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Washington University Experience | NEOPLASMS (NEURONAL) | Ganglioglioma | 4B1 Ganglioglioma (Case 4) H&E 1

4B1-4 This is a hypercellular glioneuronal neoplasm. Some areas strongly resemble pilocytic astrocytoma, showing predominantly bipolar cells with thin cell processes and mildly irregular, elongate-oval hyperchromatic nuclei, within a loose, fibrillary background. Eosinophilic granular bodies and Rosenthal fibers are abundant, and vessels show glomeruloid features, hyalinization, and associated lymphocytes. However, a large proportion of the tumor tissue appears histologically different. In these areas, the tumor parenchyma shows greater density, contributed by a network of small vessels and thin fascicles of tumor cell processes. In those areas most of the resident cells are ganglion cells with one or more large round nuclei with open chromatin, prominent eosinophilic nucleoli, abundant pale amphophilic, occasionally granular or bubbly cytoplasm, and peripheral Nissl substance. Scattered gemistocytic cells are also observed. Mitotic figures are rare. There is no evidence of necrosis. (H&E)

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