The grading of gliomas is important and critical for assessing prognosis and planning therapy. A simple grading system for gliomas relies upon recognition of four parameters: nuclear atypia, mitoses, endothelial proliferation and necrosis. The presence of two or more of the above-described features in a glioma places the tumor in the high-grade category [1]. High-grade gliomas are tumors with both expansive and infiltrative growth [2]. They show some degree of anaplasia, without any cleavage plane, and in microscopic examination tumor cells extend beyond the tumor margins. Anaplastic astrocytoma (WHO grade III) and glioblastoma multiforme (WHO grade IV), the most common primary malignant brain tumors, are classified as highgrade tumors. Gliosarcoma, a rare (WHO grade IV) tumor composed of neoplastic glial cells and sarcomatous component, will be also reviewed with the highgrade tumors. Finally, the gliomatosis cerebri is considered as an high-grade (WHO grade III) astrocytoma because of the poor prognosis of patients with this tumor, while the tumor histologically consists of lowgrade astrocytoma cells.


Apparent Diffusion Coefficient Glioblastoma Multiforme Anaplastic Astrocytoma Vasogenic Edema Peritumoral Edema 
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  • A. Drevelegas
  • G. Karkavelas

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