The patient went on to have an excision.
The sections show evidence of organising haemorrhage with sheets of foamy macrophages and many intermixed blood vessels. A few other fragments show a densely cellular astrocytic tumour. The tumour cells have elongated, angulated and hyperchromatic nuclei. Scattered mitotic figures are identified. Microvascular proliferation is inconspicuous. Small foci of tumour cell necrosis are seen. The tumour cells are GFAP, p53 and MGMT immunostains positive. The topoisomerase index is about 15%. IDH-1 and melan-A are negative. The features are those of glioblastoma.
Glioblastoma (WHO Grade IV).
features images from this case