Cellular astroglial tumor composed of sheets of atypical gemistocytes admixed with other areas showing tumor looks fibrillary composed of irregular short bundles of proliferating spindle cells with enlarged hyperchromatic nuclei. Tumor shows foci of necrosis palisaded by radially arranged viable fibrillary cells. Tumor is vascular with evidence of endothelial proliferation (glomeruloid pattern). Mitosis is markedly active. Picture is consistent with glioblastoma multiforme WHO grade IV, progressing from WHO grade II gemistocytic astrocytoma.
Headache and vomiting with personality changes MRI: An Abnormal signal intensity lesion was noted at the left temporo-occipital lobe deep white matter and periventricular regions, collectivcly measuring about 6.4 x 4.5 x 4.8 cm, surrounded by moderate vasogenic edema causing a mass effect upon the adjacent cortical sulci and ventricles.
Soft tissue pieces collectively measured 2.5x2.2x0.8 cm, totally embedded in one cassette.
Left temporo-occipital intra-axial brain mass, biopsy:
Glioblastoma multiforme WHO grade IV, complicating pre-existing gemistocytic astrocytoma.