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1.
Gac. méd. Méx ; 155(5): 439-446, Sep.-Oct. 2019. tab, graf
Article in English | LILACS | ID: biblio-1286540

ABSTRACT

Introduction: Gliomas are neoplasms with high recurrence and mortality. Due to the difficulty to apply the World Health Organization (2016) classification, developing countries continue to use histological evaluation to diagnose and classify these neoplasms. Objective: To develop a semi-quantitative scale to numerically grade gliomas by its morphological characteristics. Method: A cohort of patients with gliomas was assessed and followed for 36 months. Tumor tissue sections were analyzed and graded, including aspects such as cell line, cellularity, nuclear pleomorphism, mitosis, endothelial hyperplasia, hypoxic changes, apoptotic bodies, necrosis, hemorrhage and proliferation index. Results: 58 cases were analyzed. Low-grade gliomas median score was 12 points (9 and 13.5 for percentiles 25 and 75, respectively), whereas for high-grade gliomas it was 17 points (16 and 20.5 for percentiles 25 and 75, respectively) (p < 0.0001). Thirty-six-month survival of patients with low (13/17) and high grade gliomas (6/41) was also significantly different (p < 0.0001). Conclusions: The semi-quantitative morphological scale allows an objective evaluation of gliomas, with an adequate correlation between the score, tumor grade and survival time.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Brain Neoplasms/pathology , Glioma/pathology , Oligodendroglioma/mortality , Oligodendroglioma/pathology , Astrocytoma/mortality , Astrocytoma/pathology , Brain Neoplasms/classification , Brain Neoplasms/mortality , Survival Analysis , Cohort Studies , Glioblastoma/mortality , Glioblastoma/pathology , Ependymoma/mortality , Ependymoma/pathology , Neoplasm Grading , Glioma/classification
2.
Rev. Assoc. Med. Bras. (1992) ; 64(12): 1129-1133, Dec. 2018. tab, graf
Article in English | LILACS | ID: biblio-976809

ABSTRACT

SUMMARY OBJECTIVE: This study aims to compare estrogen receptor expression between low and high-grade astrocytomas. METHOD: A study using paraffin blocks of glial tumors from the Anatomy Pathology archives of São Marcos Hospital was carried out and began after approval by the Review Board of the Federal University of Piaui. Specimens were histochemically marked with an anti-ER alpha antibody. Brown-stained nuclei were considered positive, regardless of reaction intensity. Data were statistically analyzed using the Mann-Whitney test and Spearman's correlation. Statistical significance was established at p<0.05. RESULTS: The mean percentage of nuclei stained with anti-ER alpha in low-and high-grade astrocytomas was 0.04 and zero, respectively, while Spearman's correlation showed a strong negative association between low and high-grade tumors (p<0.001) and (r= −0.67), respectively. CONCLUSION: In the current study, estrogen receptor expression was positive only in low-grade astrocytomas and nil in high-grade astrocytomas, showing that ER expression declines with the grade of tumor malignancy.


RESUMO OBJETIVO: O objetivo deste estudo é comparar a expressão do receptor de estrogênio entre astrocitomas de baixo e alto grau. MÉTODO: Foi realizado um estudo usando blocos de parafina de tumores gliais dos arquivos de Anatomia Patológica do Hospital São Marcos e iniciado após aprovação pelo Comitê de Ética da Universidade Federal do Piauí. Os espécimes foram marcados histoquimicamente com anticorpo anti-ER alpha. Os núcleos corados em marrom foram considerados positivos, independentemente da intensidade da reação. Os dados foram analisados estatisticamente utilizando o teste de Mann-Whitney e a correlação de Spearman. A significância estatística foi estabelecida em p<0,05. RESULTADOS: A porcentagem média de núcleos corados com anti-ER alfa em astrocitomas de baixo e alto grau foi de 0,04 e zero, respectivamente, enquanto a correlação de Spearman mostrou uma forte correlação negativa entre tumores de baixa e alta qualidade (p<0,001) e (r=-0,67), respectivamente. CONCLUSÕES: No presente estudo, a expressão do receptor de estrogênio foi positiva apenas em astrocitomas de baixo grau e nula em astrocitomas de alto grau, mostrando que a expressão de ER diminui com o grau de malignidade tumoral.


Subject(s)
Humans , Astrocytoma/metabolism , Brain Neoplasms/metabolism , Receptors, Estrogen/metabolism , Biomarkers, Tumor/metabolism , Gene Expression Regulation, Neoplastic , Astrocytoma/pathology , Brain Neoplasms/pathology , Immunohistochemistry , Neoplasm Grading
3.
Clinics ; 71(8): 481-486, Aug. 2016. tab, graf
Article in English | LILACS | ID: lil-794633

ABSTRACT

Gliomas are the most common type of primary central nervous system neoplasm. Astrocytomas are the most prevalent type of glioma and these tumors may be influenced by sex steroid hormones. A literature review for the presence of estrogen and progesterone receptors in astrocytomas was conducted in the PubMed database using the following MeSH terms: “estrogen receptor beta” OR “estrogen receptor alpha” OR “estrogen receptor antagonists” OR “progesterone receptors” OR “astrocytoma” OR “glioma” OR “glioblastoma”. Among the 111 articles identified, 13 studies met our inclusion criteria. The majority of reports showed the presence of estrogen and progesterone receptors in astrocytomas. Overall, higher tumor grades were associated with decreased estrogen receptor expression and increased progesterone receptor expression.


