Glioblastoma NOS

Case contributed by Dr Trent Orton

Patient Data

Age: 65 years
Gender: Female
CT

Enhancing cortical mass near the central sulcus. 

MRI

Heterogeneously enhancing right parietal mass with diffusion restriction suggesting high cellularity. 

Case Discussion

The patient went on to have a craniotomy and excision. 

Histology

Microscopic Description:

Sections show multiple fragments involved by a very cellular neoplastic process. For the most part, the tumour cells are spindly with significant pleomorphism and hyperchromasia accompanied by microvascular proliferation. Geographic areas of necrosis are seen. There are a significant number of neutrophils at the interface between viable tumour and necrosis. The tumour cells also assume a microgemistocytic appearance in some areas. Mitotic figures are identified, particularly in the frozen sections. In some areas, the tumour is seen within the Virchow-Robin spaces. Special stains (reticulin and Masson trichrome) show that the collagen fibres are limited to blood vessels, and there is the absence of reticulin fibres around individual tumour cells.

Immunohistochemically, the malignant cells react strongly to GFAP with a significant number labelled by MIB-1 nuclear stain.

Final Diagnosis: glioblastoma

 

Note: IDH mutation status is not provided in this case and according to the current (2016) WHO classification of CNS tumours, this tumour would, therefore, be designated as a glioblastoma NOS

 

 

 

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Case information

rID: 4925
Case created: 4th Nov 2008
Last edited: 22nd May 2017
Inclusion in quiz mode: Included

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