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The object was to describe the clinical, radiologic, and pathologic features of astroblastomas in an unselected group of children who were treated in a single institution during an 11-year period.Eight children with astroblastomas of the brain were examined. Diagnosis was based on cell morphology, vascular attachment of the cell main process, lack of an epithelial-free surface differentiation, and poor intercellular cohesiveness. In addition to sections, tumor smears and electron microscopy were required for demonstrating or confirming such features.Clinical findings seem to confirm an apparent predilection of astroblastomas for younger children (median age of onset, 5 years) and the existence of two prognostically different types of tumor-well differentiated (low grade) and anaplastic (high grade). Microscopic findings suggest a closer resemblance of tumor cells to astroblasts rather than to "tanycytes" or ependymal cells. It seems, however, that anaplastic astroblasts have a tendency to evolve toward, or be associated with, less differentiated cells, either neuroepithelial or sarcomatous.

Astroblastoma is a rare glial tumour about which little is known.We report a case of cerebral high grade astroblastoma and discuss the clinical, histopathological, surgical, radiological and prognostic features of this tumour, in the light of the pertinent literature.Present patient had an initial histological diagnosis of glioblastoma multiforme. Three years later an histological reevaluation was performed and revealed a high grade astroblastoma. Our patient underwent surgical removal and radiotherapy; five years after the operation he is alive and without evidence of recurrence.Classification and histogenesis of this tumour is still debated. The lack of a clinicopathological correlation makes the prognosis of this tumour unpredictable. The optimal management is not defined, but total resection and post-operative radiotherapy seem to be the effective means to treat the astroblastoma.

We report a case of extraventricular ependymoma arising in a 50-year-old woman that took an aggressive clinical course with recurrence three times. The initial tumor was a well-circumscribed nodule in the right temporal white matter measuring 2 cm in diameter. It showed variegated histological findings mimicking metastatic adenocarcinoma: an epithelioid arrangement of highly pleomorphic cells with pseudopapillary structures and perivascular pseudorosettes, and bizarre multinucleated giant cells with occasional emperiporesis surrounded by abundant mononuclear inflammatory cells, as well as a focal small area of conventional ependymoma. Emperiporesis and abundant mononuclear cell infiltration were not previously described in an ependymoma. The recurrent tumors predominantly showed an epithelioid pattern with frequent formation of astroblastoma-like pseudopapillary structures. Neoplastic cells were markedly atypical and had characteristic intracytoplasmic eosinophilic inclusion bodies. Much of the cells in both the initial and recurrent tumors showed a positive immunostaining for glial fibrillary acidic protein (GFAP) with accentuation to the cytoplasmic processes of the pseudorosettes and pseudopapillary structures. Epithelial membrane antigen (EMA) highlighted the epithelial differentiation of the tumor cells, while cytokeratin was completely negative. Although this tumor might be classified to at least WHO grade III from the histology and aggressive behavior, the exact grading is still controversial because of the rarity of such cases.

We report a case of astroblastoma with unusual signet-ring-like cell components. A 33-year-old-woman presented with occasional partial seizures of the face. Radiological studies revealed an enhanced frontal mass lesion. At surgery, a gray, soft, well-circumscribed mass was seen and shelled out. Histologically, the tumor showed a perivascular arrangement and papillary-like patterns with compact cellularity. The tumor cells radiating from the hyalinized vessels showed broader, shorter, less tapered processes. A part of each tumor cell displayed prominent islands of signet-ring-like cells. Glial fibrillary acidic protein reaction revealed strongly positive staining of tumor cells and signet-ring-like cells. Eight years after the operation the patient remains well with no tumor recurrence. It remains to be determined whether, in this astroblastoma, the unusual signet-ring-like cell components were related to benign biological characteristics or to the tumor's low-grade form with incidental signet-ring-like cell appearance.

A patient with grade II astroblastoma is reported. The tumor revealed an inhomogenous enhancement pattern on T 1-weighted images after contrast medium. It contained cyst-like structures with high signal in FLAIR images, consistent with presence of viscous material. In spectroscopy, NAA was decreased, and Cho was increased. Peaks belonging to lipids and a combined broad peak belonging to myoinositol and glycine were noticed. In diffusion MRI, the mean apparent diffusion coefficient (ADC) value of intratumoral cyst-like structures was 2.12×10 −3 mm 2 /s less than that of CSF. The matrix of the tumor had lower ADC values ranging from 1.19 to 1.25×10 −3 mm 2 /s, higher than that of normal cerebral parenchyma.