Subject(s)
Humans , Male , Female , Astrocytoma/metabolism , Brain Neoplasms/metabolism , Receptors, Estrogen/metabolism , Receptors, Progesterone/metabolism , Astrocytoma/pathology , Biomarkers, Tumor/metabolism , Brain Neoplasms/pathology , Neoplasm Grading
4.
São Paulo; s.n; s.n; 2014. 189 p. tab, graf, ilus.
Thesis in Portuguese | LILACS | ID: biblio-847104

ABSTRACT

Glioblastoma multiforme (G BM), ou astrocitoma grau IV, é o tumor mais comum e letal do sistema nervoso central. Uma de suas características mais marcantes é seu alto potencial invasivo do tecido normal adjacente. Neste processo, o remodelamento da matriz extracelular, modulado por enzimas que degradam seus componentes e por inibidores destas enzimas, é crucial. Foi descrito que a expressão de MMP-2 e MMP-9, membros da família das metaloproteinases de matriz, aumentam conforme a progressão de astrocitomas. A variante canônica de RECK suprime a invasão tumoral e metástase através da inibição da atividade de, pelo menos, três MMPs: MMP-2, MMP-9 e MMP-14. Uma correlação positiva tem sido observada entre a abundância da expressão de RECK em amostras tumorais e um prognóstico mais favorável para pacientes com diversos tipos de tumores. Neste estudo, variantes de splicing do gene supressor de tumor RECK foram identificadas através da análise de Expressed sequenced Tags (ESTs), isoladas por RT-PCR, sequenciadas e clonadas. Três novas variantes de splicing do gene RECK foram identificadas e caracterizadas. O perfil de expressão dos transcritos de RECK foi determinado através de ensaios de RT-PCR quantitativo em um painel de tecidos normais e, também, durante a progressão de astrocitomas. Foram utilizadas, para esta análise, amostras macro dissecadas de tumores de pacientes com astrocitomas grau I (n=15), II (n=15), III (n=15) e GBMs (n=30). Os resultados mostram que maior expressão de RECK canônico, acompanhada de maior razão de expressão da variante canônica em relação às variantes de splicing alternativo, correlaciona positivamente com maior sobrevida global de pacientes com GBM, sugerindo seu papel como potenciais biomarcadores para o prognóstico destes pacientes. Análise funcional das isoform as de RECK em células U87 MG revelou que as células superexpressando as isoformas não apresentam inibição do processo de invasão celular, como observado para superexpressão da proteína canônica. Dentre as isoformas analisadas, destaca-se RECK-B, isoforma potencialmente ancorada à membrana plasmática por GPI, como a proteína canônica RECK, sugerindo uma possível colocalização destas variantes. Observa-se que células superexpressando RECK-B apresentam maior capacidade tumorigênica. Os resultados indicam que as variantes de RECK e o balanço entre a expressão destas variantes, apresentam um papel importante no comportamento e na agressividade de GBMs, tendo potencial valor na clínica. Além disso, para abrir perspectivas para o estudo das variantes de RECK, o balanço de expressão dos transcritos canônico e alternativos deste gene foi explorado durante os processos de diferenciação osteogênica e adipogênica. Os resultados indicam que a expressão da variante canônica é mais abundante em relação à expressão de suas isoformas em estágios tardios da adipogênese, sendo que o perfil inverso é observado em relação à isoforma B durante a osteogênese, sugerindo que o balanço entre os níveis de expressão das isformas de RECK possui um potencial papel biológico que deve ser explorado durante esses processos. Em conjunto, os resultados demonstram a existência de, pelo menos, três variantes de splicing do gene supressor de tumor RECK com envolvimento na tumorigênese e na diferenciação celular, abrindo novas perspectivas para o estudo e a aplicação do gene RECK na clínica


