Anaplastic pleomorphic xanthoastrocytomas are a more aggressive and less common version of pleomorphic xanthoastrocytoma (PXA).
In the current (2016) WHO classification of CNS tumors, they are considered WHO grade III lesions (whereas pleomorphic xanthoastrocytomas are WHO grade II tumors) 1.
As clinical and imaging features are essentially the same as lower grade tumors, they are not repeated here but rather discussed as part of the article on pleomorphic xanthoastrocytoma.
Anaplastic pleomorphic xanthoastrocytomas are defined as a tumor consistent with a pleomorphic xanthoastrocytoma but with an increased mitotic rate of >5 mitoses per 10 high-power fields 1. Otherwise, histologically they are very similar with lower grade tumors, however, necrosis and vascular proliferation are more common 1. They can be difficult to distinguish from epithelioid glioblastomas 1.
Treatment and prognosis
Anaplastic pleomorphic xanthoastrocytomas have a substantially worse prognosis; 40-50% 5-year-survival compared to ~90% 5-year-survival for pleomorphic xanthoastrocytomas 1.
- 1. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK "WHO Classification of Tumours of the Central Nervous System. 4th Edition Revised" ISBN: 9789283244929
Related Radiopaedia articles
- WHO classification of CNS tumors
- WHO grading of CNS tumors
- VASARI MRI feature set
- diffuse astrocytoma grading
- grade I:
- grade II:
- grade III
- grade IV:
- glioblastoma vs cerebral metastasis
- radiation-induced gliomas
- gliomatosis cerebri (growth pattern)
- specific locations
- treatment response
- Stupp protocol
- glioma treatment response assessment in clinical trials
- multicentric glioblastoma
- multifocal glioblastoma
- prognostic genetic markers