Diffuse Astrocytoma

WHO grade II

Diagnosis:

Suggested by MRI and confirmed by pathology (brain biopsy/resection)

Findings on Investigations:

Ill defined, homogenous lesion, cystic degeneration may occur. Usually non-enhancing. Enhancement suggests anaplasia
CT: hypodense. May be unapparent.
T2/FLAIR: high signal

Pathology:

Histology:

  • Nuclear atypia, extremely rare mitosis, no microvascular proliferation, no necrosis
  • Variants: fibrillary, gemistocytic, protoplasmic
  • FISH: deletion of 1q & 19p.
Treatment:

Surgery
Consider Chemotherapy:

  • Temozolamide TMZ if 1p/19q codeletion (200 mg/m2/day for 5 consecutive days, repeated every 28 days).

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