Glioblastoma multiforme (GBM) or grade IV astrocytoma is the most common and lethal tumor of the central nervous system. One of the most striking features of GBMs is their invasive potential of the normal surrounding brain tissue. It has been described that MMP-2 and MMP-9 expression levels increase during astrocytoma progression. Canonical RECK suppresses tumor invasion and metastasis by negatively regulating at least three matrix metalloproteinases, namely: MMP-9, MMP-2 and MT1-MMP. A positive correlation has been observed between the abundance of RECK express ion in tumor samples and a more favorable prognosis for patients with several types of tumors. In this study, splice variants of the RECK tumor suppressor gene were identified by Expressed Sequence Tag (EST) analysis, isolated by RT-PCR, sequenced and cloned. Three novel alternatively spliced variants of the RECK tumor suppressor gene were identified and characterized. The RECK transcripts expression profiles were investigated using quantitative RT-PCR assays in a normal tissue RNA panel and, also, during astrocytoma progression in macrodissected tumor samples of patients with astrocytoma grades I (n=15), II (n=15), III (n=15) and IV/GBM (n=30). The results show that higher canonical RECK expression, accompanied by a higher ratio of canonical to alternative transcript expression, positively correlated with higher overall survival rate after chemotherapeutic treatment of GBM patients. Our findings suggest that these RECK transcript variants may potentially be used as biomarkers for prognosis of GBM patients. U87 MG cells overexpressing each RECK alternative variant were generated and found to lack the supressive role of cellular invasion processes found upon overexpressing the canonical protein. Among the characterized isoforms, RECK-B stands out, since this isoform is potentially anchored to the cell membrane by a GPI anchor, exactly as the canonical RECK and, also, since cells overexpressing RECK-B display greater tumorigenic capacity. The results indicate that RECK variants and the balance between the expressions of these variants, play an important role in the behavior and aggressiviness of GBMs, therefore have a potential translational application. In addition, in order to investigate new perspectives for the analysis of these isoforms, the expression balance of RECK transcripts was assessed during osteogenesis and adipogenesis, by qRT - PCR. The results show that the expression of the canonical RECK variant is more abundant that that of its alternative isoforms in later stages of adipogenic differentiation. The opposite profile is found regarding RECK-B during osteogenesis, suggesting that the balance between the expressions of these transcripts may have a potential role during these processes. Taken together, the results show the existence of, at least, three alternatively spliced variants of the RECK tumor suppressor gene, which are involved in tumogigenesis and cellular differentiation, o pening new perspectives for studies and clinical application of the RECK gene


Subject(s)
Alternative Splicing , Astrocytoma/pathology , Biomarkers, Tumor , Glioblastoma/pathology , Brain Neoplasms/complications , Gene Expression/genetics , Matrix Metalloproteinase 2/analysis , Matrix Metalloproteinase 9/analysis , Polymerase Chain Reaction/methods
5.
Medicina (B.Aires) ; 73(3): 201-206, jun. 2013. ilus, tab
Article in Spanish | LILACS | ID: lil-694765

ABSTRACT

La tomografía por emisión de positrones con metionina carbono 11 (11C-metionina PET/TC) se utiliza en la evaluación de los tumores primarios del sistema nervioso central. Describimos nuestra experiencia sobre los primeros 4 pacientes con tumores de la serie glial estudiados con 11C-metionina PET/TC. Este es un estudio descriptivo, observacional y prospectivo. Se presentan 4 pacientes entre 38-50 años de edad con diagnóstico de gliomas (clasificación de la OMS). A todos se les realizó RM y 11C-metionina PET/TC para evaluar actividad tumoral y diferenciar progresión tumoral de pseudoprogresión. Caso 1, gliomatosis cerebri grado II posradioterapia. Caso 2, glioblastoma grado IV postratamiento RT + temozolomida. Caso 3, oligodendroglioma grado II posradioterapia en 1993. Caso 4, oligoastrocitoma anaplásico grado III postratamiento RT + temozolomida. El patrón de captación de la 11C-metionina comparativamente con la RM, demostró progresión tumoral en los casos 1, 3 y 4; en el caso 2 mostró captación aunque el diagnóstico final fue pseudoprogresión. A diferencia del PET con 18fluordeoxiglucosa, la captación de 11C-metionina en el tejido cerebral normal y en la pseudoprogresión es baja, y los gliomas se visualizan como áreas metabólicamente activas. En los casos presentados, el 11C-metionina PET/TC proveyó información valiosa sobre el comportamiento y extensión de la lesión, aunque en uno de los casos presentados no diferenció progresión tumoral de pseudoprogresión. El 11C-metionina PET/TC sería una herramienta útil en el estudio y seguimiento de los pacientes con gliomas.


Positron emission tomography (PET) with 11C-methionine (11C-methionine PET/CT) is a new technique used to evaluate primary central nervous system (CNS) tumors. We describe our experience regarding the first 4 patients with glial tumors and 11C-methionine PET/CT. This is a descriptive, observational and prospective study of 4 patients between 38-50 years of age, with different gliomas (WHO classification). MRI and 11C-methionine PET/CT were performed in all cases. Case 1, gliomatosis cerebri grade II post-radiotherapy. Case 2, oligodendroglioma grade II diagnosed and treated with radiotherapy in 1993. Case 3, glioblastoma grade IV post-radiotherapy + temozolomide. Case 4, anaplastic oligoastrocytoma grade III post-radiotherapy + temozolomide. The pattern of 11C-methionine uptake compared with MRI showed tumor progression in cases 1, 3 and 4, and in case 2 showed uptake although the final diagnosis was pseudoprogression. Unlike 18fluordeoxiglucose PET/TC, 11C-methionine uptake in normal brain tissue and pseudoprogression is low, and gliomas are displayed as metabolically active areas. The 11C-methionine PET/CT provided valuable information on the tumoral behavior and extension, although in one case presented did not differentiate tumor progression from pseudoprogression. 11C-methionine PET/CT could be a useful tool in the study and follow-up to patients with gliomas.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Brain Neoplasms , Glioma , Methionine , Multimodal Imaging/methods , Positron-Emission Tomography/methods , Radiopharmaceuticals , Astrocytoma/pathology , Astrocytoma , Brain Neoplasms/pathology , Gliosarcoma/pathology , Gliosarcoma , Prospective Studies , Tomography, X-Ray Computed/methods
6.
Acta cir. bras ; 28(1): 48-54, jan. 2013. ilus, tab
Article in English | LILACS | ID: lil-662347

