Anaplastic Pilocytic Astrocytoma: The “fusion” of good and bad. -Case report-

Anaplastic Pilocytic Astrocytoma: The “fusion” of good and bad. -Case report-

Alexandrina Nikova, Charalampos-Chrysovalantis Chytoudis-Peroudis, Penelope Korkolopoulou, Dimitrios Kanakis


Pilocytic astrocytoma is considered by the WHO classification of the CNS tumors (2007) as a benign neoplasm (grade I), whereas the same taxonomy applies to anaplastic astrocytoma a high grade of malignancy (grade III). The occurrence of tumors combining both features of pilocytic and anaplastic astrocytomas has been already described previously in a few case reports.

Herein, we present the case of a three years old boy, who presented signs and symptoms consistent with obstructive hydrocephalus caused by an intracerebellar sited neoplasm. The latter demonstrated both solid and cystic areas and contrast enhancement in the performed magnetic resonance imaging (MRI). The microscopic evaluation of the excised specimens showed the typical biphasic pattern of pilocytic astrocytoma together with Rosenthal fibers, eosinophilic granular bodies (EGBs) and hyaline droplets but also anaplastic features such as hypercellularity, endothelial proliferation, high mitotic index and focal necrosis.

Due to the rarity of this neoplasm and the absence of definite diagnostic criteria and exact grading, there are no consistent therapeutic approach, which in turn allows no accurate prognosis and prediction to be made. Therefore, it is our belief that this combined tumor should be reviewed accordingly and included as a distinct entity in WHO classification of CNS tumors. 


anaplastic pilocytic astrocytoma, Rosenthal fibers, eosinophilic granular bodies, hyaline bodies

Full Text:



D.N. Louis, H. Ohgaki, O.D. Wiestler, W.K. Cavenee: ʺWHO Classification of Tumours of the CNS”, International Agency for Research on Cancer, Lyon, 2007; 22-24 & 33-47

Rosemberg S, Fujiwara D. Epidemiology of pediatric tumors of the nervous system according to the WHO 2000 classification: a report of 1195 cases from a single institution. Childs Nerv Syst. 2005; 21: 940-944.

Ohgaki H, Kleihues P. Population-based studies on incidence, survival rates, and genetic alterations in astrocytic and oligodendroglial gliomas. J Neuropathol Exp Neurol. 2005; 64: 479-489.

Chourmouzi D, Papadopoulou E, Konstantinidis M, Syrris V, Kouskouras K, Haritanti A, et al. Manifestations of pilocytic astrocytoma: a pictorial review. Insights imaging. 2014; 5: 387-402.

Collins VP, Jones DT, Giannini C. Pilocytic astrocytoma: pathology, molecular mechanisms and markers. Acta Neuropathol. 2015; 129: 775-788.

Rodriguez FJ, Scheithauer BW, Burger PC, Jenkins S, Giannini C. Anaplasia in pilocytic astrocytoma predicts aggressive behavior. Am J Surg Pathol. 2010; 34: 147-160.


  • There are currently no refbacks.

Copyright 2015-2017, Hellenic Society of Pathology
ISSN: 2459-3443