Pathological anatomy of autopsy brain with malignant glioma

The morphology of supratentorial malignant glioma was examined in autopsy brains from three anaplastic astrocytoma and 11 glioblastoma multiforme patients. Large histological preparations and routine preparations were used to investigate the primary lesion site, infiltration to adjacent brain, and cerebrospinal fluid (CSF) dissemination. The primary lesion sites showed active tumor growth with mass effect in three cases, necrotic tumor and brain with no or mild mass effect in nine, and no residual tumor in two. Tumor infiltration included extensive bilateral cerebral hemisphere infiltration in seven cases, moderate infiltration of one or two lobes in three, minimal infiltration just beyond the tumor bed in two, and no infiltration in two. Infiltration occurred along the fiber tract and subependymal tissue. CSF tumor cell dissemination occurred in the ventricular system in two cases, cerebral subarachnoid space in five, and spinal subarachnoid space in one. Small fibrillated cells and small anaplastic cells predominated in infiltrated lesions and CSF dissemination.