Anaplastic astrocytoma

Case contributed by A.Prof Frank Gaillard

Presentation

Middle aged patient presenting with a seizure.

MRI

MRI of the brain demonstrating a left occipito-temporal mass which has high T2 signal, heterogeneous low T1 signal (cystic change? necrosis?) with only moderate ill-defined areas of enhancement.

Features suggest a primary intermediate to high grade glial tumour. 

The patient went on to have surgery. 

Histology

The sections show a moderately cellular astrocytic tumour. Some of the astrocytes contain elongated, angulated and hyperchromatic nuclei. Others show protoplasmic form with rounder nuclei in a loose background. Scattered mitoses are seen. Some of the blood vessels appear hyalinised but there is no evidence of endothelial cell hyperplasia. Small numbers of tumour cells extend into the overlying cortex. No evidence of necrosis is seen. The Ki-67 index is 5-6%.

Final Diagnosis: The features are those of an anaplastic astrocytoma (WHO grade III)

Case Discussion

Fairly typical appearances of an anaplasic astrocytoma. Presence of enhancement suggests a grade III tumour. 

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Case information

rID: 3977
Case created: 6th Jul 2008
Last edited: 12th Jun 2016
Inclusion in quiz mode: Included

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