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.
Imaging wise primary diagnosis : Infiltrative Glioma_ Anaplastic Astrocytoma.
Differential diagnosis: Nil.
REPORT OF HISTOPATHOLOGICAL EXAMINATION
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).