Background: Astroblastoma is a rare glial neoplastic lesion that affects children and adolescents; its histogenesis remains uncertain. It is considered to account for 0.5% of all glial neoplasms, and two different subtypes have been defined based upon histologic characteristics. Case Description: We present the case of a 9-year-old girl who presented with headache, motor symptoms, and seizures few days before she was admitted to our institution. Computed tomography (CT) and magnetic resonance imaging (MRI) scans showed an intra-axial heterogeneous frontoparietal lesion with a striking “bubbly” appearance in MRI T2-weighted sequences and features of intracranial hypertension. Gross total resection of the tumor was achieved and the histopathologic diagnosis revealed high-grade astroblastoma. We reviewed the current published cases of astroblastoma to highlight the demographic, clinical, radiologic, and pathologic data. Conclusion: Astroblastomas are a distinct clinicopathologic entity, with well-described radiologic, pathologic, and cytogenetic features. Its recurrence is high and efforts must be made to elucidate the role and usefulness of radiotherapy and chemotherapy in these tumors.

Astroblastoma is a rare glial neoplasm whose histogenesis has been clarified recently. It primarily occurs in children and young adults. We are reporting a case of 12-year-old girl child who presented with features of raised intracranial tension and generalized tonic-clonic seizures. Brain magnetic resonance imaging revealed a large well-circumscribed, cystic lesion without perifocal edema, and enhancing mural nodule in right parietal region. A radiological differential diagnosis of pilocytic astrocytoma and cerebral astroblastoma was made. A complete excision was done and histologically the lesion turned out to be an astroblastoma. We review the histology, immunohistochemistry, and imaging features of astroblastoma and survey the current literature, treatment strategies, and prognostic aspects for the management of this rare neoplasm.

An astroblastoma of high-grade type arising in the brain of a 3-year-old child is reported. The first description of the ultrastructural, immunohistochemical, and cytogenetic findings in this rare tumor variant are presented.

OBJECTIVE: Astroblastomas are rare glial neoplasms that usually occur in young adults and have a predilection for the cerebral hemispheres. Patients typically present with signs of increased intracranial pressure and seizures Imaging studies reveal circumscribed, contrast-enhancing tumors that contain both cystic and solid components with variable perituirioralederna, Hemorrhage, which suggested the presence of a vascular lesion in this patient, has not been previously described as a feature of this neoplasm. CLINICAL PRESENTATION:The authors report the case of a 33-year-old woman who presented with spontaneous intraparenchymal hemorrhage. The collective radiographic data suggested the presence of a cavernous malformation. INTERVENTION: A right frontotemporal craniotomy was performed under frameless stereotactic image guidance. An astroblastoma was diagnosed after resection and neuropathological examination. CONCLUSION: A rare radiological to pathological correlation of astroblastoma is presented in which the evolving hematoma, as observed onmagnetic resonance imaging scans, complicated the radiographic diagnosis of this lesion. The clinical, radiographic, and pathological features of astroblastoma, as well as the natural history of these rare glial neoplasms, are reviewed. This case illustrates the capacity of astroblastoma to hemorrhage, disguising the classic radiographic findings typical of this glial neoplasm.

Pediatric brain tumors occur within a frequency of 24 to 27 cases/year within a cohort of 1 million children. Nearly 25% of these lesions will involve the cerebral hemisphere, with the low-grade glioma representing the most common group of tumors in this location. Pilocytic and fibrillary astrocytomas are the most frequently encountered glioma, although other variants, such as the ganglioglioma, pleomorphic xanthoastrocytoma, astroblastoma, ependymoma, and oligodendroglioma, must also be considered in the differential diagnosis. The etiology of these tumors remains obscure, although may be linked to therapeutic radiotherapy, previous history of hematopoietic malignancy, and maternal exposure to nitrosamine-laden foods. An associated link to a phakomatosis, e.g., neurofibromatosis, tuberous sclerosis, has also been documented to exist with astrocytomas, in particular. The goals of surgery include a complete removal, in most circumstances, with an attempt to alleviate an associated seizure disorder when intractable. This is possible in nearly every type of hemispheric glioma with the aid of intraoperative navigational systems, i.e., frameless stereotaxy, neurophsyiological based stimulation mapping, and electrocorticography. In the setting where a complete removal is possible, no further therapy is warranted. For those lesions that are incompletely resected, conservative management with routine diagnostic imaging follow-up is appropriate. Reoperation is necessary if recurrence is documented and radiotherapy is utilized for those lesions that are incompletely resected following recurrence.

