Xanthomatous change in tumours of glial origin

Six patients with glial tumours showing xanthomatous change are reported here. Four patients in the series showed features of anaplastic (malignant) glioma or glioblastoma multiforme. In these patients, the astrocytic origin of the xanthomatous cells was confirmed by electron microscopy and immunohistochemistry using glial fibrillary acidic protein (GFAP). Of these, in one patient (no. 4) xanthomatous change was seen in an anaplastic (malignant) mixed glioma with significant ependymal component. Only one patient (no. 5) could be considered histologically as pleomorphic xanthoastrocytoma, but no clinical follow up was available. The value of immunohistochemical staining for GFAP in distinguishing gliomas with xanthomatous change from true xanthofibromas and xanthosarcomas was demonstrated in one patient (no. 6) in whom the glioblastomatous areas were GFAP positive but the xanthomatous areas were negative. This was therefore considered as a rare condition of glioblastoma with xanthosarcoma.