Table of Contents
Washington University Experience | NEOPLASMS (GLIAL) | Astrocytoma, pilocytic - Microscopic | 32A0 Case 32 History
Case 32 History ---- 24 year old male, cerebellum (No available test for FISH BRAF) ---- More detailed history: The patient is a 24-year-old man with a history of pilocytic astrocytoma of the fourth ventricle diagnosed in 2010. After an initial diagnosis of glioblastoma, rendered at an outside institution, he was treated with two doses of Temodar; subsequently, he was treated with post operative radiation therapy which he completed in 12/2010. MRI in 5/2012 showed a cystic and solid fourth ventricular mass with nodular mural enhancement which had increased in size since 11/2011. Concerning for progression of disease, the tumor was resected. The pathologic findings showed a residual pilocytic astrocytoma, WHO Grade I, with radiation treatment effects. Scattered amongst these cells were numerous, large eosinophilic granular bodies (EGBs) and swollen neuroaxonal spheroids. Vessels within the tumor tissue often show extensive mural thickening and hyalinization, sometimes superimposed upon complex (occasionally 'glomeruloid') architecture. No mitotic figures were identified. ---- Immunohistochemically stained sections show reactivity for glial fibrillary acidic protein in a subset of the tumor cells. Synaptophysin stains the numerous axonal spheroids as well as a subset of the tumor cells. Reactivity for neurofilament stains only rare entrapped axons within the tumor tissue and minute foci of non-neoplastic parenchyma. ---- The patient was seen again 9 years later with no evidence of tumor recurrence.
