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Pilocytic astrocytomas

Yıl 2004, Cilt: 10 Sayı: 1-2, 51 - 56, 01.05.2004

Öz

Pilocytic astrocytoma (PA) is a well circumscribed neoplasm compared to diffuse astrocytoma. It is generally encountered under the age of 20 with a peak incidence between the ages 8 and 13. With respect to incidence, localization is as follows: cerebellum, optic nerve, optic chiasm, third ventricle region, spinal cord and temporal lobe. It arises as an exophytic mass at the dorsal part of the pons. It may be associated with neuorfibromatosis (NF) type I. Allelic loss is noticed at chromosome 17q in the sporadic cases. When compared with diffuse astrocytomas, TP 53 mutation is very low in these tumors. Gross features of pilocytic astrocytoma differ in various localizations. Histologically it is characterized by biphasic tissue pattern. “Rosenthal” fibres, eosinophilic granular bodies and hyalinization of vessels may be observed. Cellular pleomorphism, nuclear hyperchromasia, vascular proliferation, meningeal extension and the presence of necrosis are not indicators of anaplasia. In pilocytic astrocytoma the feature of anaplasia (malignancy) is considerable increase of mitoses. Treatment is total surgical excision. For midline tumors which cannot be removed surgically, radiotherapy may be applied. In children under the age of five with tumors of hypothalamus and optic tract, chemotherapy may be administered till the end of age five in order to protect the child from the traumatic effects of surgery and radiotherapy. Pilocytic astrocytoma is a benign, slow growing neoplasm with a long clinical history. Survival without recurrences may be over 20 years. Malignant recurrence may be rarely encountered (Anaplastic PA, WHO Grade III)

Kaynakça

  • Ellison D, Love S, Chimelli L, Harding B.N, Lowe J, Vinters H.V Astrocytic neoplasms. Mosby: Edinburgh 2004; 623- 640.
  • Fisher PG, Breiter SN, Calson BS et al A clinicopatho- logıcal reappraisal of braın stem tumour classification. Identification of pilocytic astrocytoma and fibrillary astro- cytoma as dıstinct entites. Cancer 2000; 89: 1569-1576.
  • Listernıck R, Louis DN, Packer RJ Gutmann DH et al Optic pathway gliomas in children with neurofibromatosis 1: Consensus statement from the NF 1 Optıc Pathway Glioma Task Force. Ann Neurol 1997; 41: 143-149.
  • Giannini C, Scheithauer BW, Burger PC et al, Cellular proliferation in pilocytıc and diffuse astrocytomas. J Neuro- pathol Exp Neurol 1999; 58: 46-53.
  • Ito S, Hoschino T, Shibuya M etal. Proliferative charac- teristics of juvenile pilocytic astrocytomas determined by bromodeoxyuridine labelling. Neurosurgery 1992; 31: 413- 419.
  • Christoforidis GA, Drevelegas A, Bourekas EC, Karkavelas G. Low grade gliomas. İn: Drevelegas A. (Ed) İmaging of Brain Tumors with Histological Correlations. Springer. Berlin, 2002 241: 40-47.
  • Peter L. Lantos, David N. Louis, Marc K.Rosenblum and Paul Kleihues. Tumors of the Nervous System. In: David I Graham and Peter L Lantos. Greenfield’s Neuropathology Vol 2 Arnold: London. 2002: 767-1052.
  • Deimlıng A von, Louis DN, Menon AG etal, Deletions on the long arm of choromosome 17 in pilocytic astrocytoma. Acta Neuropathol (Berl) 1993: 86-81-5.
  • Shoshan Y, Nıshiyama A, Chang A et al. Expression of oligodendrocyte progenitor cell antigens by gliomas: implications for the histogenesis of brain tumors. Proc Natl Acad Sci USA 1999; 96: 10361-6.
  • Figarella-Branger D, Daniel L, Andre P etal. The PEN5 epitope identifies an oligodendrocyte precursor cell popula- tion and pilocytic astrocytomas Am J Pathol 1999; 155: 1261-9.
  • Kirser RJ de, Wolt Rouendaal D de, Bots GT et al. Optic glioma with intraocular tumour and seeding in a child with neurofibromatosis. Am. J. Ophthalmol 1989; 108: 717-25.
  • Mamelak AN, Prados MD. Obana WG et al. Treatment options and prognosis for multicentric juvenile pilocytic astrocytoma. J Neurosurg 1994; 81: 24-30.
  • Matsumoto T, Uekusa T, Abe H et al. Multıcentric astro- cytomas of the optic chiasm, braın stem and spinal cord. Acta Pathol Jpn 1989; 39: 664-9.
  • Janss AJ, Grundy R, Cnaan A et al (1995) Optic pathway and hypothalamıc (Chismatic gliomas in children younger than age 5 years with a 6-year fallow-up. Cancer 75: 1051- 1059.
  • Perilongo G, Carollo C, Salviati L et al. Diencephalic syndrome and disseminated juvenile pilocytic astrocytomas of the hypothalamic-optic chiazm region. Cancer 1997; 80: 142-6.
  • In: Ironside JW, Moss TH, Louis DN, Lowe JS, Weller RO Astrositic tumors. Churchıll Lıvıngstone: London, 2002, 53- 121.
  • Tomlinson FH, Scheithauer BW, Hayostek C J et al. The sıgnificance of atypia and histologic malignancy in pilocytic astrocytoma of the cerebellum: a clınıcopathologic and flow cytometric study. Child Neurol 1994; 9: 301-310.

