The patient went on to have surgery.

Histology

The sections show features of a moderately cellular astrocytic tumor. The tumor cells have elongated, angulated and hyperchromatic nuclei. Some gemistocytes are noted, occupying about 5% of the cell population. 1 mitosis is seen. No microvascular proliferation or necrosis is present. There is no oligodendroglial component. The features are those of diffuse astrocytoma.

The tumor cells are p53 and IDH-1 positive (mutated). ATRX shows loss of staining (mutated). MGMT is negative (likely methylated). The topoisomerase index is about 3%.

Final diagnose

Astrocytoma, IDH-mutant (WHO Grade 2)