Contributed by Xiaoyan Wang, MD, PhD; Charleen T. Chu, MD, PhD
Published on line in October, 2002
The patient is a 27-year-old woman presenting with a three-week history of progressive headache, nausea and vomiting. She experienced loss of consciousness for 10 minutes. Physical examination did not reveal any focal neurological deficits. MRI imaging studies showed a large parietal occipital mass. Craniotomy was performed to resect the tumor. Intraoperative consultation was requested.
MRI examination showed a large, heterogeneously enhancing parietal occipital mass measuring 5 x 4.5 cm (Figures 1, 2, 3, and 4).
Touch and smear preparations reveal a densely cellular specimen composed of predominantly cohesive cells with round to oval nuclei, and a moderately high nuclear to cytoplasmic ratio (Figure 5). Although glial processes are not prominent, regions of the smear display a glial-appearing background (Figure 6). Some nuclei exhibit grooving and occasional intranuclear pseudoinclusions (Figure 7). Mitotic figures are easily identified in the smear (Figure 8).
BRAIN, RIGHT PARIETAL, "TUMOR", RESECTION (Touch/Smear preparation)
The specimen for permanent section was received fresh in multiple parts, consisting of brown-tan, focally hemorrhagic soft tissue measuring 3.1 x 2.2 x 1.5 cm in aggregate.