Diffuse astrocytoma IDH-mutant

Case contributed by A.Prof Frank Gaillard

Presentation

Seizures

Patient Data

Age: 35 Years
Gender: Male
CT

A left frontal region of low density is present with mass effect. A small curvilinear region of increased density is noted, which is of uncertain significance. 

MRI

A large left frontal mass is demonstrated without enhancement, calcification, necrosis or haemorrhage. 

Features favour a diffuse low grade glioma. 

Case Discussion

The patient went on to have surgery.

Histology

MICROSCOPIC DESCRIPTION: 

The sections show features of a moderately cellular astrocytic tumour. The tumour cells have elongated, angulated and hyperchromatic nuclei. Some gemistocytes are noted, occupying about 5% of the cell population. 1 mitosis is seen. No microvascular proliferation or necrosis is present. There is no oligodendroglial component. The features are those of diffuse astrocytoma.

The tumour cells are p53 and IDH-1 positive. ATRX shows loss of staining (mutated). MGMT is negative (likely methylated). The topoisomerase index is about 3%.

FINAL DIAGNOSIS: Diffuse astrocytoma (WHO Grade II)

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Case information

rID: 43678
Case created: 21st Mar 2016
Last edited: 16th Jun 2017
Inclusion in quiz mode: Included

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