The patient went on to have a biopsy, confirming the diagnosis.
The sections show fragments of cerebral cortex and white matter. A portion of hippocampus is included in specimen 4. In all specimens, the white matter shows moderate hypercellularity and the cortex shows prominent perineuronal secondary structuring by atypical fibrillary astrocytes. Moderate numbers of mature neurons are identified in white matter. No mitotic figures are identified. There is no microvascular proliferation and no necrosis is seen. The topoisomerase labeling index is approximately 3%.