Pathology
CLINICAL NOTES: (R) frontal lesion
MACROSCOPIC DESCRIPTION: 1. "Brain tissue": A piece of firm tan tissue
FROZEN SECTION DIAGNOSIS: High grade glioma. A1.
MICROSCOPIC DESCRIPTION: 1-3. Sections show a moderately cellular astrocytic glioma with extensive areas of tumour necrosis. There are multiple foci of microvascular proliferation. Tumour cells demonstrate marked nuclear pleomorphism with hyperchromasia and prominent nucleoli. Frequent mitoses are observed.
IMMUNOHISTOCHEMISTRY: GFAP positive Nestin positive (high) Nogo A negative IDH-1 R132H negative (not mutated) ATRX positive (not mutated) P53 positive P16 negative Topoisomerase labelling index 15%.
DIAGNOSIS: The features are of glioblastoma IDH wild type (WHO Grade IV)