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Clinical history
45 year old woman with a lesion in the left temporal lobe.
Primary image
Supratentorial lesion. H&E stain.
Intermediate magnification
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Intermediate magnification. H&E stain.
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High magnification
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High magnification. H&E stain.
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Differential diagnosis
Differential diagnosis
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Astrocytoma, Oligodendroglioma, pilomyxoid astrocytoma, dysembryoplastic neuroepithelial tumor
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Additional tests
More history
More history
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The lesion shows no enhancement after CM application.
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Ask a friend
Ask a friend
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Extensive microcyst formations and mucoid degeneration is indicative of a protoplasmic glial brain tumor.
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Stains
Alcian blue/PAS to Bilirubin |
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Test | Result |
Alcian blue/PAS | I'm sorry but this is of no help. |
Alican blue pH 1.0 | I'm sorry but this is of no help. |
Alcian blue pH 2.5 | I'm sorry but this is of no help. |
Auramine | I'm sorry but this is of no help. |
Bielchowsky | I'm sorry but this is of no help. |
Bilirubin | I'm sorry but this is of no help. |
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Colloidal iron to Fontana-Masson |
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Test | Result |
Colloidal iron | I'm sorry but this is of no help. |
Congo red | I'm sorry but this is of no help. |
Cresyl violet | I'm sorry but this is of no help. |
Dieterle | I'm sorry but this is of no help. |
Diff Quik | I'm sorry but this is of no help. |
Fontana-Masson | I'm sorry but this is of no help. |
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Gallyas to Gremelius |
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Test | Result |
Gallyas | I'm sorry but this is of no help. |
Giemsa | I'm sorry but this is of no help. |
GMS | I'm sorry but this is of no help. |
Gomori's trichrome | I'm sorry but this is of no help. |
Gram | I'm sorry but this is of no help. |
Gremelius | I'm sorry but this is of no help. |
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JMS to Mucicarmine |
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Test | Result |
JMS | I'm sorry but this is of no help. |
Jones | I'm sorry but this is of no help. |
Kinyoun | I'm sorry but this is of no help. |
Luxol fast blue | I'm sorry but this is of no help. |
Masson trichrome | I'm sorry but this is of no help. |
M-MAS | I'm sorry but this is of no help. |
Movat | I'm sorry but this is of no help. |
Mucicarmine | I'm sorry but this is of no help. |
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Oil red O to Prussian blue |
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Test | Result |
Oil red O | I'm sorry but this is of no help. |
Orecein | I'm sorry but this is of no help. |
PAS | I'm sorry but this is of no help. |
PASD | I'm sorry but this is of no help. |
PASF | I'm sorry but this is of no help. |
PTAH | I'm sorry but this is of no help. |
Prussian blue | I'm sorry but this is of no help. |
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Reticulin to Ziehl-Neelsen |
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Test | Result |
Reticulin | This stain highlights the capillaries within the tumor |
Sudan black B | I'm sorry but this is of no help. |
Toluidine blue | I'm sorry but this is of no help. |
Verhoeff | I'm sorry but this is of no help. |
Von Kossa | I'm sorry but this is of no help. |
Warthin-Starry | I'm sorry but this is of no help. |
Ziehl-Neeslen | I'm sorry but this is of no help. |
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IHC
Alpha-1 AT to Cathepsin K |
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Test | Result |
alpha-1 AT | I'm sorry but this is of no help. |
ACTH | I'm sorry but this is of no help. |
AE1/AE1 | NEGATIVE |
alpha-fetoprotein | I'm sorry but this is of no help. |
Alk-I | I'm sorry but this is of no help. |
AMACR | I'm sorry but this is of no help. |
AR | I'm sorry but this is of no help. |
ATRX | |
Beta2-microglobulin | I'm sorry but this is of no help. |
B72.3 | I'm sorry but this is of no help. |
Beta-catenin | I'm sorry but this is of no help. |
BCL2 | I'm sorry but this is of no help. |
BCL6 | I'm sorry but this is of no help. |