Pilositik astrositom

Yıl 2004, Cilt: 10 Sayı: 1-2, 51 - 56, 01.05.2004

Öz

Pilositik astrositom (PA) diffuz astrositom ile karşılaştırıldığında iyi sınırlı bir neoplazmdır. Genellikle 20 yaşın altında görülür, 8-13 yaşları arasında pik yapar. Lokalizasyon, serebellum, optik sinir, optik kiazma, hipotalamus, üçüncü ventrikül bölgesi, spinal kord ve temporal lob olarak sıklık sırasına göre sıralanabilir. Ponsun dorsal bölümünde ekzofitik gelişir. Nörofibromatozis (N.F) tip I ile birlikte görülebilir. Sporadik olanların %20’sinde 17 q kromozomda allelik kayıp görülür. Bu tümörlerde diffüz astrositomlardan farklı olarak TP 53 mutasyonu çok azdır. Pilositik astrositomun makroskopik özellikleri farklı lokalizasyonlarda, farklılık gösterir. Histolojik olarak; bifazik doku paterni ile karakterizedir. “Rosenthal” fibrilleri, eozinofilik granüler cisimcikler ve damarlarda hiyalinizasyon görülebilir. Hücresel pleomorfizm, nükleer hiperkromazi, vasküler proliferasyon, meningial yayılım ve nekrozun bulunuşu anaplazi belirtisi değildir. Pilositik astrositomda anaplazi (malignite) bulgusu, mitozun anlamlı artışıdır. Sağaltım, total cerrahi rezeksiyondur. Cerrahi olarak çıkarılamıyan orta hat yerleşimli tümörlerde radyoterapi uygulanabilir. 5 yaşın altındaki çocuklarda hipotalamus ve optik traktüs lokalizasyonlu tümörlerde, 5 yaşın sonuna kadar, çocuğu cerrahi tedavi ve RT’nin travmatik etkisinden korumak için kemoterapi kullanılabilir. Pilositik astrositom, benign, yavaş büyüyen, klinik öyküsü uzun olan bir tümördür. Rekürrensiz survi 20 yılın üzerinde olabilir. PA’da seyrek olarak malign rekürrens görülebilir (Anaplastik PA, WHO Grade III)

