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Proliferative activity and histopathological features in diffuse grade II astrocytomas.

Tove Lind-Landström1, Andreas H Habberstad, Sverre H Torp

  • 1Department of Laboratory Medicine, Children's and Women's Health, Faculty of Medicine, University Hospital, NTNU, Trondheim, Norway.

APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica
|July 12, 2012
PubMed
Summary

Diffuse astrocytomas show varied histology, with fibrillary types most common. Recognizing this morphological diversity and using Ki-67/MIB-1 staining aids accurate diagnosis of these challenging grade II brain tumors.

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Area of Science:

  • Neuro-oncology
  • Pathology
  • Histology

Background:

  • Diffuse astrocytomas exhibit significant histopathological heterogeneity.
  • Accurate grading and subtyping are crucial for prognosis and treatment planning.
  • Understanding the frequency of specific histological features is essential for diagnosis.

Purpose of the Study:

  • To investigate the frequency of various histological features in grade II diffuse astrocytomas.
  • To establish correlations between histological features and malignancy indicators.
  • To evaluate the utility of Ki-67/MIB-1 immunostaining in improving diagnostic accuracy.

Main Methods:

  • Microscopic examination and revision of 109 consecutively operated grade II astrocytomas.
  • Classification of histological subtypes (fibrillary, gemistocytic, protoplasmic).
  • Assessment of cell density, cellular/nuclear atypia, mitoses, apoptotic figures, and other specific features; Ki-67/MIB-1 proliferation indices were correlated.

Main Results:

  • Fibrillary astrocytoma was the most frequent subtype (87%).
  • Mild to moderate cell density (90%) and atypia (96%) were common; mitoses observed in ~25%.
  • Significant correlations found between mitotic activity, apoptosis, cell density, and Ki-67/MIB-1 indices.

Conclusions:

  • The diverse histopathological appearance of diffuse astrocytomas presents diagnostic challenges.
  • Awareness of morphological variations is critical for routine diagnosis.
  • Ki-67/MIB-1 immunostaining can enhance diagnostic accuracy for these tumors.