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Washington University Experience | NEOPLASMS (NEURONAL) | DNET | 17G DNET (Case 17) AA Recurrence Ki-67 1.jpg
The Ki-67 labeling index is moderate. ---- Comment: The morphologic and immunohistochemical features of the 2008 specimen are consistent with a high grade astrocytoma with extensive radiation effects and radiation necrosis. Given the latter, it is hard to provide a definite WHO grade. Unlike classic glioblastoma, there was no clear microvascular proliferation or pseudopalisading necrosis. However, based on the presence of occasional mitotic figures and an elevated Ki-67 labeling index, this tumor is probably at least a WHO grade III astrocytoma. The presence of extensive radiation changes and necrosis also suggest that this tumor may be radiation associated. Given the marked change in morphologic appearance from the 2000 specimen, it is unclear whether this represents malignant degeneration of the original tumor or a second primary glioma.