Standardized postembedding immunoelectron microscopy was performed to demonstrate glial fibrillary acidic protein (GFAP) and vimentin in individual intermediate filaments to determine the diagnostic value of demonstrating ultrastructural and immunophenotypic characteristics of intermediate filaments in routine brain biopsy specimens. Dual expression of GFAP and vimentin was observed in the astroblastoma and astrocytes of Alexander's disease. The antigen availability for vimentin, however, was too low to allow reliable assessment of the GFAP:vimentin ratio in individual intermediate filaments and/or filament bundles. In meningioma, only vimentin positive intermediate filaments were found. GFAP positive intermediate filaments were present in all other specimens except the oligodendroglial components of the mixed glioma, which were devoid of intermediate filaments. GFAP positivity in the filamentous periphery and electron-dense core of Rosenthal fibers was demonstrated. Technical and tissue processing factors had a significant effect on particle density values obtained for individual specimens. Although the number, distribution, and density of glial intermediate filaments varies in different astroglial entities, correlation of particle density values determined by immunoelectron microscopy with relative GFAP concentrations in different lesions requires utmost caution. Nevertheless, application of the postembedding approach to routinely fixed biopsy specimens indicated an association of different entities with the exclusive presence of GFAP and/or vimentin in individual intermediate filaments, thus emphasizing the diagnostic value of intermediate filament typing for pathological characterization.

Astroblastomas are rare tumors of cerebral hemispheres of young adults. We report an astroblastoma in a 15-year-old girl and present the first descriptions of cytogenetic abnormalities in this tumor. The tumor was relatively well demarcated from the brain and revealed prominent perivascular rosettes as well as intervascular clear cells that contained abundant glycogen. Cytogenetic analysis revealed an abnormal hypodiploid karyotype with 45 chromosomes and monosomies of chromosomes 10, 21, and 22 and two marker chromosomes in all cells examined. The tumor had a Ki-67 labelling index of 4. 7% and assessment of ploidy by flow cytometry revealed 96% of cells in the G0G1 phase and 4% of cells in the G2M phase. Assessment of proliferation and ploidy indices in further cases may provide important prognostic data for this poorly understood entity. Further cytogenetic studies will also help to identify if there are consistent karyotypic abnormalities in these enigmatic tumors.

The aims of this study were to correlate cytogenetic studies and molecular genetic loss of heterozygosity (LOH) analyses in human astrocytomas and mixed oligo-astrocytomas, and to locate putative tumor suppressor genes on chromosome 10. Paired blood and tumor samples from 53 patients were analyzed. The tumors included 45 diffuse astrocytomas (39 grade 4, 4 grade 3, and 2 grade 2), 1 astroblastoma, and 7 mixed oligo-astrocytomas (2 grade 4,4 grade 3, and 1 grade 2). By cytogenetic analyses the most common numeric chromosome abnormalities were +7, −10, −13, −14, −17, +19, −22, and −Y. The most common structural abnormalities involved chromosome arms 1p, 1q, 5p, and 9p. By LOH and dosage analysis the most common molecular genetic abnormalities were of chromosome arms 5p, 6p, 7q, 9p, 10p, 10q, 13q, 14q, 17p, and 19p. When the results of all methods were combined, the most commonly abnormal chromosomes were, in descending frequency, 10, Y, 17, 7, 13, and 9. In 80 percent of cases the cytogenetic and molecular genetic studies were concordant. LOH studies were more sensitive in detecting loss of genetic material than cytogenetic analyses and accounted for 60% of the discordant results. When there were structural abnormalities, such as translocations or inversions, cytogenetic analysis was more sensitive in detecting an abnormality than molecular genetic studies. In addition to the 24 tumors which appeared to lose an entire copy of chromosome 10, there were 10 tumors with molecular genetic or cytogenetic evidence of loss of only a portion of chromosome 10. The genetic analyses of these tumors suggest that there are 2 regions on chromosome 10 that may contain potential tumor suppressor genes. One lies distal to locus D10S22 from 10q22 to 10qter, and the other lies proximal to locus TSTI on the 10q arm near the centromere or on the 10p arm. © 1992 Wiley-Liss, Inc.

