Glioblastoma with large numbers of eosinophilic hyaline droplets in neoplastic astrocytes.
We report a case of glioblastoma with unusual histological features arising in the left frontal lobe of a 79-year-old woman. On routine histological examinations of specimens obtained at the surgical resection, the tumor was consistent with glioblastoma, and intracytoplasmic inclusions of bright eosinophilic, round objects were found in a large number of neoplastic astrocytes. Pathological studies using histochemical/ immunohistochemical stainings and electron microscopy demonstrated that the inclusions were compatible with eosinophilic hyaline droplets (EHD), which are predominantly seen in pleomorphic xanthoastrocytoma and pilocytic astrocytoma. EHD-bearing cells were distributed throughout the tumor tissue and focally abundant (182/mm2). Most of those cells were negative for MIB- I immunostaining, although mitotic figures were rarely observed. Neither round granular body nor Rosenthal fibers were seen. Based on these neuropathological findings and a review of the literature, we concluded that this case was a very rare case of glioblastoma with numerous EHDs. The presence of numerous EHDs is considered a diagnostically helpful feature suggesting low-grade astrocytomas. The present case suggested that diagnostic application of numerous EHDs should be careful, particularly in small biopsy samples such as stereotactic biopsy.
Sasaki
A
A
Department of Pathology, Gunma University School of Medicine, Maebashi, Japan. achie@med.gunma-u.ac.jp
Yoshida
T
T
Kurihara
H
H
Sasaki
T
T
Nakazato
Y
Y
D000368:Aged; D001253:Astrocytes / Q000378:metabolism*; D001932:Brain Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D004802:Eosinophilia / Q000175:diagnosis / Q000378:metabolism / Q000473:pathology; D005260:Female; D005909:Glioblastoma / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D006818:Hyalin / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D008854:Microscopy, Electron; D008863:Microspheres