the who 2000 tumor classification - Radiology - Uniformed Services ...

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PILOCYTIC ASTROCYTOMARadiology• Cerebellum, Diencephalon– rare in BS or Cerebrum• Majority have significant “cyst”– “Cyst and Mural Nodule”• part of lining does NOT enhance– Nodule may be heterogeneous– Exceptional purely solid• Nodule has increased water• Calcification in 5-25% 5USU – Learning to Care for Those in Harm’s WayPilocytic AstrocytomaRadiology - http://rad.usuhs.eduUSU – Learning to Care for Those in Harm’s WayUSU – Learning to Care for Those in Harm’s WayPilocytic AstrocytomaRadiology - http://rad.usuhs.edu“Cyst”NoduleRadiology - http://rad.usuhs.eduCyst and Mural Nodule– balanced morphology• Wall may not enhance• Cyst fluid has protein– Not identical to CSF• Nodule low density on CT– may calcify up to 25%• No increase in vascularity• WHO Grade 1• Peak at ~10 yrsUSU – Learning to Care for Those in Harm’s Way“Cyst” with NoduleUSU – Learning to Care for Those in Harm’s Way“Cyst” with NoduleRadiology - http://rad.usuhs.eduRadiology - http://rad.usuhs.eduNOT a true cyst - no lining, just gliosis
USU – Learning to Care for Those in Harm’s WaySharply Demarcated NoduleRadiology - http://rad.usuhs.eduUSU – Learning to Care for Those in Harm’s WayRadiology - http://rad.usuhs.eduCircumscribed Mass:Cyst w/NoduleWHO Gr1 – PilocyticAstrocytomaPushing MarginPATHOLOGY• Biphasic pattern– dense pilocytic glia– Rosenthal fibers– loose microcystic areas• No necrosis• Low grade• Abnormal capillaries– allow enhancement– fluid productionUSU – Learning to Care for Those in Harm’s WayPilocytic AstrocytomaRadiology - http://rad.usuhs.edu• Variant Appearance• Variant LocationUSU – Learning to Care for Those in Harm’s WayPilocytic AstrocytomaRadiology - http://rad.usuhs.eduNot Always !!!A Cyst with mural nodule?Neoplasm + thinrim of enhancinggliosisUSU – Learning to Care for Those in Harm’s WayPilocytic AstrocytomaRadiology - http://rad.usuhs.eduDiffusion is NOT restricted – in either the fluid nor in the nodule
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