I think this is a glioblastoma, WHO grade IV, because of glial differentiation, marked cytologic atypia, prominent tumor mecrosis, and focal possible vascular proliferation. Though I do not see obvious mitotic figures in the photos, I don't doubt there are some. Certainly, the relatively young patient's age and the circumscription of the lesion on MRI and CT scans suggest less malignant lesions like PXA. However, there are no eosinophilic granular bodies or characteristic perivascular inflammation to support PXA.

 免疫组化均为GFAP，怪异大细胞不是全阳性

 如果没有进一步工作的话，我宁愿诊断脑室内脑膜瘤或室管膜瘤

 请大家发表高见，我再做些免疫组化

 考虑为多形性胶质母。

 请问病理切片的图3那些空亮的象脂肪的细胞是什么细胞，那些怪异的多形性的巨核细胞很象黄色瘤细胞，请指教。

 PXA细胞成分较杂，可见一些黄瘤样细胞，本例细胞成分较单一，不太符合。既然GFAP阳性那么要考虑胶质细胞来源的肿瘤，毛细胞是否要除外一下啊。如果是复发病例，则要除外胶质母继发胶质肉瘤可能，巨细胞可能是恶变的肉瘤成分。

  I think this is a glioblastoma, WHO grade IV, because of glial differentiation, marked cytologic atypia, prominent tumor mecrosis, and focal possible vascular proliferation. 由于有胶质分化,细胞异形性以及明显的肿瘤性坏死和局灶性血管增生,我考虑是胶质母细胞瘤,WHOIV级,    Though I do not see obvious mitotic figures in the photos, I don't doubt there are some. 提供的图像中没有看到明显的核丝分裂,我认为肯定有一些核丝分裂.Certainly, the relatively young patient's age and the circumsc ription of the lesion on MRI and CT scans suggest less malignant lesions like PXA. However, there are no eosinophilic granular bodies or characteristic perivascular inflammation to support PXA. 尽管患者年龄较青,MRI和CT提示为低度恶性PXA样病变,但是没有嗜酸性颗粒小体、没有特征性的血管周围炎症，不支持PXA。

 多形性胶质母。