Patient Data
Large enhancing lesion crossing the corpus callosum with subependymal spread. Note that the mass is somewhat hyperdense suggesting high cellularity.
Large butterfly glioma (crossing the corpus callosum) with extensive leptomeningeal enhancement, consistent with spread, seen not only in the intracranial compartment but also coating the cervical cord.
Case Discussion
The patient went on to have a resection.
Histology
Microscopic Description:
Sections show pieces of a high-grade glioma showing areas of necrosis, and vascular neogenesis. The tumor cells show astrocytic features with increased nuclear pleomorphism. A giant cell component is noted. Mitotic activity is increased. Bizarre mitotic figures are seen. Vascular neogenesis is seen. The tumor cells are strongly immunoreactive for GFAP.
Final Diagnosis: Glioblastoma with giant cell glioblastoma component.
Note: This case predates the recent (2016) revision WHO classification of CNS tumors and IDH status is not available. As such, this tumor would now be classified as a glioblastoma NOS.