Case 026

History/Physical

53-year-old right-handed male.

Impaired sensation on left side of body over past two months.

There is an expansile lesion in the right thalamus.

In addition to the right thalamic lesion (*), there is another area of abnormality in the medial right temporal lobe (arrow).

There is enhancement in the posterior right thalamus (arrows).

Diagnosis: Astrocytoma, IDH-mutant, grade 3

Fibrillary tumour composed of tumours with generous cytoplasm, stellate processes, nuclear pleomorphism and mitotic activity.

GFAP, 40x

Tumour cells express Glial Fibrillary Acidic protein (GFAP).

Moderate proliferation as evidenced by nuclear expression of Ki-67 .

IDH-1

Cytoplasmic expression of mutated IDH-1 (R132H).
Molecular analyses did not identify CDKN2A/B deletions.