ABSTRACT

PURPOSE: To evaluate the relationship between microvascular density and the expression of vascular endothelial growth factor (VEGF) and KIT as possible markers of angiogenic stimulus in astrocytic tumors and correlate it with histopathological grading. METHODS: We enrolled 99 surgical specimens of supratentorial astrocytic tumors for analysis of VEGF and KIT and subsequent correlation with MVD and grading. RESULTS: KIT and VEGF expression correlated with microvascular density (p<0.005) and both VEGF and microvascular density correlated with grading (p<0.005). KIT had no significant relationship with grading (p=0.657). CONCLUSION: KIT and VEGF constitute important pathways in the angiogenesis of astrocytomas and therefore are promising prognostic tools and options for therapeutic intervention.


Subject(s)
Adult , Aged , Female , Humans , Male , Young Adult , Astrocytoma/pathology , Neovascularization, Pathologic/pathology , Proto-Oncogene Proteins c-kit/metabolism , Supratentorial Neoplasms/pathology , Biomarkers, Tumor/metabolism , Vascular Endothelial Growth Factor A/metabolism , Age Distribution , Immunohistochemistry , Microvessels/pathology , Neoplasm Grading , Retrospective Studies , Statistics, Nonparametric
8.
Arq. neuropsiquiatr ; 71(1): 31-34, Jan. 2013. ilus, tab
Article in English | LILACS | ID: lil-662409

ABSTRACT

A retrospective study of 81 patients with low-grade astrocytoma (LGA) comparing the efficacy of aggressive versus less aggressive surgery in eloquent and non-eloquent brain areas was conducted. Extent of surgical resection was analyzed to assess overall survival (OS) and progression- free survival (PFS). Degree of tumor resection was classified as gross total resection (GTR), subtotal resection (STR) or biopsy. GTR, STR and biopsy in patients with tumors in non-eloquent areas were performed in 31, 48 and 21% subjects, whereas in patients with tumors in eloquent areas resections were 22.5, 35 and 42.5%. Overall survival was 4.7 and 1.9 years in patients with tumors in non-eloquent brain areas submitted to GTR/STR and biopsy (p=0.013), whereas overall survival among patients with tumors in eloquent area was 4.5 and 2.1 years (p=0.33). Improved outcome for adult patients with LGA is predicted by more aggressive surgery in both eloquent and non-eloquent brain areas.


Foi realizado estudo retrospectivo em 81 pacientes com astrocitoma de baixo grau (LGA) comparando a eficácia da ressecção cirúrgica com cirurgia menos agressiva em relação à área eloquente e não eloquente do cérebro. A extensão da ressecção cirúrgica foi analisada para avaliar a sobrevida geral (OS) e o tempo livre de doença (PFS). O grau da ressecção cirúrgica foi classificado como ressecção total (GTR), subtotal (STR) e biópsia. Nos pacientes com lesão em área não eloquente foram realizadas GTR, STR e biópsia em 31, 48 e 21% dos casos, enquanto, naqueles com lesão em área eloquente, em 22,5, 35 e 42,5%, respectivamente. A sobrevida geral foi de 4,7 e 1,9 anos em pacientes com lesões em área não eloquente submetidos à GTR/STR e biópsia (p=0,013). Nos pacientes com lesão em áreas eloquentes, a sobrevida geral foi de 4,5 e 2,1 anos (p=0,33), respectivamente. A extensão da ressecção é fator preditivo de sobrevida tanto nas lesões em áreas eloquentes quanto nas não eloquentes.


Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Astrocytoma/surgery , Brain Neoplasms/surgery , Neurosurgical Procedures/methods , Astrocytoma/mortality , Astrocytoma/pathology , Biopsy , Brain Neoplasms/mortality , Brain Neoplasms/pathology , Neoplasm Grading , Neoplasm Invasiveness , Prognosis , Retrospective Studies , Survival Analysis , Treatment Outcome
9.
Arq. neuropsiquiatr ; 71(1): 35-39, Jan. 2013. ilus, tab
Article in English | LILACS | ID: lil-662417

ABSTRACT

Pleomorphic xanthoastrocytoma (PXA) is a rare glioma. This paper aimed to analyze magnetic resonance imaging (MRI) characteristics in a series of patients diagnosed with PXA. We analyzed MRI findings in 9 patients with histopathologic diagnosis of PXA in our department over the last 12 years. The mean age of patients was 27.3 years. Cortical location was observed in all cases. The lesion imaging was solid-cystic in six cases. In eight cases, the solid component presented hypo or isointense on T1 and iso or hyperintense on T2. Contrast enhancement in the solid component was observed in eight cases. The observed imaging pattern of PXA was superficial location with leptomeningeal involvement, solid-cystic pattern and contrast enhancement in the solid component. We should consider that the association between PXA and other cortical tumors may occur, particularly, with gangliogliomas, which tend to be the main differential diagnosis in MRI.


