Astroblastoma in childhood:: pathological and clinical analysis

Object: 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. Methods: 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. Conclusions: 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.