单就这一次的组织学图像看，更像是间变性室管膜瘤或GBM;

不过复发的肿瘤组织学变化较大，应结合首次病理改变来综合考虑

以下是引用xiaohl在2009-2-18 23:39:00的发言：  单就这一次的组织学图像看，更像是间变性室管膜瘤或GBM; 不过复发的肿瘤组织学变化较大，应结合首次病理改变来综合考虑

支持！！！！

不知道，三者在临床处理上区别有多大？

请指教！

The high cellularity, vascular proliferation, and high MIB-1 labeling index are that of a malignancy. Neoplastic cells are relatively small with either elongated or round to slightly oval nuclei, uniform nuclear shape and size (at least focally) and little cytoplasm. GFAP was reported as negative, which would be unusual for anaplastic ependymoma, anaplastic oligodendroglioma/mixed oligoastrocytoma, and glioblastoma. There is a past history of anaplastic oligodendroglioma, and I believe that limits your differential diagnoses to anaplastic oligodendroglioma and glioblastoma with an oligodendroglioma component (the two are not much different in histopathology). To be sure, I would stain for EMA to rule out anaplastic ependymoma, and synaptophysin and NSE to rule out primitive neuroectodermal tumor (PNET). A challenging case this is.