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Glioblastoma multiforme: radiologic-pathologic correlation

J H Rees1, J G Smirniotopoulos, R V Jones

  • 1Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC, USA.

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|November 1, 1996
PubMed
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Glioblastoma multiforme (GBM) is an aggressive astrocytic tumor. Radiologists play a crucial role in the accurate and timely diagnosis of GBM, aiding in patient treatment strategies.

Area of Science:

  • Neuro-oncology
  • Radiology
  • Pathology

Background:

  • Astrocytic tumors range from circumscribed (grade I) to diffuse (grades II-IV).
  • Diffuse astrocytomas can progress to glioblastoma multiforme (GBM), a grade IV tumor.
  • GBM exhibits characteristics like neovascularity, increased mitosis, cellularity, nuclear pleomorphism, and necrosis.

Purpose of the Study:

  • To summarize the key pathological and imaging features of glioblastoma multiforme (GBM).
  • To highlight the diagnostic importance of radiologists in GBM detection.

Main Methods:

  • Review of histopathological features of GBM, including cellularity, mitosis, necrosis, and pseudopalisading.
  • Analysis of common and less frequent imaging appearances of GBM, including location, mass effect, and edema.

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  • Discussion of GBM's metastatic pathways, including direct extension, cerebrospinal fluid, subependymal, and hematogenous spread.

    • Main Results:

    • GBM presents as a heterogeneous supratentorial mass with mass effect, often with central necrosis and surrounding edema.
    • Histopathology reveals increased cellularity, mitosis, pleomorphism, necrosis, and characteristic pseudopalisading.
    • GBM can occur in various locations and exhibit diverse imaging features, including cystic changes and mural nodules.

    Conclusions:

    • Accurate diagnosis of GBM relies on integrating histopathological and imaging findings.
    • Radiologists are essential for timely and precise GBM diagnosis due to the tumor's complexity and rapid progression.
    • Understanding GBM's varied presentation and metastatic potential is critical for effective patient management.