Grading of astrocytoma

Astrocytoma is the most common intracranial tumor, accounting for about 80% of gliomas, and originates from astroglial cells. Common symptoms include increased intracranial pressure, headache, vomiting, papilledema, visual field changes, epilepsy, diplopia, cranial enlargement, and changes in vital signs.

Understanding the grading of astrocytomas is of guiding significance for treatment and prognosis. Currently, astrocytomas are mainly divided into grades I to IV based on cell biological characteristics in clinical practice.

Grade I is pilocytic astrocytoma, and rarely there is subependymal giant cell astrocytoma. The tumor tissue is grayish white or grayish yellow, and has a rubber-like hardness. There is generally no hemorrhage or necrosis, but it may become cystic. One type is a cyst containing tumor nodules, and the other type is a tumor containing cysts.

Grade II is diffuse astrocytoma, which progresses slowly. Fibrous, protoplasmic, and obese cell types are more common, while mixed oligoastrocytoma and pleomorphic xanthomatous astrocytoma are rare.

Grade III is anaplastic astrocytoma, and Grade IV is glioblastoma. When the disease develops to this level, it is often highly malignant, with more than half of them having cystic changes, mostly located in the cerebral hemispheres, and invading the basal ganglia and thalamus. They are rich in blood vessels, prone to bleeding, and the surrounding brain tissue has obvious edema, which can cause the disease to suddenly worsen and the course of the disease is usually short.