BCLxL | I'm sorry but this is of no help. |
C3 comp | I'm sorry but this is of no help. |
CA9 | I'm sorry but this is of no help. |
Calcitonin | I'm sorry but this is of no help. |
Calponin | I'm sorry but this is of no help. |
Calretinin | I'm sorry but this is of no help. |
CAM5.2 | I'm sorry but this is of no help. |
Cathepsin K | I'm sorry but this is of no help. |
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CD10 to Chromogranin |
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Test | Result |
CD10 | I'm sorry but this is of no help. |
CD117 | I'm sorry but this is of no help. |
CD138 | I'm sorry but this is of no help. |
CD15 | I'm sorry but this is of no help. |
CD1a | I'm sorry but this is of no help. |
CD20 | I'm sorry but this is of no help. |
CD21 | I'm sorry but this is of no help. |
CD23 | I'm sorry but this is of no help. |
CD3 | I'm sorry but this is of no help. |
CD30 | I'm sorry but this is of no help. |
CD31 | I'm sorry but this is of no help. |
CD34 | NEGATIVE |
CD35 | I'm sorry but this is of no help. |
CD4 | I'm sorry but this is of no help. |
CD43 | I'm sorry but this is of no help. |
CD45 (LCA) | NEGATIVE |
CD5 | I'm sorry but this is of no help. |
CD56 | I'm sorry but this is of no help. |
CD57 | I'm sorry but this is of no help. |
CD68 | I'm sorry but this is of no help. |
CD7 | I'm sorry but this is of no help. |
CD79a | I'm sorry but this is of no help. |
CD8 | I'm sorry but this is of no help. |
CD99 | I'm sorry but this is of no help. |
CDX2 | I'm sorry but this is of no help. |
CEA-m | I'm sorry but this is of no help. |
Chromogranin | I'm sorry but this is of no help. |
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CK17 to Glypican 3 |
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Test | Result |
CK17 | I'm sorry but this is of no help. |
CK19 | I'm sorry but this is of no help. |
CK20 | I'm sorry but this is of no help. |
CK34betaE12 | I'm sorry but this is of no help. |
CK5/6 | I'm sorry but this is of no help. |
CK7 | I'm sorry but this is of no help. |
CMV | I'm sorry but this is of no help. |
c-MYC | I'm sorry but this is of no help. |
Cyclin D1 | I'm sorry but this is of no help. |
D2-40 | I'm sorry but this is of no help. |
Desmin | I'm sorry but this is of no help. |
DOG1 | I'm sorry but this is of no help. |
EBV | I'm sorry but this is of no help. |
EMA | NEGATIVE |
ER and PR | I'm sorry but this is of no help. |
Factor VIII | I'm sorry but this is of no help. |
Factor XIIIa | I'm sorry but this is of no help. |
Fascin | I'm sorry but this is of no help. |
FH | I'm sorry but this is of no help. |
FSH | I'm sorry but this is of no help. |
Gastrin | I'm sorry but this is of no help. |
GATA3 | I'm sorry but this is of no help. |
GCDFP-15 (BRST2) | I'm sorry but this is of no help. |
GFAP | |
GH | I'm sorry but this is of no help. |
Glucagon | I'm sorry but this is of no help. |
Glypican-3 | I'm sorry but this is of no help. |
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HBME-1 to IgM |
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Test | Result |
HBME-1 | I'm sorry but this is of no help. |
HBV core | I'm sorry but this is of no help. |
HBV surface | I'm sorry but this is of no help. |
H-caldesmon | I'm sorry but this is of no help. |
HCG | I'm sorry but this is of no help. |
Helicobacter | I'm sorry but this is of no help. |
Hepatocyte | I'm sorry but this is of no help. |
HER2/neu | I'm sorry but this is of no help. |
HHV-8 | I'm sorry but this is of no help. |
HMB-45 | I'm sorry but this is of no help. |
HNF1beta | I'm sorry but this is of no help. |
HPV | I'm sorry but this is of no help. |
HSV-I | I'm sorry but this is of no help. |
HSV-II | I'm sorry but this is of no help. |
IDH-1 | |
Inhibin | I'm sorry but this is of no help. |
INI1 (BAF47) | I'm sorry but this is of no help. |
Insulin | I'm sorry but this is of no help. |
Kappa | I'm sorry but this is of no help. |
Ki-67 | |
Lambda | I'm sorry but this is of no help. |
Leu 7 | I'm sorry but this is of no help. |
IgA | I'm sorry but this is of no help. |
IgG | I'm sorry but this is of no help. |
IgM | I'm sorry but this is of no help. |
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LH to PDGFR |
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Test | Result |
LH | I'm sorry but this is of no help. |
LIN28 | I'm sorry but this is of no help. |
Lysozyme | I'm sorry but this is of no help. |
mammoglobin | I'm sorry but this is of no help. |
MAP2 | |
MCV | I'm sorry but this is of no help. |
Melanin A | I'm sorry but this is of no help. |
MHC class I | I'm sorry but this is of no help. |
MITF | I'm sorry but this is of no help. |
