Slide 162.Glioblastoma multiforme, Cerebrum

A. Brief Descriptions

  1. Astrocytic tumors: tumors composed  predominantly of neoplastic astrocytes.

  2. WHO grading : diffuse astrocytoma (WHO grade II), anaplastic astrocytoma (WHO grade III), glioblastoma  (WHO grade IV).

  3. Glioblastoma multiforme: high agressive, poor prognosis (mean survival 1 year), and irregular infiltrative lesion.

B. Gross Findings

  1. 可以同時觀察到firm white areasyellow softer necrotic areas甚至有時可以看到cystic change和出血區。

C. Micro Findings

  1. Necrosis and pseudopalisading.

  2. Endothelial proliferation & anaplastic astrocytes.

  3. Hypercellularity,bazarre nuclei,multinucleated cells,mitoses (vary considerably).

D. Others:

  1. GBM可以視為uniformly undifferentiated glioma,通常可以局部混有astrocytoma,甚至是oligodendroglioma,或是ependymoma,不過罕見。

  2. Lower grade glioma隨著時間一久可以進展到glioblastoma,可能與染色體第10對的基因缺損有關。

  3.  GBM好發的位置常在supratentorial,也可能在brain stem發現,cerebellum和spinal cord的發生雖然也可能,不過罕見。

E. Reference:

  1. Robbins Pathologic Basis of Disease, 6th ed.  P.1343-1348.



Fig. 162-1 (LP)Infiltrated border in junction of normal part (left) and tumor (right).




Fig. 162-2 (LP)Hypercellular tumor with necrosis and perinecrotic pseudopalisading.




Fig. 162-3 (LP)Atypical (ring-shaped) mitosis  and the  vascular proliferation with endothelial cell hyperplasia were noted.



Fig. 162-4 (LP)Vascular proliferation with endothelial cell hyperplasia.



Fig. 162-5 (LP)




Fig. 162-6 (HP)




Fig. 162-7 (HP)Tumor giant cells in the center.