PATHOLOGY

Biopsy: 20 x 5 x 3 mm brown tissue aggregate. Hemorrhagic brain barenchyma with diffuse infiltration of large cells with nuclear pleomorphism (including multinucleated and bizzare looking cells). Intrinsic necrosis and microvascular proliferation.

GFAP: strongly positive
IDH1: negative (wildtype)
ATRX: weak staining (mutated)
MGMT: negative
p53: positive
H3 K27M: negative
S100: occasional
NeuN: negative
CD34: present
MIB1: very high

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Diagnosis

Glioblastoma WHO grade 4; IDH1 wildtype; MGMT unmethylated