21 Questions
What are the diagnostic histological features of glioblastoma multiforme?
Marked cellularity, cellular pleomorphism, mitoses, multinucleated tumor giant cells, pseudopalisading necrosis, microvascular proliferation
How does Grade IV Astrocytoma-Glioblastoma multiforme appear grossly?
Soft and yellow or red due to necrosis or hemorrhage, with features like necrosis, hemorrhage, cystic changes
What are the criteria for diagnosing Glioblastoma multiforme?
At least three out of the four criteria: marked cellularity, cellular pleomorphism, mitoses, multinucleated tumor giant cells
How does Pilocytic astrocytoma (WHO Grade 1) differ from Glioblastoma multiforme in terms of behavior?
Pilocytic astrocytoma shows relatively benign behavior compared to Glioblastoma multiforme.
What is the characteristic feature of Glioblastoma multiforme pseudopalisading necrosis?
Serpentine areas of necrosis surrounded by crowded tumor cells
What are the unique characteristics that set CNS tumors apart from neoplastic processes elsewhere in the body?
CNS tumors are not described as benign vs malignant but graded according to the WHO scale from Grade I (most indolent) to Grade IV (most aggressive) based on the biologic behavior of the neoplasm. A benign neoplasm can still be fatal in the CNS.
What is the common genetic fusion/duplication found in Pilocytic astrocytoma?
KIAA1549-BRAF gene fusion/duplication
What is the key histological feature that defines a Grade IV astrocytoma, also known as glioblastoma multiforme?
The key histological feature that defines a Grade IV astrocytoma, or glioblastoma multiforme, is the presence of necrosis and microvascular proliferation.
What are the key cell types from which primary brain tumors can originate, according to the information provided?
Primary brain tumors can originate from the following cell types: astrocytes, oligodendroglia cells, ependymal cells, choroid plexus cells, neurons (mature and immature), meningeal/meningothelial cells, vascular cells, lymphoid cells, Schwann cells, embryonic remnants, and germ cells.
How do pilocytic astrocytomas differ from glioblastoma multiforme in terms of their biologic behavior and WHO grade?
Pilocytic astrocytomas are WHO Grade I tumors, which are the most indolent, while glioblastoma multiforme is a WHO Grade IV tumor, which is the most aggressive. Pilocytic astrocytomas have a much more favorable prognosis compared to the highly aggressive glioblastoma multiforme.
What are the key criteria that define a glioblastoma multiforme (Grade IV astrocytoma) according to the information provided?
The key criteria that define a glioblastoma multiforme (Grade IV astrocytoma) are the presence of necrosis and microvascular proliferation in the histological features.
What is the most common type of glioma, accounting for 60% of all gliomas?
Glioblastoma multiforme
What are the two main genetic subtypes of glioblastoma multiforme based on IDH mutation status?
IDH-wild type and IDH-mutant
What are the four key histological criteria that define a glioblastoma multiforme (Grade IV astrocytoma)?
The four key histological criteria for glioblastoma multiforme are: nuclear pleomorphism, increased cellularity, mitoses, and either microvascular proliferation or necrosis.
What is the typical age of onset for glioblastoma multiforme?
The peak age of onset for glioblastoma multiforme is 45-60 years.
What are the two main ways glioblastoma multiforme can present - primary (de novo) and secondary?
Glioblastoma multiforme can present as either a primary (de novo) tumor or as a secondary tumor progressing from a lower-grade diffuse astrocytoma.
What are the typical locations that glioblastoma multiforme occurs in the brain?
Glioblastoma multiforme most commonly occurs in the cerebral hemispheres, less commonly in the brainstem, and rarely in the cerebellum.
What is the prognosis for patients with glioblastoma multiforme?
Glioblastoma multiforme has an extremely poor prognosis, with most patients dying within 18 months of diagnosis. Patients with IDH-wild type glioblastoma have a worse prognosis than those with IDH-mutant tumors.
How does a pilocytic astrocytoma (Grade I) differ from a diffuse astrocytoma (Grade II) in terms of histological features and clinical behavior?
Pilocytic astrocytomas (Grade I) are well-differentiated, localized tumors that typically remain static or progress slowly, while diffuse astrocytomas (Grade II) are more infiltrative, with increased cellularity and nuclear pleomorphism, and have a tendency to progress to higher-grade tumors.
What are the typical presenting symptoms of glioblastoma multiforme?
Common presenting symptoms of glioblastoma multiforme include seizures, headaches, and neurological deficits.
What are the typical MRI findings for a glioblastoma multiforme?
On MRI, a glioblastoma multiforme typically appears as an enhancing mass in the cerebral hemispheres with a central area of lucency (necrosis) and an irregular, infiltrative border.
Test your knowledge on the gross examination findings of glioblastoma multiforme, including necrosis, hemorrhage, cystic changes, and mass effect in the brain. Identify the diagnostic histological features associated with this aggressive Grade IV astrocytoma.
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