glioblastoma


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  • Clinical

    • most common brain tumor
    • mean age 60
    • site: hemispheres, subcortical white matter
    • mostly de novo, can arise from diffuse and anaplastic astrocytoma
    • WHO grade IV

  • Histology

    • anaplastic glial cells
    • abundant mitosis
    • necrosis (pseudopalisading) or microvascular proliferation
    • other possible components
      • metaplasia: adenoid (glandular), squamous
      • oligodendroglial component
      • gemistocytes, granular cells, lipidized cells
    • variants
      • giant cell glioblastoma
        • giant cells are S100+ and GFAP variable
      • gliosarcoma
        • biphasic (separate or mixed) glioblastoma and sarcoma component
        • sarcoma component loses GFAP

  • Ddx

    • demyelinating disease (lots of macrophages)
    • lymphoma (perivascular cuffing)
    • abscess

  • Molecular

    • get IDH1/2, 1p19q, MGMT for therapy purposes
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