Jan. 24, 1933

Dr. Hass

Material:

• Tumor from between optic nerves. Jan. 24, 1933. (Dr. Cutler).
• Previous entry in July with + ventriculogram for 3rd ventricle tumor. Negative transfrontal exploration by Dr. Cushing. X-ray and relief. Recurrence of bitemporal hemianopsia and 3d ventricle symptoms:

Gross description:

• Specimen consists of a few small bits of tissue on cotton patties. The largest of these bits is probably ¼ cc. in volume. They are all hemorrhagic and yellow, and of a soft, gelatinous consistency. Frozen section is made and shows a quite cellular tumor. The nuclei of the cells are large, oval. They contain a fine chromatin network and one or two eccentrically placed nucleoli. The striking feature is the fibrillary structure.
  • Impression: glioma.

  • Fixed in Zenker.

Microscopic report:

• Two sections, one stained with E.M.B. and one with P.T.A.H.

• The histology is essentially that of a glioblastoma multiforme. The tumor is composed of large numbers of glioblasts. These cells are quite large. They usually contain one nucleus, although multinucleated cells are very common. The nuclei are sharply circumscribed and contain large amounts of deeply staining chromatin. Mitotic figures are not infrequent. The cytoplasm of the cells takes a fairly deeply acidophilic stain. It is continued into long cytoplasmic processes. Between these cells are the small cells which resemble unipolar spongioblasts. Other cells have characteristics more like those of astrocytes. The P.T.A.H. stains show numerous glia fibrils. Several portions of the tumor are quite vascular. In these areas occasional groups of lymphocytes may be found around blood vessels.

DIAGNOSIS: Glioblastoma Multiforme

Dr. Hass.
George Hass M.D.
Resident Pathologist.