《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 areas和yellow 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.