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- 20100331-左额叶占位
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There is severe nuclear pleomorphism and atypia, focal tumor necrosis, and many giant cells in this seemingly malignant neoplasm. The cytoplasmic processes are consistent with astrocytic/glial differentiation. Although I am not certain how frequent mitotic figures are found, I think this may be a case of giant cell variant of WHO grade IV glioblastoma. Giant cell glioblastoma is not a common variant of all glioblastomas, constituting about 3% in my personal experience. It has a few characteristic - relatively circumscribed (but still infiltrative), often contains many small lymphocyte-like cells, and arguably a slightly better prognosis than usual glioblastomas. The only differential diagnosis would be WHo grade II pleomorphic xanthoastrocytoma, which should contain similar giant cells, eosinophilic granular bodies, perivascular inflammation, very rare mitoses, and no tumor necrosis. Mitotic figures,once again, are important to find before making a diagnostic conclusion.
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| 以下是引用mjma在2010-3-31 10:59:00的发言： There is severe nuclear pleomorphism and atypia, focal tumor necrosis, and many giant cells in this seemingly malignant neoplasm. The cytoplasmic processes are consistent with astrocytic/glial differentiation. Although I am not certain how frequent mitotic figures are found, I think this may be a case of giant cell variant of WHO grade IV glioblastoma. Giant cell glioblastoma is not a common variant of all glioblastomas, constituting about 3% in my personal experience. It has a few characteristic - relatively circumscribed (but still infiltrative), often contains many small lymphocyte-like cells, and arguably a slightly better prognosis than usual glioblastomas. The only differential diagnosis would be WHo grade II pleomorphic xanthoastrocytoma, which should contain similar giant cells, eosinophilic granular bodies, perivascular inflammation, very rare mitoses, and no tumor necrosis. Mitotic figures,once again, are important to find before making a diagnostic conclusion. |
