Histopathology:
MICROSCOPIC DESCRIPTION: Sections show fragments of a hypercellular glial tumour. Tumour cells show moderate nuclear and cellular pleomorphism with round to oval nuclei and prominent nucleoli. Frequent mitotic figures are identified. There is microvascular proliferation and areas of pallisaded tumour necrosis. Immunohistochemistry results show tumour cells stain:
- GFAP Positive (focal)
- Nestin Positive (high)
- NogoA Positive
- IDH-1 R132H Negative (not mutated)
- ATRX Positive (not mutated)
- MGMT Negative (likely methylated)
- p53 Positive
- p16 CDKN2A Negative
Topoisomerase labelling index: Approximately 40%.
DIAGNOSIS: High grade glioma, IDH1 wild type, favouring glioblastoma (WHO Grade IV).