Unusual Histological Findings in a Cohort of Gliomas with High Grade Features: A Clinicopathological Study of 5 Cases at a Single Institution.
Ying Sun, Xianyuan Song, Inam Kureshi, Thomas Ciesielski, Srinivas Mandavilli. Hartford Hospital, CT
Background: Rosenthal fibers (RF) and eosinophilic granular bodies (EGB) are commonly encountered in pilocytic astrocytoma (PA), pleomorphic xanthoastrocytoma (PXA) and ganglioglioma, and usually associated with long standing processes. There is limited literature addressing the clinical significance of RF and EGB in gliomas with high grade features (HGF). The aim of this study is to evaluate the clinical, radiologic and pathologic findings in such cases.
Design: The pathology database for the time period 2003-2010 was queried for Gliomas with HGF and there were 5 cases in which RF and/ or EGB were described as a prominent finding. The pathologic diagnoses were: 2 PXA, 2 grade III gliomas, and 1 mixed tumor with glial and neurocytic features. The clinical follow-up ranged from 1 month to over 20 years (see Table 1).
Results: All patients underwent tumor resection. Histologically, all tumors showed high grade features including high cellularity, pseudopalisading necrosis, vascular proliferation and variable mitotic activity. Two cases (#1 and #2) had EGB and RF. Two (#3 and #5) had RF and one (#4) had EGB.
|1||PXA||II-III||16M||Acute; 1 week||Left frontal lobe enhancing mass||9mo; stable|
|2||Mixed tumor with glial and neurocytic features||Uncertain||61F||Increasing headache 1 month||4th ventricle complex cystic mass with peripheral enhancement||1 mo; stable|
|3||Glioma with pilocytic features||III||33F||Recent headache, seizure||Right frontal lobe mass with decreased attenuation||13 mo; stable|
|4*||PXA*||II-III*||31M *||Headache *||Right frontal lobe enhancing mass *||14 years; alive *|
|5||Astrocytoma||III-IV||29M||Mental status changes||Left frontal lobe mass||6 years; recent status unknown|