Xantoastrocitoma pleomórfico (PXA) é um glioma raro. Este estudo teve como objetivo analisar aspectos de imagem por ressonância magnética (RM) de uma série de pacientes com diagnóstico de PXA. Foram analisados exames de RM de 9 pacientes com diagnóstico histopatológico de PXA nos últimos 12 anos. A média de idade dos pacientes foi de 27,3 anos. Localização cortical foi observada em todos os casos. Padrão sólido-cístico foi observado em seis casos. Em oito casos, o componente sólido apresentou-se hipo ou isointenso em T1 e iso ou hiperintenso em T2. Foi observada captação de contraste na porção sólida em oito casos. O padrão de imagem observado do PXA foi de localização superficial com envolvimento leptomeníngeo, padrão sólido-cístico e captação de contraste pelo componente sólido. Devemos considerar que a associação entre PXA e outros tumores corticais pode ocorrer, particularmente, com ganglioglioma, que tende a ser o principal diagnóstico diferencial em RM.


Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Astrocytoma/pathology , Brain Neoplasms/pathology , Magnetic Resonance Imaging
10.
Arq. neuropsiquiatr ; 70(9): 710-714, Sept. 2012. ilus, tab
Article in English | LILACS | ID: lil-649315

ABSTRACT

Dysembryoplastic neuroepithelial tumor (DNT), described in 1988 and introduced in the WHO classification in 1993, affects predominantly children or young adults causing intractable complex partial seizures. Since it is benign and treated with surgical resection, its recognition is important. It has similarities with low-grade gliomas and gangliogliomas, which may recur and become malignant. OBJECTIVES: To investigate whether DNT was previously diagnosed as astrocytoma, oligodendroglioma, or ganglioglioma and to determine its frequency in a series of low-grade glial/glio-neuronal tumors. METHODS: Clinical, radiological, and histological aspects of 58 tumors operated from 1978 to 2008, classified as astrocytomas (32, including 8 pilocytic), oligodendrogliomas (12), gangliogliomas (7), and DNT (7), were reviewed. RESULTS: Four new DNT, one operated before 1993, previously classified as astrocytoma (3) and oligodendroglioma (1), were identified. One DNT diagnosed in 2002 was classified once more as angiocentric glioma. Therefore, 10 DNT (17.2%) were identified. CONCLUSIONS: Clinical-radiological and histopathological correlations have contributed to diagnose the DNT.


O tumor neuroepitelial disembrioplásico (DNT), descrito em 1988 e incorporado na classificação da OMS em 1993, acomete predominantemente crianças ou adultos jovens, causando crises convulsivas parciais complexas farmacorresistentes. Como é benigno e tratável com ressecção cirúrgica, seu reconhecimento é importante. Tem semelhanças com gliomas de baixo grau e gangliogliomas, que podem recidivar e malignizar. OBJETIVOS: Investigar se o DNT foi originalmente diagnosticado como astrocitoma, oligodendroglioma ou ganglioglioma e determinar sua frequência numa série de neoplasias gliais/glioneuronais de baixo grau. MÉTODOS: Foram revistos aspectos clínicos, radiológicos e histológicos de 58 neoplasias operadas entre 1978 e 2008, classificadas como astrocitomas (32, sendo 8 pilocíticas), oligodendrogliomas (12), gangliogliomas (7) e DNT (7). RESULTADOS: Foram identificados quatro novos DNT, um operado antes de 1993, originalmente diagnosticado como astrocitoma (3) e oligodendroglioma (1). Um DNT diagnosticado em 2002 foi reclassificado como glioma angiocêntrico. Portanto, 10 DNT (17,2%) foram identificados. CONCLUSÕES: Correlações clínico-radiológicas e histopatológicas contribuíram para o diagnóstico do DNT.


Subject(s)
Adolescent , Adult , Child , Child, Preschool , Humans , Young Adult , Brain Neoplasms/pathology , Neoplasms, Neuroepithelial/pathology , Astrocytoma/pathology , Biopsy , Diagnosis, Differential , Epilepsy/complications , Ganglioglioma/pathology , Magnetic Resonance Imaging , Oligodendroglioma/pathology , Retrospective Studies , Tomography, X-Ray Computed , World Health Organization
11.
Einstein (Säo Paulo) ; 10(2)apr.-jun. 2012. ilus
Article in English, Portuguese | LILACS | ID: lil-644890

ABSTRACT

Pilomyxoid astrocytoma, an entity described as a histological variant of pilocytic astrocytoma, is a rare primary tumor of the central nervous system. It is usually located in the hypothalamic-chiasmatic area, affecting children with a mean age of 10 months. It has a high rate of recurrence and cerebrospinal fluid dissemination, which may be present throughout the neuroaxis. Due to its topography, it may present developmental delay in childhood and diencephalic syndrome, characterized by extreme weight loss, lack of fat accumulation, hyperactivity, euphoria and alertness. Magnetic resonance imaging has an important role in its diagnosis, staging and follow-up of pilomyxoid astrocytoma. However, for a definitive diagnosis, anatomopathology is particularly important to differentiate it from pilocytic astrocytoma. Some cases, as in this present one, have simultaneous histological features of pilocytic and pilomyxoid astrocytomas, constituting a group called intermediate pilomyxoid astrocytoma. Surgery is the best treatment option and it usually requires adjuvant therapy.