Kaynakça

  • Ellison D, Love S, Chimelli L, Harding B.N, Lowe J, Vinters H.V Astrocytic neoplasms. Mosby: Edinburgh 2004; 623- 640.
  • Fisher PG, Breiter SN, Calson BS et al A clinicopatho- logıcal reappraisal of braın stem tumour classification. Identification of pilocytic astrocytoma and fibrillary astro- cytoma as dıstinct entites. Cancer 2000; 89: 1569-1576.
  • Listernıck R, Louis DN, Packer RJ Gutmann DH et al Optic pathway gliomas in children with neurofibromatosis 1: Consensus statement from the NF 1 Optıc Pathway Glioma Task Force. Ann Neurol 1997; 41: 143-149.
  • Giannini C, Scheithauer BW, Burger PC et al, Cellular proliferation in pilocytıc and diffuse astrocytomas. J Neuro- pathol Exp Neurol 1999; 58: 46-53.
  • Ito S, Hoschino T, Shibuya M etal. Proliferative charac- teristics of juvenile pilocytic astrocytomas determined by bromodeoxyuridine labelling. Neurosurgery 1992; 31: 413- 419.
  • Christoforidis GA, Drevelegas A, Bourekas EC, Karkavelas G. Low grade gliomas. İn: Drevelegas A. (Ed) İmaging of Brain Tumors with Histological Correlations. Springer. Berlin, 2002 241: 40-47.
  • Peter L. Lantos, David N. Louis, Marc K.Rosenblum and Paul Kleihues. Tumors of the Nervous System. In: David I Graham and Peter L Lantos. Greenfield’s Neuropathology Vol 2 Arnold: London. 2002: 767-1052.
  • Deimlıng A von, Louis DN, Menon AG etal, Deletions on the long arm of choromosome 17 in pilocytic astrocytoma. Acta Neuropathol (Berl) 1993: 86-81-5.
  • Shoshan Y, Nıshiyama A, Chang A et al. Expression of oligodendrocyte progenitor cell antigens by gliomas: implications for the histogenesis of brain tumors. Proc Natl Acad Sci USA 1999; 96: 10361-6.
  • Figarella-Branger D, Daniel L, Andre P etal. The PEN5 epitope identifies an oligodendrocyte precursor cell popula- tion and pilocytic astrocytomas Am J Pathol 1999; 155: 1261-9.
  • Kirser RJ de, Wolt Rouendaal D de, Bots GT et al. Optic glioma with intraocular tumour and seeding in a child with neurofibromatosis. Am. J. Ophthalmol 1989; 108: 717-25.
  • Mamelak AN, Prados MD. Obana WG et al. Treatment options and prognosis for multicentric juvenile pilocytic astrocytoma. J Neurosurg 1994; 81: 24-30.
  • Matsumoto T, Uekusa T, Abe H et al. Multıcentric astro- cytomas of the optic chiasm, braın stem and spinal cord. Acta Pathol Jpn 1989; 39: 664-9.
  • Janss AJ, Grundy R, Cnaan A et al (1995) Optic pathway and hypothalamıc (Chismatic gliomas in children younger than age 5 years with a 6-year fallow-up. Cancer 75: 1051- 1059.
  • Perilongo G, Carollo C, Salviati L et al. Diencephalic syndrome and disseminated juvenile pilocytic astrocytomas of the hypothalamic-optic chiazm region. Cancer 1997; 80: 142-6.
  • In: Ironside JW, Moss TH, Louis DN, Lowe JS, Weller RO Astrositic tumors. Churchıll Lıvıngstone: London, 2002, 53- 121.
  • Tomlinson FH, Scheithauer BW, Hayostek C J et al. The sıgnificance of atypia and histologic malignancy in pilocytic astrocytoma of the cerebellum: a clınıcopathologic and flow cytometric study. Child Neurol 1994; 9: 301-310.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Ç. Bayındır Bu kişi benim

Yayımlanma Tarihi 1 Mayıs 2004
Yayımlandığı Sayı Yıl 2004 Cilt: 10 Sayı: 1-2

Kaynak Göster

APA Bayındır, Ç. (2004). Pilositik astrositom. Türkiye Ekopatoloji Dergisi, 10(1-2), 51-56.
AMA Bayındır Ç. Pilositik astrositom. Türkiye Ekopatoloji Dergisi. Mayıs 2004;10(1-2):51-56.
Chicago Bayındır, Ç. “Pilositik Astrositom”. Türkiye Ekopatoloji Dergisi 10, sy. 1-2 (Mayıs 2004): 51-56.
EndNote Bayındır Ç (01 Mayıs 2004) Pilositik astrositom. Türkiye Ekopatoloji Dergisi 10 1-2 51–56.
IEEE Ç. Bayındır, “Pilositik astrositom”, Türkiye Ekopatoloji Dergisi, c. 10, sy. 1-2, ss. 51–56, 2004.
ISNAD Bayındır, Ç. “Pilositik Astrositom”. Türkiye Ekopatoloji Dergisi 10/1-2 (Mayıs 2004), 51-56.
JAMA Bayındır Ç. Pilositik astrositom. Türkiye Ekopatoloji Dergisi. 2004;10:51–56.
MLA Bayındır, Ç. “Pilositik Astrositom”. Türkiye Ekopatoloji Dergisi, c. 10, sy. 1-2, 2004, ss. 51-56.
Vancouver Bayındır Ç. Pilositik astrositom. Türkiye Ekopatoloji Dergisi. 2004;10(1-2):51-6.