PMC5987230_01
MRI showing a right temporal-parietal cystic mass that is T1 hypointense.
CRIS2018-1285729.001.jpg
PMC5987230_01_CRIS2018-1285729.001.jpg
fig1
This mass was hypointense on T1 (Figure 1) and hyperintense on T2 (Figure 2).
The cystic mass is hyperintense on T2-weighted MRI, with rim enhancement.
CRIS2018-1285729.002.jpg
PMC5987230_01_CRIS2018-1285729.002.jpg
fig2
This mass was hypointense on T1 (Figure 1) and hyperintense on T2 (Figure 2).
Intermediate power view of the tumor showing a cellular proliferation of large, epithelioid cells with abundant cytoplasm. Numerous multinucleated giants cells are present (H&E stain, 200x original magnification).
CRIS2018-1285729.003.jpg
PMC5987230_01_CRIS2018-1285729.003.jpg
fig3
Permanent histologic sections show a cellular neoplasm composed of large, epithelioid cells, with numerous multinucleated giant cells (Figure 3).
Significant variation in size and shapes (pleomorphism) is noted, with mitotic figures and regions of haemorrhage and necrosis (H&E stain, 400x original magnification).
CRIS2018-1285729.004.jpg
PMC5987230_01_CRIS2018-1285729.004.jpg
fig4
There is significant nuclear pleomorphism, with mitotic activity, haemorrhage, and necrosis (Figure 4).
Microvascular proliferation is evident in some regions of the tumor (H&E stain, 200x original magnification).
CRIS2018-1285729.005.jpg
PMC5987230_01_CRIS2018-1285729.005.jpg
fig5
Microvascular proliferation is seen (Figure 5), and an infiltrative interface is observed with adjacent brain parenchyma (Figure 6).
Intermediate power view of the tumor at interface with adjacent brain parenchyma, demonstrating an infiltrative border (H&E stain, 200x original magnification).
CRIS2018-1285729.006.jpg
PMC5987230_01_CRIS2018-1285729.006.jpg
fig6
Microvascular proliferation is seen (Figure 5), and an infiltrative interface is observed with adjacent brain parenchyma (Figure 6).
Diffuse immunoreactivity for GFAP confirms that the tumor is of glial-astrocytic origin (200x original magnification).
CRIS2018-1285729.007.jpg
PMC5987230_01_CRIS2018-1285729.007.jpg
fig7
Neoplastic cells show diffuse reactivity for the glial fibrillary acidic protein (GFAP) (Figure 7) and S-100 protein, confirming glial origin.
Immunohistochemistry for pancytokeratin shows no reactivity (positive control verified) (200x original magnification).
CRIS2018-1285729.008.jpg
PMC5987230_01_CRIS2018-1285729.008.jpg
fig8
There is no reactivity for pancytokeratin or AE1/AE3 (Figure 8).
The Ki-67 proliferative index is markedly elevated, indicating a high-grade, aggressive lesion (100x original magnification).
CRIS2018-1285729.009.jpg
PMC5987230_01_CRIS2018-1285729.009.jpg
fig9
The Ki-67 proliferative index is markedly elevated (Figure 9).