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Washington University Experience | NEOPLASMS (GLIAL) | Glioblastoma - Gross Pathology | 23A4 GBM, unsuspected, bilat (Case 23) H&E _5
Close-up of post-traumatic lesion. ---- Not shown: Microscopic examination of the brain sections taken from discrete mass like areas show a diffusely infiltrative, malignant glioma with pseudopalisading necrosis and microvascular proliferation, consistent with glioblastoma. IDH1 (R132H) mutant protein was tested and is negative in the tumor. Multiple sections from different regions of cerebral cortices as well as left deep gray nuclei (basal ganglia and thalamus) showed involvement by a diffuse glioma consistent with a diagnosis of gliomatosis cerebri. Left temporal lobe encephalomalacia shows remote changes comprised by volume loss, exuberant hemosiderin (and focal hematoidin) pigment deposition, foreign body giant cell reaction, cholesterol clefts, and marked gliosis, a likely residuum of his fall 3 years earlier. Sections of the left frontal cortex and left hippocampus additionally show scattered diffuse and neuritic plaques consistent with Alzheimer Disease Neuropathologic Change.
