Department of Pathology/Neuropathology, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR.
Adv Anat Pathol. 2017 Nov;24(6):379-391. doi: 10.1097/PAP.0000000000000170.
As its historical name glioblastoma multiforme implies, glioblastoma is a histologically diverse, World Health Organization grade IV astrocytic neoplasm. In spite of its simple definition of presence of vascular proliferation and/or necrosis in a diffuse astrocytoma, the wide variety of cytohistomorphologic appearances overlap with many other neoplastic or non-neoplastic lesions. Here, after a brief review of glioblastoma is provided, the differential diagnostic possibilities with an emphasis on mimics and pitfalls are discussed. To provide an approach applicable to diagnostic practice, these discussions are grouped arbitrarily according to general malignant appearance such as pleomorphic xanthoastrocytoma and ganglioglioma, especially their anaplastic versions, and cellular features such as small cell and epithelioid glioblastoma. Some non-neoplastic lesions that can potentially be mistaken for glioblastoma under certain circumstances are also briefly mentioned. Additional studies, including immunohistochemistry and molecular markers, are included where applicable. Otherwise, exhaustive review of these individual entities, including their epidemiology and molecular biology, is outside the scope of this discussion.
正如其历史名称多形性胶质母细胞瘤所暗示的，胶质母细胞瘤是一种组织学上多样化的、世界卫生组织分级为 IV 级的星形细胞肿瘤。尽管其简单的定义为弥漫性星形细胞瘤中存在血管增生和/或坏死，但广泛的细胞组织形态学表现与许多其他肿瘤性或非肿瘤性病变重叠。在这里，简要回顾了胶质母细胞瘤之后，重点讨论了其鉴别诊断的可能性，包括模拟和陷阱。为了提供一种适用于诊断实践的方法，这些讨论是根据一般恶性外观（如多形性黄色星形细胞瘤和神经节胶质瘤，特别是它们的间变性版本）和细胞特征（如小细胞和上皮样胶质母细胞瘤）进行任意分组的。还简要提到了一些在某些情况下可能被误认为是胶质母细胞瘤的非肿瘤性病变。在适用的情况下，还包括免疫组织化学和分子标志物等其他研究。否则，对这些实体的详尽回顾，包括其流行病学和分子生物学，超出了本次讨论的范围。
