患者，男，27岁，1年前胶质瘤手术。现复发。

您的诊断

1、多形性黄色瘤型星形细胞瘤

2、室管膜下巨细胞星形细胞瘤

3、横纹肌样脑膜瘤

间变少突？

间变少突

This is a difficult case, you have at least following differential diagnosis to consider:
1 recurrent glioma, 2 treatment related changes (so called pseudo-progression), you need to know if patient receive radiation treatment or not, since most atypical cells here may be related to radiation.  Some IHC may be helpful, such as p53, if you have some p53 positive tumor cells, you may call it recurrent glioma. For the diagnosis of PXA (多形性黄色瘤型星形细胞瘤), i feel PXA is less likely, since too soon to recur.  you need to check location, MRI and others.  I favor this is a recurrent glioma with radiation changes.

黄色瘤型星形细胞瘤

多形性黄色瘤型星形细胞瘤

多形性黄色瘤型星形细胞瘤。

 anaplastic astrocytoma

多形性黄色瘤型星形细胞瘤。

巨细胞性胶质母