MUM1 | I'm sorry but this is of no help. |
Myeloperoxidase | I'm sorry but this is of no help. |
MYO D1 | I'm sorry but this is of no help. |
Myoglobin | I'm sorry but this is of no help. |
Napsin | I'm sorry but this is of no help. |
NF | NEGATIVE |
NKX3.1 | I'm sorry but this is of no help. |
NSE | NEGATIVE |
OCT3/4 | I'm sorry but this is of no help. |
p16 | I'm sorry but this is of no help. |
P501S | I'm sorry but this is of no help. |
p53 | I'm sorry but this is of no help. |
p57 | I'm sorry but this is of no help. |
p63 | I'm sorry but this is of no help. |
Pankeratin | NEGATIVE |
PAX2 | I'm sorry but this is of no help. |
PAX5 | I'm sorry but this is of no help. |
PAX8 | I'm sorry but this is of no help. |
PCNA | I'm sorry but this is of no help. |
PDGFR | I'm sorry but this is of no help. |
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PLAP to WT1 |
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Test | Result |
PLAP | I'm sorry but this is of no help. |
PNL-2C | I'm sorry but this is of no help. |
Prolactin | I'm sorry but this is of no help. |
PSA | I'm sorry but this is of no help. |
PSAP | I'm sorry but this is of no help. |
RCC | I'm sorry but this is of no help. |
S-100 | POSITIVE |
SALL4 | I'm sorry but this is of no help. |
Smooth muscle actin | I'm sorry but this is of no help. |
Somatostatin | I'm sorry but this is of no help. |
STAT6 | I'm sorry but this is of no help. |
Synaptophysin | I'm sorry but this is of no help. |
TdT | I'm sorry but this is of no help. |
TFE3 | I'm sorry but this is of no help. |
TFEB | I'm sorry but this is of no help. |
Thyroglobulin | I'm sorry but this is of no help. |
Toxoplasma | I'm sorry but this is of no help. |
TSH | I'm sorry but this is of no help. |
TTF-1 | I'm sorry but this is of no help. |
Ubiquitin | I'm sorry but this is of no help. |
UCHL1 (PGP9.5) | I'm sorry but this is of no help. |
Ulex Europaeus | I'm sorry but this is of no help. |
Vimentin | I'm sorry but this is of no help. |
VIP | I'm sorry but this is of no help. |
VZV | I'm sorry but this is of no help. |
WT-1 | I'm sorry but this is of no help. |
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Other molecular tests
Molecular tests (A-B) |
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Test | Result |
ALK sequencing | Dr Torres would ask why! |
B cell clonality Southern / PCR | Dr Torres would ask why! |
BCL2 PCR | Dr Torres would ask why! |
BRAF sequencing | Dr Torres would ask why! |
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Molecular tests (C-H) |
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Test | Result |
EBV PCR | Dr Torres would ask why! |
EGRF sequencing | Dr Torres would ask why! |
H3F3A sequencing | NEGATIVE |
HHV-8 PCR | Dr Torres would ask why! |
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Molecular tests (I-J) |
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Test | Result |
Identity testing PCR | Dr Torres would ask why! |
IDH1/2 PCR | IDH1 R132H mutation |
JAK2 V617F ARMS | Dr Torres would ask why! |
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Molecular tests (K-Z) |
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Test | Result |
KIT sequencing | Dr Torres would ask why! |
LOH 1p/19q PCR | NEGATIVE |
T cell clonality Southern / PCR | Dr Torres would ask why! |
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Diagnosis
Diagnosis
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Diffuse Astrocytoma, WHO grade II. Comment: This protoplasmic variant has scant GFAP expression and thus is often misdiagnosed as oligodendroglioma, but nuclear ATRX loss and absence of deletions in chromosomal arms 1p/19q confirm the diagnosis.
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Other cases
|
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| Number | |
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| Subspecialty (Difficulty) |
Autopsy pathology (jr,sr, f/e)
Breast pathology (jr,sr, f/e)
Cardiovascular pathology (jr,sr, f/e)
Cytopathology (jr,sr, f/e)
Dermatopathology (jr,sr, f/e)
Endocrine pathology (jr,sr, f/e)
Forensic pathology (jr,sr, f/e)
Gastrointestinal pathology (jr,sr, f/e)
Genitourinary pathology (jr,sr, f/e)
Gynecologic pathology (jr,sr, f/e)
Hematopathology (jr,sr, f/e)
Head and neck pathology (jr,sr, f/e)
Lymph node pathology (jr,sr, f/e)
Medical kidney pathology (jr,sr, f/e)
Molecular pathology (jr,sr, f/e)
Neuropathology (jr,sr, f/e)
Pediatric pathology (jr,sr, f/e)
Pulmonary pathology (jr,sr, f/e)
Placental pathology (jr,sr, f/e)
Soft tissue pathology (jr,sr, f/e) |
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| Difficulty | |
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