General:
- Adult tumor
- poorly circumscribed, parenchymal, infiltrating growth pattern
- WHO grade II (standard)
- WHO grade III (anaplastic) - more mitotically active
- If there is necrosis, it is considered a GBM
- Better prognosis than infiltrating astrocytomas - may be because they respond better to therapy
- Can occur anywhere in the brain - including intraventricularly (may resemble central neurocytoma)
Molecular biology:
- 1p and 19q codeletion - marker of response to chemotherapy and radiation and thus better prognosis. More characteristic of oligodendroglioma (vs astrocytoma)
- Intact 1p/19q: worse response to chemo/RT
Path
- fried egg appearance - round nuclei with halos (retraction artifact?)
- in background of normal neurons - infiltrating cells
- can occur with fine/small branching capillaries giving it a "chicken wire" appearance
Imaging:
- Usually calcified (70-90% calcified)
- Sometimes focally hemorrhagic. Sometimes (20%) cystic.
- CT bright: calcifications or hemorrhage, may erode overlying skull
- T1 dark, T2 bright
- Minimal peritumoral edema
- May enhance, enhancement usually heterogenous
- These tumors typically go all the way to the outer cortex of the brain
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