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Pleomorphic xanthoastrocytoma

Case contributed by Frank Gaillard
Diagnosis certain

Patient Data

Age: Adult

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri

Selected images from an MRI of the brain demonstrate an enhancing lesion of the left frontal lobe with surrounding edema. Small peripheral cystic areas are present. 

Case Discussion

The patient went on to have a resection. 

Histology

Paraffin sections show a densely hypercellular glial tumor. Tumor cells are a mixture of gemistocytic astrocytes and large cells with foamy, GFAP positive cytoplasm. There are also scattered large cells with markedly pleomorphic hyperchromatic nuclei.

Frequent mitotic figures are noted (>10/10HPF) and there are occasional foci of vascular endothelial cell hyperplasia. Several perivascular cuffs of mononuclear inflammatory cells are also present. No necrosis is seen in any of the specimens submitted.

The Ki-67/MIB-1 proliferation index is approximately 8%.

FINAL DIAGNOSIS: pleomorphic xanthoastrocytoma - grade 3

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