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14 楼 发表于2009-02-23 12:32:00举报|引用
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As many who have commented, I agree with the diagnosis of fibrillary astrocytoma. The grade of this neoplasm is difficult to decide based on the photos. There is calcification to suggest a low grade (WHO grade II) diffuse astrocytoma, but cellularity is high focally and nuclear atypia significant. I have not seen a mitotic figure in any of the photos. Please do a careful count of mitotic figures and look at the pre-surgical MRI of the lesion. If very rare mitoses are found (<3 per slide) and no contrast enhancement was detected on MRI, I would favor WHO grade II diffuse astrocytoma. On the other hand, if mitotic figures are easily seen (either focally or diffusely) and there was MRI contrast enhancement, I would favor WHO grade III anaplastic astrocytoma.
As many who have commented, I agree with the diagnosis of fibrillary astrocytoma. The grade of this neoplasm is difficult to decide based on the photos. There is calcification to suggest a low grade (WHO grade II) diffuse astrocytoma, but cellularity is high focally and nuclear atypia significant. I have not seen a mitotic figure in any of the photos. Please do a careful count of mitotic figures and look at the pre-surgical MRI of the lesion. If very rare mitoses are found (<3 per slide) and no contrast enhancement was detected on MRI, I would favor WHO grade II diffuse astrocytoma. On the other hand, if mitotic figures are easily seen (either focally or diffusely) and there was MRI contrast enhancement, I would favor WHO grade III anaplastic astrocytoma.
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huzhihon..
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