| • A high power view of the glioblastoma showing another
characteristic change known as capillary endothelial
proliferation.
• In capillary endothelial proliferation, the capillaries
demonstrate swollen endothelial cells.
• This is seen only in one nonmalignant tumor - the
pilocytic astrocytoma.
• Otherwise it denotes malignancy. |
| Glioblastoma Multiforme |
| Etiology |
•The exact etiology is not known but has to do
with
several mutations in protooncogenes and tumor
suppressor genes. •Some appear as a part of several hereditary syndromes
such as neurofibromatosis or Turcot^s syndrome. |
| Pathogenesis |
•The cause of the
glioblastoma or any brain tumor is not
known but changes or loss of chromosome 17 and inactivation
of a tumor suppressor gene, p53, play a role. Thus far,
we do not know what precipitates these changes. |
| Epidemiology |
•Glioblastomas are the most comman primary brain tumor. •They account for 50% of all gliomas and arise after
age 50 in most patients. •Younger patients tend to have a better prognosis than
the elderly. •Radiation and chemotherapy appear to extend the life of
the patient. |
| Clinical |
•Slowly progressive focal
neurological deficit. •Aggressive neoplasms with overall poor prognosis. •For more information on prognosis and treatment, consult the NCI web site. |
| General Gross Description |
•The glioblastoma multiforme has a multiform or variable
appearance with evidence of old and recent hemorrhage
(yellowish-brown to red), necrosis and areas of
firm tissue. •Usually the glioblastoma is seen as a mass lesion
involving a focal area although it may cross the
corpus callosum to the other hemisphere or be multifocal. |
| General Micro Description |
•Microscopically the glioblastoma has many forms as well. •Is a highly cellular tumor with pleomorphic, basophilic
nuclei with indistinct cytoplasmic borders or plump
pink cytoplasm and a delicate fibrillary background. •Mitoses,necrosis, and capillary endothelial
proliferation are common. |
| Reference |
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1342-1344. • • Poirer J et.al. Manual of basic neuropathology. Philadelphia: Saunders, 1990, pp. 25-26.
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