Daumas-Duport et al developed a histologic grading system for astrocytomas. This is intended to be simple and reproducible. The authors are from the Mayo Clinic.
Histologic parameters:
(1) nuclear atypia
(2) mitotic activity
(3) tumor necrosis
(4) endothelial proliferation
|
Parameter |
Finding |
Points |
|
nuclear atypia |
absent (minimal variation in nuclear size and shape) |
0 |
|
|
present (hyperchromasia and/or obvious variation in size and shape) |
1 |
|
mitotic activity |
none |
0 |
|
|
present |
1 |
|
tumor necrosis |
absent |
0 |
|
|
present |
1 |
|
endothelial proliferation |
absent |
0 |
|
|
present (vascular lumina surrounded by a haphazardly arranged or "piled up" endothelial cells) |
1 |
total score =
= SUM(points for all 4 histologic features)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the higher the grade.
|
Total Score |
Histologic Grade |
5 Year Survival After Surgery (1988) |
|
0 |
Grade 1 |
100% |
|
1 |
Grade 2 |
42% |
|
2 |
Grade 3 |
12% |
|
3 or 4 |
Grade 4 |
2% |
from Figure 10, page 2157
Specialty: Hematology Oncology, Surgery, general, Neurology