O astrocitoma pilomixoide, entidade descrita como variante histológica do astrocitoma pilocítico, é um raro tumor primário do sistema nervoso central. Geralmente, localiza-se em topografia hipotálamoquiasmática, acomentendo crianças com idade média de 10 meses. Apresenta alta taxa de recorrência e disseminação liquórica, podendo se apresentar ao longo de todo o neuroeixo. Dada sua topografia, pode se apresentar com atraso do desenvolvimento na infância e síndrome diencefálica, caracterizada por emagrecimento extremo, ausência de acúmulo de tecido adiposo, hiperatividade motora, euforia e estado de alerta. A ressonância magnética possui um papel importante para o diagnóstico, estadiamento e seguimento do astrocitoma pilomixoide. No entanto, para o diagnóstico definitivo, o estudo anatomopatológico é fundamental, principalmente na diferenciação com o astrocitoma pilocítico. Além disso, em alguns casos, como o aqui apresentado, evidencia-se a apresentação simultânea de características histológicas do astrocitoma pilomixoide e pilocítico, constituindo um grupo denominado astrocitoma pilomixoide intermediário. A cirurgia é a melhor opção de tratamento e geralmente há necessidade de tratamento adjuvante.


Subject(s)
Humans , Child , Astrocytoma/pathology , Diencephalon , Magnetic Resonance Imaging
12.
AJM-Alexandria Journal of Medicine. 2012; 48 (2): 131-137
in English | IMEMR | ID: emr-145348

ABSTRACT

Pilocytic astrocytomas are the second overall most common pediatric brain tumor. Magnetic resonance [MR] imaging is widely used in the diagnosis and follow up of pediatric patients with pilocytic astrocytomas because of its ability to provide anatomical detail. However conventional MR imaging does not provide information about tissue biochemistry. To study the role of proton magnetic resonance spectroscopy in diagnosis of pilocytic astrocytoma in children. This study included seven pediatric patients with histopathologically proven pilocytic astrocytoma. All patients were subjected to full history taking and thorough clinical examination. Magnetic resonance [MR] imaging was performed at 1.5 Tesla MR system using a standard head coil. Imaging included conventional MRI and proton magnetic resonance spectroscopy. Proton magnetic resonance spectroscopy was done using either single or multi-voxel technique. Surgical biopsy was then performed to all patients and correlation with histopathological data was done. Out of the seven patients included in this study, six were females and one was male with mean age of 9.5 years, the tumor was located in five of them in the posterior fossa, located in right thalamo-peduncular region in one patient and located in the hypothalamic-chiasmatic region in one patient. MR spectroscopic study showed the same findings in all the lesions including high Cho/NAA and Cho/Cr ratios [3.53 +/- 1.5] and [7.21 +/- 4.2], respectively, relative low concentration of creatine with increased NAA/Cr ratio [2.32 +/- 1.1]. Lactate doublet was detected in all cases while no lipid peaks were detected. Based on the findings in this study we suggest that pilocytic astrocytoma has a specific spectroscopic metabolic profile which could be diagnostic for this type of tumor


Subject(s)
Humans , Female , Male , Child , Magnetic Resonance Spectroscopy/methods , Astrocytoma/pathology , Histology
13.
Indian J Pathol Microbiol ; 2011 Jul-Sept 54(3): 520-525
Article in English | IMSEAR | ID: sea-142035

ABSTRACT

Background : The MIB-1 labeling index (LI) has proved to be useful in assigning grading and prognosis to astrocytomas. The purpose of our study was to analyze the utility of MIB-1 LI in differentiating astrocytomas of varying grades and the possible relationships of MIB-1 LI with clinical parameters like age and sex. We also wanted to study the prognostic role of MIB-1 index in predicting behavior of astrocytomas. Materials and Methods : Our study included 145 patients with astrocytic tumors of varying grades. Immunolabeling for all patients was done using MIB-1 antibody. Survival data could be obtained for 64 patients. A Mann-Whitney U test was used to test the difference in MIB-1 LI between different histological grades. The univariate analysis was done by the Kaplan-Meier method, and the multivariate analysis for survival was performed using the Cox proportional hazard model. Results : Significant differences were noted in mean MIB-1 LI of high-grade and low-grade diffuse astrocytomas. MIB-1 LI did not vary significantly with age and sex. Univariate analysis showed favorable prognostic factors for low histopathological grade, young patient age and low MIB-1 LI; however, multivariate analysis showed that only histopathological grade had independent prognostic significance. Conclusions : Our study proves that MIB-1 LI is not dependent on factors like age and sex and is solely dependent on histological grade. Though the average level of MIB-1 LI varies considerably in the different grades of astrocytomas, considerable overlap can be observed between them. MIB-1 LI is a very useful adjunct to the histopathological diagnosis and can be of great help in situations where the clinical and radiological findings do not correlate with histological diagnosis.


