Granular cell astrocytoma

Case report

Rohan Gupta, Supriya Gupta, Nathaniel Shapiro, Scott Y Rahimi, Suash Sharma

Research output: Contribution to journalArticle

Abstract

Granular Cell Astrocytoma (GCA) is a rare astrocytic brain tumor histologically composed of plump astrocytic cells with abundant eosinophilic granular cytoplasm that exhibits immunoreactivity for GFAP and S100 proteins. It is associated with poor outcome often akin to glioblastoma despite its bland histologic appearance. We report a case of GCA in which neoplastic cells resembled macrophages on intra-operative frozen section and smear. Paraffin sections showed features of a granular cell astrocytoma, WHO grade IV, with diffuse immunohistochemical coexpression of GFAP and S100. No mutation of IDH1 or P53 was identified by immunohistochemistry; however, ATRX loss indicating mutation supported an astrocytic lineage. Additionally, sporadic weak cytoplasmic staining for CD68 and EMA and negative staining for CD163 is likely non-specific due to increased lysosomal activity and does not indicate true histiocytic or epithelial differentiation. We recommend that in the absence of overt high-grade features or admixture with conventional diffuse astrocytoma on intra-operative smear and frozen section, it may be advisable to wait to confirm the diagnosis on paraffin section histology and immunohistochemical stains before proceeding with definitive tumor resection. This diagnostic approach will prevent over-treatment by resection of non-neoplastic mimics of GCA.

Original languageEnglish (US)
Pages (from-to)4-7
Number of pages4
JournalHuman Pathology: Case Reports
Volume14
DOIs
StatePublished - Nov 1 2018

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Astrocytoma
Frozen Sections
Glioblastoma
Paraffin
Negative Staining
Mutation
S100 Proteins
Brain Neoplasms
Histology
Cytoplasm
Coloring Agents
Immunohistochemistry
Macrophages
Staining and Labeling
Neoplasms

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Granular cell astrocytoma : Case report. / Gupta, Rohan; Gupta, Supriya; Shapiro, Nathaniel; Rahimi, Scott Y; Sharma, Suash.

In: Human Pathology: Case Reports, Vol. 14, 01.11.2018, p. 4-7.

Research output: Contribution to journalArticle

Gupta, Rohan ; Gupta, Supriya ; Shapiro, Nathaniel ; Rahimi, Scott Y ; Sharma, Suash. / Granular cell astrocytoma : Case report. In: Human Pathology: Case Reports. 2018 ; Vol. 14. pp. 4-7.
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