Pleomorphic xanthoastrocytoma with anaplastic features: A case report.
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Date
2014-01
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Abstract
Pleomorphic xanthoastrocytoma has been considered as an astrocytic tumor
with relatively favorable prognosis. It corresponds to WHO Grade-II neoplasm.
Recently, several patterns with relatively poor prognosis have been recorded
and a new concept of “PXA with anaplastic features” has been proposed. The
present case is about a 9-year–old girl who presented with symptoms of recurrent
headache, seizures and poor academic performance. MRI revealed left frontoparietal
irregular enhancing mass lesion with callosal involvement and right
mid-brain arteriovenous malformation. Clinical and radiological examination was
suggestive of a high grade glial neoplasm/PNET. A diagnosis of high grade glial
neoplasm was rendered on the squash smears submitted for frozen sections
based on the presence of spindle cells, admixed with pleomorphic bizarre,
giant cells with multilobated nuclei showing few atypical mitosis and abundant
eosinophilic cytoplasm. Frontal craniotomy with debulking of the tumor was
performed and permanent sections revealed a biphasic glial neoplasm with
spindle cells arranged in fascicles admixed with bizarre multinucleated giant cells
showing abundant vacuolated and lipidized cytoplasm, nuclear hyperchromasia
with intranuclear inclusions. Eosinophilic granular bodies, mitosis of 7/10 HPF,
micro vascular proliferation, necrosis and invasion into the underlying brain
parenchyma were noted. With these histomorphological fi ndings a diagnosis of
pleomorphic xanthoastrocytoma with anaplastic features was rendered.
Description
Keywords
Anaplastic features, astrocytic tumor, pleomorphic xanthoastrocytoma
Citation
Niamathullah Sadiya, Sivaselvam S, Ghosh Mitra, Ghosh Siddhartha. Pleomorphic xanthoastrocytoma with anaplastic features: A case report. Indian Journal of Pathology & Microbiology. 2014 Jan-Mar 57 (1): 101-104.