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Washington University Experience | NEOPLASMS (GLIAL) | Astrocytoma, IDH-mutant, WHO Grade 4 | 8A2 IDHmut Astro Gr4 (Case 8) H&E 4.jpg
Sections of the resected left brain tumor show a malignant primary glial neoplasm with several appearances. The majority of the tumor is made up of relatively small, mildly pleomorphic cells diffusely infiltrating the parenchyma. A second population shows greater pleomorphism, cytoplasmic clearing and a more nested appearance due to prolific microvascular hyperplasia and multiple endothelial mitoses. There are large areas of geographic necrosis associated with vascular hyalinization.
