Glioblastoma

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Glioblastoma
Diagnosis in short

Glioblastoma. H&E stain.

LM astrocytic differentiation, nuclear atypia, necrosis, microvascular proliferation, +/-pseudopalisading necrosis
Subtypes gliosarcoma
LM DDx anaplastic astrocytoma
IHC GFAP +ve, IDH-1 -ve/+ve
Site brain, spinal cord

Radiology intra-axial
Prognosis very poor
Clin. DDx metastatic brain tumours

Glioblastoma a very common malignant primary brain tumour in adults. It has a very poor prognosis.

It was previously known as glioblastoma multiforme, abbreviated GBM.

General

  • Median survival is measured in months.[1]
  • Only about 5% can expect to survive more than three years.[2]

Microscopic

Features:

  • Astrocytic tumour with:
    • Nuclear atypia.
    • Necrosis.
    • Endothelial proliferation (AKA microvascular proliferation).
    • +/-"Pseudopalisading necrosis" - tumour cells lined-up like a picket fence around necrotic areas.

Images

www:

IHC

  • GFAP +ve (cytoplasm).
  • IDH-1 -ve.
    • +ve if developed from lower grade astrocytoma. (???)

See also

References

  1. Jubelirer, SJ.. "A review of the treatment and survival rates of 138 patients with glioblastoma multiforme.". W V Med J 92 (4): 186-90. PMID 8772403.
  2. Krex, D.; Klink, B.; Hartmann, C.; von Deimling, A.; Pietsch, T.; Simon, M.; Sabel, M.; Steinbach, JP. et al. (Oct 2007). "Long-term survival with glioblastoma multiforme.". Brain 130 (Pt 10): 2596-606. doi:10.1093/brain/awm204. PMID 17785346.