43. Clinical case report of anaplastic pleomorphic xanthoastrocytoma

Nguyen Duc Hoan, Khuat Thi Lay, Le Ngoc Anh, Tran Van Hop, Ha Kim Trung

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Abstract

Anaplastic nucleomorphic xanthoastrocytoma is a rare tumor, with an incidence of 0.3% in glial cells. When the tumor exceeds 5 nuclei/10 microscopic fields, it is classified as hypodifferentiated anaplastic pleomorphic xanthoastrocytoma. At Hong Ngoc General Hospital, we met a case of a 28-year-old male patient who was diagnosed with a left frontal lobe tumor measuring 7x6 cm. On microscopic examination, the tumor consisted of cells with pleomorphic nuclei, some atypical nuclei, extensive cytoplasm, 6/10 mitotic ratio on congested, bleeding stromal background, tumor cells positive for immunohistochemical markers including GFAP, Oligo2, ATRX, CD68. The immunohistochemical results also showed that the tumor had no IDH mutation, while BRAF V600E was strongly positive, Ki67 positive rate was 35%. Conclusion: Grade III anaplastic pleomorphic xanthoastrocytoma has histopathological features that need to be distinguished from epithelioid glioblastoma. For differential diagnosis, it is necessary to combine histopathological and immunohistochemical morphological features of the tumor.

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References

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