index of approximately 10%. Based on the material received, the features are consistent with a low grade glioma.

Features consistent with a low grade glioma and most in keeping with a protoplasmic astrocytoma.

Case Discussion

Protoplasmic astrocytoma is a rare subtype of diffuse low grade astrocytoma.

Until recently, protoplasmic astrocytomas were classified as a subtype low-grade astrocytoma, however, in the latest (2016) update to WHO classification of CNS tumours, protoplasmic astrocytomas no longer exists as a distinct entity. 

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Case Information

rID: 23788
Case created: 8th Jul 2013
Last edited: 4th Apr 2017
Tag: tumour
Inclusion in quiz mode: Included

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