形态上考虑为多形性胶质母细胞瘤，似乎伴有间变性少突胶质细胞瘤成分。第一张IHC图片是否为GFAP，不太象GFAP的表达方式。此外还需考虑PNET或GBM+转移性神经内分泌癌。临床病史很重要。

Figures 1-7 show a high grade infiltrating malignant glial neoplasm with necrosis and possible vascular/endothelial proliferation consistent with WHO grade IV glioblastoma. Figures 8-13 show a delicate capillary network between relatively uniform neoplastic cells suggestive of oligodendroglioma, but this determination can be very subjective. The neoplastic cells in these areas also suggest neuronal/neurocytic differentiation. Figures 15 and 16 must be S100 protein and synaptophysin (I am not absolutely sure which is which) and, if so, bring an interesting differential diagnosis of mixed glioneuronal tumor. Figure 14 and Figure 17 are obviously CD34 and GFAP stains. It is important to compare synaptophysin and GFAP stains in the same cellular areas of the tumor. Please provide a GFAP photo taken in the cellular areas (as in Figures 15 and 16) so that we can compare. Thanks.