Subject(s)
Adolescent , Adult , Astrocytoma/diagnosis , Astrocytoma/mortality , Astrocytoma/pathology , Child , Female , Humans , Immunohistochemistry/methods , Male , Microscopy , Middle Aged , Prognosis , Severity of Illness Index , Survival Analysis
14.
Clinics ; 65(3): 305-309, 2010. ilus
Article in English | LILACS | ID: lil-544010

ABSTRACT

INTRODUCTION: Astrocytic gliomas are the most common intracranial central nervous system neoplasias, accounting for about 60 percent of all primary central nervous system tumors. Despite advances in the treatment of gliomas, no effective therapeutic approach is yet available; hence, the search for a more realistic model to generate more effective therapies is essential. OBJECTIVE: To develop an experimental malignant astrocytoma model with the characteristics of the human tumor. METHOD: Primary cells from subcutaneous xenograft tumors produced with malignant astrocytoma U87MG cells were inoculated intracerebrally by stereotaxis into immunosuppressed (athymic) Rowett rats. RESULTS: All four injected animals developed non-infiltrative tumors, although other glioblastoma characteristics, such as necrosis, pseudopalisading cells and intense mitotic activity, were observed. CONCLUSION: A malignant astrocytoma intracerebral xenograft model with poorly invasive behavior was achieved in athymic Rowett rats. Tumor invasiveness in an experimental animal model may depend on a combination of several factors, including the cell line used to induce tumor formation, the rat strains and the status of the animal's immune system.


Subject(s)
Animals , Female , Humans , Rats , Astrocytoma/pathology , Brain Neoplasms/pathology , Glioblastoma/pathology , Immunocompromised Host , Brain Neoplasms/immunology , Cell Line, Tumor , Disease Models, Animal , Glioblastoma/immunology , Neoplasm Transplantation , Rats, Nude , Transplantation, Heterologous
15.
Indian J Cancer ; 2009 Apr-Jun; 46(2): 108-19
Article in English | IMSEAR | ID: sea-50507

ABSTRACT

In recent years, there has been a marked improvement in our understanding of molecular genetics of gliomas. These advancements offer hope for development of tailored therapies targeting a tumor's unique molecular profile, and may also translate into improved classification and identification of newer prognostic markers. This review focuses on the neuropathological features of different types of glial neoplasms according to the World Health Organization classification, and the recent advances in their molecular biology with emphasis on the genetic mechanisms underlying tumor progression, diagnostic and prognostic markers and potential therapeutic targets.


Subject(s)
Astrocytoma/genetics , Astrocytoma/pathology , Brain Neoplasms/classification , Brain Neoplasms/genetics , Brain Neoplasms/pathology , Gene Deletion , Glioma/classification , Glioma/genetics , Glioma/pathology , Humans , Oligodendroglioma/genetics , Oligodendroglioma/pathology , Prognosis
16.
Indian J Cancer ; 2009 Apr-Jun; 46(2): 88-95
Article in English | IMSEAR | ID: sea-50345

ABSTRACT

Primary malignant brain tumors account for only 2% of all adult cancers but they cause a disproportionately high cancer-related disability and death. Survival of malignant glioma patients has changed only modestly over the past three decades despite the emergence of new treatment strategies for these tumors. In this review, we describe the standard treatment modalities for malignant glioma, which include surgery, radiation therapy and chemotherapy, as well as the status of novel therapies that have been developed to target various aspects of glioma cell biology. We also address this issue of drug delivery as a factor limiting the efficacy of systemic administration of therapeutics and attempts to overcome this barrier. Further progress towards a cure for malignant gliomas will require a greater understanding of the underlying mechanisms driving the growth, and resistance to therapy, of these challenging tumors.


Subject(s)
Astrocytoma/genetics , Astrocytoma/pathology , Brain Neoplasms/classification , Brain Neoplasms/genetics , Brain Neoplasms/pathology , Gene Deletion , Glioma/classification , Glioma/genetics , Glioma/pathology , Humans , Oligodendroglioma/genetics , Oligodendroglioma/pathology , Prognosis
17.
Medicina (B.Aires) ; 69(1,supl.1): 8-14, 2009. ilus, graf, tab
Article in Spanish | LILACS | ID: lil-633612