Astroblastoma is thought to arise from astroblast - an intermittent cell between spongioblast and astrocytes and is a rare tumor in the pediatric age group. The histological appearance are characterized by radiating arrangement of spindle-shaped tumor cells forming perivascular pseudorosettes, and being very similar to that seen in ependymomas, makes differentiation difficult. The authors report the case of a 5-year-old girl who had a large frontal tumor, which was thought to be an astroblastoma preoperatively, based on the unique magnetic resonance imaging features these tumors have. The histological findings, in association with the preoperative radiology confirmed the diagnosis of astroblastoma. The authors conclude that the MR imaging of astroblastomas is extremely helpful in differentiating from ependymomas and is used for preparing the histopathology reports in these patients.

Astroblastoma is a rarely diagnosed primary brain neoplasm whose histogenesis has been clarified recently. It occurs in children and young adults and presents as a well circumscribed, contrast-enhancing lesion in the cerebral hemisphere. We present a case of 20-year-old woman with an astroblastoma in the left temporal convexity that was treated with total tumor resection alone. We thought the mass was extra-axial neoplasm based on radiological findings of computed tomography and magnetic resonance imaging initially, but later, we obtained angiographic findings suggesting an intra-axial neoplasm. The patient is doing well even two years after surgery. The characteristic radiological and histopathological features of this case are described with a literature review. An astroblastoma should be included in the differential diagnosis of a superficially located tumor presenting with the findings of an extra-axial mass, especially in a young patient.

The DNA content is determined by the cytophotometric method in 16 astroglial tumours, classified according to the degree of clinical malignancy. The values are compared to those found in non-tumoural astrocytes. This method appears to be more reliable in assessment of the degree of malignancy of the tumour in biopsy material than histological criteria and the mitotic index. It is also shown to be of great value in cases where the biopsy is taken at the margin of the tumour and in which malignant histological features are missing.

Summary The angioarchitecture of an astroblastoma of the corpus callosum is studied on serial carotid angiograms, made during life, and on post mortem angiograms, performed by filling of the cerebral arterial system with a colloidal bariumsulphate solution and by using the translucidation technique. The results of these investigations are compared to the histological aspect of the tumour. This study reveals the close relationship between the astroblasts and the bloodvessels. The angio-architectural pattern of this tumour is characterized by new formation of capillaries. It is considered as an additional support to classify the astroblastoma as a separate type of glioma.

Two examples of cerebral astroblastoma have been studied by electron microscopy and immunohistochemistry, one of them having been maintained in vitro in an organ-culture matrix system for 8 months and the explants studied by light and electron microscopy at different time intervals. The fine structural characteristics were those of a glial cell type with features intermediary between those of astrocytes and ependymocytes. They recapitulated the structure of the tanycyte, a glial precursor cell which is normally found scattered along the ependymal lining of the embryonal and neonatal mammalian brain, but is distinct from epithelial ependymocytes. The possible origin of some astroblastomas from such a cell would account for a number of characteristics in this enigmatic type of glioma.

We report on 4 cases of brain tumors associated with tuberous sclerosis. In each case the tumor was in the region of Monro’s feramen and was associated with ventricular dilatation. Computer tomography scans, which were performed in 3 cases, revealed well-circumscribed high-density masses which were markedly enhanced by contrast medium. 3 patients underwent craniotomy. Total extirpation was performed in 2 patients. Both of them are doing well postoperatively. However, 1 patient whose tumor had been partially resected died of recurrence 6 years after surgery. The pathology of three tumors was different in each case: plump cell astrocytoma, hemangioma and astroblastoma.

