engleski

Gliofibroma : Mixed glial-mesenchymal tumour. Case report

Introduction. Gliofibroma is a controversial entity and is not included in the WHO classification of brain tumours despite several documented cases. It is characterised by an admixture of astrocytic and fibroblastic components. It commonly occurs in first two decades of life. The exact behaviour is fully unknown and its histogenesis is still debatable. Clinical details. A 14-year-old girl was at first examined by neurologist in 7 year off age due to partial sensory seizures. EEG did not reveal a focal lesion. Seizures recurred three times during seven year after initial attack. On CT scan a fairly well-defined mass was discovered in the left temporal lobe. MRI of the brain, T1-weighted, confirmed a well circumscribed isointense mass in the same region. In addition, there was no motor or sensory deficit. A gross complete surgical removal was accomplished. The tumour had a white-greyish colour and quite firm consistency, and measured 4X2x2 cm. Neuropathology. Histological examination of the formalin-fixed and paraffin-embedded material showed a tumour with a characteristic biphasic pattern. The majority of tumour cells were arranged in fascicles and whorls forming storiform pattern. Many psammoma bodies were seen in these mesenchymal components. Occasional areas revealed small clusters of bipolar GFAP positive cells. There were no mitotic figures. The tumour contained a rich vascular network ; however, there was no evidence of endothelial hyperplasia. Reticulin and Mallory-Trichrome stains disclosed the rich reticulin and collagenous network entrapping groups of glial cells. Ki-67 labelling index was very low. Conclusion. Gliofibroma is a benign cerebral tumour predominantly astrocytic glial component which determinates the biological behaviour and also the grade of WHO classification. Astrocytes in this neoplasms are capable of producting laminin, type-IV collagen and fibronectin which are essential components of the basal lamina. Therefore, subpial astrocytes have been considered to be the cell of origin of gliofibroma as well as of other desmoplastic gliomas based on their basal lamina formation and superficial cortical localisation.

nije evidentirano

nije evidentirano