location: cortex, bilateral thalamic
diagnosis: anaplastic astrocytoma (who grade iii) at autopsy, fibrillary astrocytoma (who grade ii) at initial biopsy
pre-treatment: radiation and chemotherapy
source: recurrent, autopsy
efs_(months): 2.4 from diagnosis
os_(months): 14.4 from diagnosis
pathology_of_human_tumor: from autopsy: the numerous mitotic figures and hypercellularity of the astrocytes seen at autopsy help to reclassify this tumor as a who grade iii lesion. some areas appear similar to the biopsy specimen, and have lower cellularity and only rare mitoses, but the majority of the lesion is higher grade. areas of necrosis are present, which are possibly related the the patient's therapy. definite vascular proliferation, which could indicate a higher grade neoplasm, is not identified. from initial diagnosis: sections demonstrate a moderately cellular tumor composed of uniform fibrillary astrocytes with long cell processes which infiltrate around neurons. the tumor cells have irregular hyperchromatic nuclei without mitotic activity. they stain intensely for gfap. the stroma is microcystic with scattered normal neurons, highlighted by hucn immunostain. necrosis or vascular proliferation is not present. ki67 stains ~2% of the tumor cells.