Table of Contents

Washington University Experience | NEOPLASMS (GLIAL) | Glioblastoma, primitive neuronal component | 21A2 Gliosarcoma-PNET-Adenoid var (Case 21) H&E 9

21A2,3 Sections of the initial biopsy reveal a relatively solid-appearing neoplasm with variable morphologic appearances. In some areas, the tumor resembles a high grade astrocytoma, containing fibrillary and gemistocytic astrocytes with a variably myxoid stromal background, mitotic activity, foci of microvascular proliferation, and necrosis. Another area resembles gliosarcoma, containing compact fascicles of spindled cells with moderate to marked nuclear pleomorphism and occasional bizarre multinucleated cells. A third component resembles a primitive neuronal element, composed of highly cellular aggregates of small cells with minimal cytoplasm and a brisk mitotic index. The three elements are intermingled in a fashion resembling interlocking pieces of a jigsaw puzzle. In some areas of the PNC-like component, anaplastic features are evident, with increased cell size, prominent nucleoli, and cell wrapping. Sections from the recurrent tumor resection (not shown) show only the glial component, with numerous multinucleated giant cells.

---