Department of Pathology, University of Oklahoma Health Sciences Center

NeuroTest Question #5 Next question Previous question

Answer: A (Seen in WHO Grade IV tumors, associated with enhancement on imaging, associated with poor prognosis) Level of difficulty: 3 NeuroTest NeuroLearn NeuroHelp

Discussion: [Click here to see a related case]

• Endothelial proliferation is illustrated here. The blood vessels form a glomeruloid like structure with plump endothelial cells protruding into the lumen.
• As per criteria of the World Health Organization (WHO), endothelial proliferation in an astrocytic tumor as being illustrated here is sufficient for a diagnosis of Grade IV astrocytoma (glioblastoma) which carries a poor prognosis.  Necrosis is not a necessary feature for a diagnosis of WHO grade IV tumor.
• Endothelial proliferation is associated with enhancement on imaging.
• WHO has only grade I to IV. There is no grade V.

Comment: KarMing-Fung@ouhsc.edu