Investigation of GFAP (Glial Fibrillary Acidic Protein) in 175 brain tumours showed varying amounts of fibrillary acidic protein in every glioma. In ependymal and oligodendroglial tumours a high number of positive neoplastic elements were detected, GFAP positive were also the peri-vascular cells of a so-called astroblastoma. In pilocytic astrocytomas, Rosenthal fibers were in part GFAP positive, in part negative. In giant cells gliomas, giant cells were GFAP negative or weakly positive. Intraleptomeningeal growing tumour cells presented usually a very strong positivity. In 8 recurring oligodendrogliomas, the number of GFAP positive tumour cells was the same in the primary tumour and in its recurrence. These results demonstrate that GFAP is not a specific astrocytic, but a glial-specific protein. Although GFAP is usually present in greater concentration in differentiated, slow growing gliomas, absolute reliable predictions on biological behaviour of the individual tumour are not possible, because a high GFAP content can be detected also in malignant tumours. GFAP investigation does not seem reliable for solving the pathogenetic problems of undifferentiated tumours: the results obtained in 50 medulloblastomas showed that the investigation of small tumour samples or the positivity of a single cell are inadequate data for a correct evaluation of the findings, especially bearing in mind that GFAP of degenerated astrocytes can be phagocytised by other cells, these findings giving rise to misinterpretations.

A case of immature cerebellar astrocytoma in a 1 year and 4 months-old girl was described. The tumor consisted mainly of closely packed relatively uniform round cells with prominent intervening capillaries. Although tumor cells showed negative GFA (glial fibrillary acidic protein) immunoreactivity, demonstration of occasional bundles of 10 nm intermediate filaments (glial filaments) in cytoplasm on electron microscopy confirmed the diagnosis of astrocytoma. Differential diagnosis to hemangioblastoma, astroblastoma, and primitive neuroectodermal tumor was discussed.

To provide the significance of LDH isozymes in rat CNS tumors, the changes in lactic dehydrogenase isozyme and calculated ratios of H- to M- subunit were studied by means of polyacrylamide gel enzymoelectrophoresis in tumor extracts from CNS tumors (7 astrocytomas, 4 oligodendrogliomas, 7 mixed gliomas, 6 anaplastic gliomas, 3 glioependymomas, 1 astroblastoma, 11 neurinomas, 8 anaplastic neurinomas and 1 meningioma in Wistar rats which were induced by ethylnitrosourea). The isozyme patterns were compared to those obtained from normal rat CNS tissues. Among the glioma group, oligodendroglioma showed the highest H/M ratio followed by mixed glioma, glioependymoma, astrocytoma, astroblastoma and anaplastic glioma in order of decreasing of H/M ratios. On the other hand, the H/M ratio of neurinoma was significantly higher than that of anaplastic neurinoma. These observation suggested that determination of LDH isozyme patterns could supplement the histological evaluation of brain tumors.

An astroblastoma in the cerebrum was investigated with the electron microscope. A distinctive feature of the tumor was the radial arrangement of astrocytic cells around the blood vessels. The blood vessels in the tumor commonly exhibited fenestrated endothelial cells. The endothelium was generally surrounded by lamellated basal laminae that were compactly invested in the neoplastic cells. The most remarkable feature of the tumor cells was the frequent presence of coated vesicles. The cytoplasm of some tumor cells was filled by delicate glial fibrils and microtubules, whereas that of others contained a moderate amount of rough-surfaced endoplasmic reticulum, free ribosomes, and mitochondria, but only scanty glial fibrils and microtubules. The former usually possessed long, thin cell processes, whereas the latter had poor development of cell processes and commonly showed multiple or giant nuclei containing several nuclear bodies and prominent nucleoli. In summary, this ultrastructural study of astroblastoma revealed the coexistence of varied maturity astrocytic cells and their compact arrangement around fenestrated blood vessels.

