Which of the following tumors is characterized histologically by pseudopalisading, necrosis, endoneural proliferation, hypercellularity, and atypical nuclei?
Correct Answer: Glioblastoma multiforme
Description: The features listed in the question are characteristic of a glioblastoma multiforme. Astrocytomas, the most common primary brain tumors in adults, range from low-grade to very high-grade (glioblastoma multiforme). These grades of astrocytomas include grade I (the least aggressive and histologically difficult to differentiate from reactive astrocytosis), grade II (some pleomorphism microscopically), grade III (anaplastic astrocytoma, characterized histologically by increased pleomorphism and prominent mitoses), and grade IV (glioblastoma multiforme). Glioblastoma multiforme is a highly malignant tumor characterized histologically by endothelial proliferation and serpentine areas of necrosis surrounded by peripheral palisading of tumor cells. It frequently crosses the midline ("butterfly tumor"). In contrast, schwannomas generally appear as extremely cellular spindle cell neoplasms, sometimes with metaplastic elements of bone, cailage, and skeletal muscle. Medulloblastomas occur exclusively in the cerebellum and microscopically are highly cellular with uniform nuclei, scant cytoplasm, and, in about one-third of cases, rosette formation centered by neurofibrillary material. Oligodendrogliomas, which are marked by foci of calcification in 70% of cases, commonly show a pattern of uniform cellularity and are composed of round cells with small dark nuclei, clear cytoplasm, and a clearly defined cell membrane. Ependymomas are distinguished by ependymal rosettes, which are ductlike structures with a central lumen around which columnar tumor cells are arranged in a concentric fashion. Glioblastoma Multiforme Reference: Robbins & Cotran Pathologic Basis of Disease, 9edition
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