RCPA Examinations in Anatomical pathology - Questions ... - Rcpa.tv

Case 14: Female 45 – left temporal
lobe mass
• MICROSCOPIC
• There is a thin layer of meninges overlying the cerebral cortex. There is a diffuse
infiltrate of relatively uniform small cells with round nuclei throughout t
the white
matter and the overlying grey matter. These show cells show "satellitosis" around
the cortical neurones and also condensation in the outer cortex. Most of the cells
have poorly defined cytoplasm and the nuclei appear to be surrounded by a clear
halo however some cells show an eccentric collection of eosinophilic ilic cytoplasm. An
area of microcystic change is present.
• Comment: The histology is of a diffuse glioma and the cellular morphology
combined with the pattern of infiltration is consistent with an oligodendroglioma. The
differential diagnosis may include a diffuse low grade glioma however on
morphological grounds (diffuse infiltration of uniform cells with peinuclear clearing)
this is less likely.
• Investigations: FISH studies for allelic losses from chromosomes 1p and 19q
should be undertaken and these may give prognostic indications as well as assistin
confirmation of the diagnosis.
• SUMMARY
• Brain: Oligodendroglioma