The presence and distribution of glial fibrillary acidic protein in fixed, paraffin embedded tissue were studied in 85 human intracranial neoplasms, using the peroxidase-anti-peroxidase method. In some cases, indirect immunofluorescence of frozen sections was used as well. In normal tissue, only the cell processes and perikarya of fibrous astrocytes were stained. Immunostaining was also observed in the following glial neoplasms: astrocytomas (all varieties), astroblastoma, subependymal giant cell astrocytoma, subependymoma, glioblastoma multiforme and ependymoma. The astrocytic elements of mixed gliomas and of medulloblastomas undergoing glial differentiation were likewise strongly stained. In contrast, oligodendrogliomas, meningiomas, pituitary adenomas, sarcomas, lymphomas and metastatic carcinomas were negative. Either a perikaryal or a diffuse fibrillary staining pattern was observed. Combination of the two patterns occasionally occurred. The perikaryal staining was prominent in gemistocytic astrocytomas and in astroblastomas. A distinct negative correlation existed between the degree of anaplasia and the intensity of immunostaining.

Astroblastomas are rare, usually circumscribed, supratentorial tumors of young subjects and are characterized by a perivascular arrangement of the tumor cells. Their clinical behavior is unpredictable and their prognosis has been regarded as intermediate between that of astrocytomas and glioblastomas. A personal series of 23 astroblastomas was reviewed, adequate postoperative follow-up being available in 13 patients. Two distinct histological types were encountered: low-grade and high-grade. The low-grade type comprised tumors with better differentiated and more benign-appearing microscopical features. Five of the 8 patients with tumors of this type who were available for follow-up have survived from 3 to 20 years after treatment; in I patient the tumor converted into a fatal glioblastoma after 4½12; years. The high-grade type consisted of tumors with more anaplastic features. Three of the 4 patients with tumors of this type available for follow-up died after 1½12; to 2½12; years, the astroblastomas in 2 of them having converted into a glioblastoma and a gliosarcoma, respectively. One patient, however, has had an unexpected length of postoperative survival of 11½12; years. The best clinical results were obtained after total or subtotal resection of the tumor, followed by radiotherapy. The role of chemotherapy is still uncertain. This form of glioma illustrates the discrepancies that may sometimes be apparent between histopathological features and length of postoperative survival. The prognosis is also further complicated by the potential of the astroblastoma to convert into a more malignant type of glioma.

Twenty-four per cent of brain tumors of children aged less than 15 years were found to be astrocytomas, 20% were medulloblastomas and 11% were ependymomas. If the astroblastomas (3%) and ependymoblastomas (3%) are added to these, these groups of tumors comprise 61% of all brain tumors of children. Gliomas constituted 84% of all the tumors in children. Six tumors were found in infants 1 year of age or less. The youngest infants were 2 months old. Astrocytomas were slightly more common in children aged 5 years or less than in the older group. Medulloblastomas and ependymomas were distinctly more common in the younger group than in the older group. Seventy-one per cent of tumors in the age group from birth through 5 years of age were infratentorial; 28% were supratentorial; 1 tumor (1%) was both infratentorial and supratentorial. In the group 6 through 14 years of age, 64% were infratentorial and 36% were supratentorial. Thirty per cent of infratentorial tumors were astrocytomas and 30% were medulloblastomas. Sixteen per cent of supratentorial tumors were craniopharyngiomas, 12% were astrocytomas and 12% were glioblastoma multiforme. Under present conditions at the Mayo Clinic, 54% of all children who undergo operation for tumor of the brain survive for six months or more. Of 256 patients observed for five years or more after operation, 13.3% survive for at least five years. The longest survival period was 20 years after operation. This patient had had an astrocytoma removed in 1926.

✓ A case is presented of a solitary primary extracerebral mixed glioma occurring in the right suprasellar and parasellar region of a 49-year-old woman who had bilateral temporal hemianopsia for 3 months. At craniotomy, the well demarcated outline and extracerebral location of the tumor suggested that it was a meningioma. However, its gliomatous nature was confirmed by identification of glial fibrillary acidic protein (GFAP) in the tumor cells. Review of nine reported solitary primary intracranial extracerebral gliomas, including the present case, revealed that they tended to occur in the third to fifth decades of life, in patients with an average age of 42½ years, and without sexual predilection. All were supratentorial with a tendency to be situated in the vicinity of the Sylvian fissure. Only the glioma in the present case was at the cranial base. They were diagnosed as three astrocytomas, two glioblastomas, two oligodendrogliomas, one astroblastoma, and one mixed glioma. A suggestion is made that all these gliomas arose primarily from heterotopic neuroglia in the leptomeninges.