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Heterogeneously, but mainly peripherally, enhancing lesion in the parietal lobe, with extensive surrounding edema and positive mass effect. Spectroscopy demonstrates elevated choline and depressed NAA. Elevation of rCBV (area under the curve) is seen in the solid component.
The patient went on to have a resection.
Sections show a glial tumor displaying necrosis, vascular proliferation, a spindle cell component (consistent with so-called gliosarcoma), and obvious mitotic activity. The tumor cells display features that range from small cell to gemistocytic characteristics. Blood vessels appear somewhat hyalinized in areas.
Final Diagnosis: gliosarcoma.
Note: This case predates the recent (2016) revision WHO classification of CNS tumors and IDH status is not available.