Radiology Quiz 19505 | Radiopaedia.org

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Questions
Findings

Are spinal cord astrocytomas common?

No, but mainly because spinal cord tumours overall are uncommon. Of spinal cord (intramedullary) tumours, astrocytoma are the second most common type, following ependymoma, representing 40% of intramedullary tumours. They account for 60% of paediatric intramedullary tumours, making them the most common spinal cord tumour in children.

Question 2

True or false: Spinal cord astrocytomas can be graded in the same way as supratentorial astrocytomas; namely low grade (WHO II) tumours do not enhance.

Show Answer

False. The vast majority of tumours, even low grade astrocytomas, enhance. In fact it was previously taught that ALL tumours enhance, although that has now clearly been shown not to be the case.

The patient went on to have a biopsy of the lesion.

Histology

MICROSCOPIC DESCRIPTION: The section shows very small fragments of moderately hypercellular tissue. In several fragments there are hypercellular areas composed of cells with moderate nuclear pleomorphism. Cells in these areas show strong immunostaining forGFAP, indicating astrocytic lineage, and an elevated Ki-67/MIB-1 labelling index (approximately 8%). No mitotic figures or areas of necrosis are seen. Thin-walled vessels are noted in some fragments. No vascular endothelial cell hyperplasia is seen. The features are strongly suggestive of astrocytoma.

FINAL DIAGNOSIS: Spinal cord astrocytoma.