Anaplastic astrocytoma with eosinophilic granular cells

Abstract

A 68-year-old man, who had no remarkable past medical history, was referred to a hospital because of disorientation and right-sided hemiparesis. On magnetic resonance imaging, a contrast-enhanced tumor in the left frontal lobe with perifocal edema was noted. He underwent left frontal lobectomy. Microscopic examination revealed infiltrative atypical astrocytes showing increased cellularity, distinct nuclear atypia, and many mitotic figures, while microvascular proliferation and necrosis were absent. Thus, the tumor was histologically diagnosed as anaplastic astrocytoma. It was of note that cytoplasmic eosinophilic granules were observed in approximately 25% of neoplastic cells. The granules were positively immunostained with anti-alphaB-crystallin antibody, and the other histochemical and immunohistochemical results also corresponded to Rosenthal fibers. The MIB-1 labeling index of the highest area of the tumor was 22%, while that of granular cells was 2.1%. An ultrastructural study revealed amorphous electron-dense structures attached to intermediate filament bundles, compatible with Rosenthal fibers. Such structures are relatively common in oligodendroglial tumors; however, they are extremely rare in astrocytic tumors. Fluorescence in situ hybridization targeted against chromosome 1 failed to demonstrate allelic loss of the short arm. The present case should also be discriminated from granular cell astrocytoma. We review related literature and discuss the significance of granules in gliomas.

Morphological and molecular features of astroblastoma, includingBRAFV600Emutations, suggest an ontological relationship to other cortical-based gliomas of children and young adults

“…2 R) or was present within gemistocytic cells (Figs 2 L; 3 I, J, M). Intracellular eosinophilic granular material has also been observed in granular cell astrocytomas 17,18 and oligodendrogliomas. 19,20 These structures were thought to represent tiny Rosenthal fibers in some cases 18,20 and autophagic lysosome-related structures in others.…”

“…Intracellular eosinophilic granular material has also been observed in granular cell astrocytomas 17,18 and oligodendrogliomas. 19,20 These structures were thought to represent tiny Rosenthal fibers in some cases 18,20 and autophagic lysosome-related structures in others. 17,19 In the latter case, their presence may suggest autophagic degeneration, possibly partially explaining the often cystic neuroimaging features of ABs.…”

Immunohistochemical and molecular genetics study of a granular cell astrocytoma: A case report of malignant transformation to a glioblastoma

“…It was first described by Markesbery et al . in 1973 as a “granular cell tumor in the central nervous system”, and there have been several reports on GCA to date . Although the GCA lesion does not appear histologically anaplastic, it frequently behaves as a malignant infiltrating astrocytoma .…”

Anaplastic astrocytomas with abundant Rosenthal fibers in elderly patients: A diagnostic pitfall of high‐grade gliomas

“…In addition, Kinjo et al . described a case of anaplastic astrocytoma with cytoplasmic eosinophilic granular cells . They demonstrated that these granules corresponded to the structures of RFs, which were identical to the eosinophilic refractile granules of Yoshida and Nakazato.…”

“…They demonstrated that these granules corresponded to the structures of RFs, which were identical to the eosinophilic refractile granules of Yoshida and Nakazato. These granules were named miniature RFs (mRFs) compared with the common type of RFs …”