Multiple gangliogliomas

Case contributed by A.Prof Frank Gaillard

Patient Data

Age: 20
Gender: Male
MRI

Multiple right cerebral cystic masses with enhancing mural nodules. 

Pathology

MICROSCOPIC DESCRIPTION:

The sections from all the specimens show features of moderately cellular glial tumor with similar appearances. In some parts, increased numbers of dysmorphic neurons are seen. They seem to aggregate with uneven distribution. They have enlarged nuclei, prominent nucleoli and abnormally clumped Nissl substance. They stain with B-tubulin, p16, p53 and focally with synaptophysin and Neu-N. They are GFAP, IDH-1 and MGMT negative.

Elsewhere, there are scattered bipolar astrocytes, which show focal fascicular arrangement. The tumor cells have elongated and hyperchromatic nuclei. There are some Rosenthal fibers and many eosinophilic granular bodies in the background. Perivascular lymphocytes, along with clumps of calcification are noted. No mitoses are seen. No microvascular proliferation or necrosis is present. The features are those of ganglioglioma with the glial component being pilocytic astrocytoma. The topoisomerase index is less than 1%.

DIAGNOSIS:

Ganglioglioma (WHO Grade I) with the glial component being pilocytic astrocytoma.

Case Discussion

Cyst with a mural nodule is a typical appearance for a pilocytic astrocytoma, although multiple lesions such as this is atypical. 

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Case information

rID: 30081
Published: 18th Jul 2014
Last edited: 16th Jul 2018
Inclusion in quiz mode: Included

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