The patient went on to have a craniotomy and excision.
MICROSCOPIC DESCRIPTION: The sections show a moderately cellular glial tumour with a proliferation of mainly protoplasmic astrocytes with some intermixed fibrillary astrocytes. The protoplasmic astrocytes have enlarged round nuclei and short GFAP+ cytoplasmic processes in a background of prominent microcystic change. The fibrillary astrocytes appear more elongated and angulated. The tumour extends to involve the cerebral cortex. Sparse mitoses are seen (0-1 per 10 high power fields). There is no endothelial cell hyperplasia or necrosis. The overall features are those of diffuse astrocytoma (predominantly protoplasmic type). The Ki-67 index is about 3-4%. p53 is diffusely positive.
DIAGNOSIS: Diffuse astrocytoma of predominantly protoplasmic type (WHO grade II).
features images from this case