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    Gliomas

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    Rabbya Nasir 5
    Gliomas are brain tumors that arise from glial cells and account for 40% of all primary brain tumors. The most common types are astrocytomas, oligodendrogliomas, and ependymomas. Genetic mutations in genes like IDH and telomerase, as well as mutations that activate growth factor receptors, contribute to glioma development and progression. Astrocytomas are the most common adult glioma and are graded from I to IV based on malignancy. Oligodendrogliomas account for 5-15% of gliomas and commonly involve the cerebral hemispheres. Ependymomas often arise near the ventricles and may form rosettes or canals microsc

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    Gliomas

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    Rabbya Nasir 5
    72 views35 pages
    Gliomas are brain tumors that arise from glial cells and account for 40% of all primary brain tumors. The most common types are astrocytomas, oligodendrogliomas, and ependymomas. Genetic mutations in genes like IDH and telomerase, as well as mutations that activate growth factor receptors, contribute to glioma development and progression. Astrocytomas are the most common adult glioma and are graded from I to IV based on malignancy. Oligodendrogliomas account for 5-15% of gliomas and commonly involve the cerebral hemispheres. Ependymomas often arise near the ventricles and may form rosettes or canals microsc

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    Gliomas are brain tumors that arise from glial cells and account for 40% of all primary brain tumors. The most common types are astrocytomas, oligodendrogliomas, and ependymomas. Genetic mutations in genes like IDH and telomerase, as well as mutations that activate growth factor receptors, contribute to glioma development and progression. Astrocytomas are the most common adult glioma and are graded from I to IV based on malignancy. Oligodendrogliomas account for 5-15% of gliomas and commonly involve the cerebral hemispheres. Ependymomas often arise near the ventricles and may form rosettes or canals microsc

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    72 views35 pages

    Gliomas

    Uploaded by

    Rabbya Nasir 5
    Gliomas are brain tumors that arise from glial cells and account for 40% of all primary brain tumors. The most common types are astrocytomas, oligodendrogliomas, and ependymomas. Genetic mutations in genes like IDH and telomerase, as well as mutations that activate growth factor receptors, contribute to glioma development and progression. Astrocytomas are the most common adult glioma and are graded from I to IV based on malignancy. Oligodendrogliomas account for 5-15% of gliomas and commonly involve the cerebral hemispheres. Ependymomas often arise near the ventricles and may form rosettes or canals microsc

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    © All Rights Reserved
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    of 35

    GLIOMAS

    DR NILOFAR
    GLIOMAS
    Gliomas are brain tumors of brain parenchyma arising
    from neuroglia and classified as
    astrocytoma,oligodendroglioma and ependymomas
    Most common of primary CNS tumor
    Account for 40% of all intracranial tumors
    Genetics and pathogenesis
    Mutation in IDH genes are commonly observed in
    grade 2 astrocytoma and oligodendrogliomas leads to
    increased production of 2-hydroxyglutarate which
    interferes with activity of several enzymes that
    regulate gene expression
    Mutation in promoter of telomerase which result in
    immortalization of tumor cells
    Genetic and pathogenesis
    Seen in glioblastoma and other astrocytic tumor
    Co deletion of 1p and 19 q in oligodendrogliomas
    Mutations that lead to overgrowth of EGF receptor or
    other receptor tyrosine kinases
    Disable p53 or RB gene
    1 :Astrocytomas
    Most common type of adult gliomas (80%)
    Most frequent in fourth through sixth decade decades
    of life
    Most common site cerebral hemisphere and
    occassionally in spinal cord
    In children and yound adults pilocytic astrocytomas
    arise in cerebellum ,optic nerve and brain stem
    Presenting sign and symptoms are seizures,headache
    and focal neurolo
    Astrocytomas
    Presenting sign and symptoms are seizures, headache
    and focal neurological deficits related to anatomical
    sites of involvment
    Astrocytomas
    WHO CLASSIFICATION
    1. Grade 1:pilocytic astrocytoma
    2. Grade 2 :low grade (diffuse) astrocytoma
    3. Grade 3 :high grade anaplastic astrocytoma
    4. Grade 4 :glioblastoma multiforme (high grade )
    1:pilocytic astrocytoma
    Effect children and young adults
    Most commonly located in cerebellum
    May also involve third ventricle ,optic pathways ,spinal
    cord and occasionally cerebral hemisphere
    Morphology
     Gross: Often cystic e mural nodule in wall of cyst
     Microscopic :If solid ,it is usually well circumscribed
    Bipolar cells e long thin hair like processes that are
    GAFP positive
    Rosenthal fibers (eosinophilic granular inclusions)
    Micro cyst are often present
    Morphology
    Morphology
    2:grade 2 diffuse astrocytoma
    They are low grade
    Gross features :
    Poorly defined ,grey white tumor of variable in size
    Infiltrative tumor
    Expand and distort the invaded brain without forming
    discrete mass
    Cut surface is either firm ,soft or gelatinous
    Cystic degeneration may be present
    Grade 2 astrocytoma
    Microscopic features
    Mild to moderate increase in glial cells nuclei
    Variable nuclear pleomorphism
    Fibrillary appearance of background due to fine ,glial
    GFAP positive astrocytic cell processes
    Morphology
    grade 3 anaplastic astrocytoma
    Gross features
    It may not be distinguishable from grade 2
    Microscopic features
    More densely cellular
    Greater nuclear pleomorphism
    Mitotic figures are present
    Morphology
    Grade 4 glioblastoma
    Gross features
    Variation in gross appearance of tumor from region to
    region is characteristic
    Some areas are firm and white ,others are soft and
    yellow
    Still other shows region of cystic degeneration and
    hemorrhage
    Grade 4 glioblastoma
    Microscopic features
    Same as anaplastic astrocytoma
    Microvascular proliferation
    Areas of tumor necrosis around which tumor cells
    form pseudopalisading
    Morphology
    Morphology
    Morphology
    Morphology
    Oligodendroglioma
    Accounts for 5 -15% of gliomas
    Occur most commonly in fourth and 5th decade of life
    Slow growing
    Site is mostly cerebral hemisphere mainly in frontal
    and temporal lobes
    Classification
    Well differentiated grade 2
    Anaplastic grade 3
    Morphology
    Grossly
    form gelatinous ,grey masses
    May show cysts ,focal hemorrhage and calcification
    Morphology
    Morphology
    Morphology
    Microscopic features
    Grade 2
    Sheets of regular cells with spherical nuclei containing
    finely granular chromatin surrounded by clear halo of
    cytoplasm
    Delicate network of anastomosing capillaries
    Calcification present in 90% of cases
    Mitotic activity is usually low
    Morphology
    Grade 3 anaplastic
    Higher cell density
    Nuclear anaplasia
    Increased mitotic activity
    Often microvascular invasion
    Ependymoma
    Often arise next to ependyma lined ventricular system
    including central canal of spinal cord
    In first two decades of life they typically occur near the
    fourth ventricle and accounts for 5 -10 %of primary
    brain tumors in this age group
    In adults spinal cord is their common site
    Morphology
    Grossly
    Grey or red color
    Solid or papillary masses
    May contain cysts
    Morphology
    Microscopical features
    Cells contain regular round to oval nuclei and
    abundant granular chromatin
    Dense fibrillary background
    Tumor cells may form
    Rounded structure or rosette
    Elongated structures or canals
    More frequently perivascular pseudo rosette are
    present
    Morphology
    In anaplastic ependymomas there is
    Increased cell density
    High mitotic rates
    Necrosis
    Microvascular proliferation
    Less evident ependymal differentiation
    Morphology
    Morphology

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