ABSTRACT

El objetivo fue describir las características clínico imagenológicas de niños con esclerosis tuberosa que presentaron el complejo Nódulo Subependimario (NS)-Astrocitoma Subependimario Gigantocelular(ASGC) y analizar el comportamiento evolutivo de dicho "complejo" para detectar precozmente su crecimiento y evitar las complicaciones de la hipertensión endocraneana (HTE). Evaluamos 22 pacientes con diagnóstico anátomo patológico de ASGC. El diagnóstico del tumor se realizó a una media de 10.1 años. Pudimos observar la evolución de NS a ASGC; estos NS se ubicaron adyacentes al agujero de Monro y con el tiempo tuvieron un importante crecimiento con intensa captación de contraste e hidrocefalia. La aceleración en el crecimiento de estos NS y su "transformación" en ASGC se produjo a los 10 años de edad promedio, con un diámetro medio de 9 mm. Ningún NS alejado de los forámenes de Monro evolucionó a ASGC. Quince pacientes (68%) fueron operados con síntomas de hipertensión endocraneana. La edad media de la cirugía fue 10.8 años. Seis pacientes presentaron déficit visual. En estos últimos, el diámetro medio mayor del tumor fue 31.5 mm, mayor que los 18.7 mm del grupo de pacientes que no presentó secuela visual. El seguimiento clínico imagenológico periódico de toda lesión subependimaria próxima a los agujeros de Monro, permitiría en etapa presintomática anticipar un tratamiento quirúrgico, que reduciría la incidencia de HTE. Estudios prospectivos podrían determinar si el complejo NS-ASGC corresponde a una misma entidad en distinta etapa evolutiva, o son dos lesiones con diferente potencial de crecimiento.


The object of this paper is to describe the imaging and clinical characteristics of subependymal nodule (SN) - subependymal giant cell astrocytoma (SGCA) complex in tuberous sclerosis and analyze its evolution in order to attempt early detection and the prevention of intracranial hypertension. We evaluated 22 patients with the pathological diagnosis of SGCA. The diagnosis was made at a median of 10.1 years old. We were able to observe the evolution of SN to ASGC: these SN were localized adjacent to the foramen of Monro and with time they underwent an important development with intense contrast enhancement and hydrocephalus. The acceleration in SN growth and its "transformation" into SGCA occurred at an average of 10 years of age, with a mean diameter of 9 mm. No SN located far from the foramen of Monro evolutioned to SGCA. Fifteen patients (68%) were operated with symptoms of intracranial hypertension. Average age at surgery was 10.8 years old. Six patients presented visual deficit and in these, the average diameter of the tumor was 31.5 mm, a high value when compared to 18.7 mm in the patients without visual deficit. The imaging and clinical follow-up of any subependymal lesion close to the foramen of Monro will permit, at a presymptomatic stage, an anticipation of surgical treatment thus reducing intracranial hypertension incidence. Prospective studies could determine whether the SN-SGCA complex corresponds to the same entity in distinct evolution stages or to two lesions with different growth potential.


Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Astrocytoma/pathology , Brain Neoplasms/pathology , Cerebral Ventricles/pathology , Tuberous Sclerosis/pathology , Astrocytoma/surgery , Brain Neoplasms , Brain Neoplasms/surgery , Cerebral Ventricle Neoplasms/pathology , Cerebral Ventricle Neoplasms , Cerebral Ventricle Neoplasms/surgery , Cerebral Ventricles/surgery , Follow-Up Studies , Hydrocephalus/etiology , Intellectual Disability/etiology , Intracranial Hypertension/prevention & control , Tuberous Sclerosis , Tuberous Sclerosis/surgery
18.
Pan Arab Journal of Neurosurgery. 2009; 13 (1): 72-75
in English | IMEMR | ID: emr-92446

ABSTRACT

Low-grade gliomas are uncommon primary brain tumours, located more often in the posterior fossa, optic pathway, and brain stem and less commonly in the cerebral hemispheres. Two patients with diagnosed recurrent cystic pilocytic astrocytoma critically located within the brain [thalamic and brain stem] were treated with gamma knife surgery. Gamma knife surgery did improve the patient's clinical condition very much which remained stable later on. Progressive reduction on the magnetic resonance imaging studies of the solid part of the tumour and almost disappearance of the cystic component was achieved within the follow-up period of 36 months in the first case with the thalamic located lesion, and 22 months in the second case with the brain stem located lesion. Gamma knife surgery represents an alternate tool in the treatment of recurrent and/or small postoperative residual pilocytic astrocytoma especially located


Subject(s)
Humans , Female , Radiosurgery , Brain Stem Neoplasms/pathology , Astrocytoma/pathology , Thalamic Diseases/surgery , Magnetic Resonance Imaging
19.
Pan Arab Journal of Neurosurgery. 2009; 13 (1): 115-118
in English | IMEMR | ID: emr-92455

ABSTRACT

A case of a very rare intra-axial brain tumour, consisting of components - maliganant meniongioma, oligodendroglioma and astrocytoma in a 36-year-old man, is described. A review of literature regarding its pathogenesis is presented and a classification for such tumours is proposed to identify pathologically different subgroups among them as they do not belong to a homogenous variety and comparison of different subgroups in not worthwhile


Subject(s)
Humans , Male , Meningioma/pathology , Astrocytoma/pathology , Review Literature as Topic , Brain Neoplasms/classification , Tomography, X-Ray Computed
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