星形细胞瘤幻灯片.pptVIP

Lecturer: Guo Xiang Classification and Diagnosis of astrocytoma 星形细胞瘤 Morbidity of Astrocytoma Astrocytic tumor 78% Glioma Primary brain tumor 40% Morbidity Type of Astrocytoma WHO classification Ⅰ~Ⅳ Ⅰ级 毛细胞型星形细胞瘤、室管膜下巨细胞星形细胞瘤 Ⅱ级 弥漫型星形细胞瘤 Ⅲ级 间变型星形细胞瘤 Ⅳ级 胶质母细胞瘤 Pilocytic astrocytoma AND Subependymal giant cell astrocytomas Diffuse astrocytoma Anaplastic astrocytoma Glioblastoma Subependymal giant cell astrocytomas-GradeⅠ Reddish-yellow pimples chromosomal disorder 染色体疾病 epiloia（结节性硬化） 8Y~18Y male-to-female ratio 3:1 subependymal nodules contrast-enhance hydrocephalus脑积水 favorable clinical outcome 红黄色丘疹 T1 T2 T1-enhance CT non-contrast M 16y Pilocytic astrocytoma-GradeⅠ Children Cerebellum hemispheres or vermis Solid and cystic part Normal tissue solid nodule cystic mass CSF in density on NCCT MRI : a high-signal-intensity cyst surrounding a iso-intensity mural nodule on T2 Contrast enhancement with both CT and MRI vermis F 62Y T1 T2 T1-enhance Pathology 弥漫型星形细胞瘤属于交界性肿瘤，容易复发，且恶性度有不断增加的趋势，最终发展为胶质母细胞瘤。 Grade-Ⅱ Diffuse astrocytoma Grade-Ⅲ Anaplastic astrocytoma Grade-Ⅳ Glioblastoma Diffuse astrocytoma-GradeⅡ borderline tumor surgery malignancy will be higher recur Imaging Characteristic Brainstem or supratentorial white matter poorly defined border Low-density on CT slightly CSF No significant enhancement No or slightly enhancement Cystic change T1WI hypointensity signal T2WI hyperintensity signal F 54Y Surgical field and Specimen The tumor showed diffusely infiltrated growing. NO hemorrhage and necrosis. Anaplastic astrocytoma-GradeⅢ the tumor enhanced distinctly T1-enhance FLAIR T1 T2 T1 Glioblastoma-Grade-Ⅳ Adulthood Mixed density or signal lesion Hemorrhage and necrosis Contrast-enhance Because the treatment of astrocytoma is mainly based on pathological type ,so it will be very helpful to make an accurate diagnosis to the level of cells . * if completely excise the tumor, we don’t need to offer the radiotherapy and c