Saturday 1 October 2016

Anaplastic Astrocytoma MRI

A 37 y o male  with right side focal seizures, left side weakness.
Previous MRI shows right insular and adjacent opercular lesion.
No change compared to previous MRIs.
MR study of brain reveals abnormal intra axial lesion as an area of T2 hyper intensity with focal parenchymal swelling involving right basal ganglia, adjacent opercular and insular cortex, non enhancing on post contrast, no restricted diffusion.
Imaging wise primary diagnosis : Infiltrative Glioma_ Anaplastic Astrocytoma.
Differential diagnosis: Nil.


Specimen         : Biopsy – Insular SOL.
Gross Appearance    : The specimen consists of irregular soft pieces of dull greyish white tissue; together measuring 2.2X1.8X1.0 cm. The entire tissue is submitted for processing.
Codes : A and B.

Microscopy        : Sections A and B both show reactive glial tissue amidst which is seen embedded fragments of astrocytic neoplasm. The tumour consists of hypercellular zones of neoplastic astrocytes displaying nuclear hyperchromasia, subtle pleomorphism, coarse chromatin and irregular nuclear membranes. The cells have scanty eosinophilic cytoplasm. The background is fibrillary with variable microvascular proliferation. No microcysts nor necrosis nor increased mitosis is seen. No granulomas seen.

Final Diagnosis : Anaplastic ( Fibrillary ) Astrocytoma ; Grade 2 to 3 of 4 (as per st. Anne - Mayo system).     

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