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DOI: 10.1148/rg.273065138
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Glioblastoma Multiforme1

David A. Altman, MD, Denis S. Atkinson, Jr, MD, and Daniel J. Brat, MD, PhD

1 From the Departments of Radiology (D.A.A., D.S.A.) and Pathology (D.J.B.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322. Received July 19, 2006; revision requested August 17 and received September 20; accepted September 22. All authors have no financial relationships to disclose.

Figure 1A
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  		Figure 1a.  Axial (a) and coronal (b) gadolinium-enhanced T1-weighted MR images demonstrate a heterogeneously enhancing mass with central necrosis centered in the posterior left temporal lobe.

 

Figure 1B
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  		Figure 1b.  Axial (a) and coronal (b) gadolinium-enhanced T1-weighted MR images demonstrate a heterogeneously enhancing mass with central necrosis centered in the posterior left temporal lobe.

 

Figure 2A
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  		Figure 2a.  Axial (a) and coronal (b) fluid-attenuated inversion recovery MR images demonstrate the mass with a large amount of surrounding T2 prolongation, a finding that suggests edema.

 

Figure 2B
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  		Figure 2b.  Axial (a) and coronal (b) fluid-attenuated inversion recovery MR images demonstrate the mass with a large amount of surrounding T2 prolongation, a finding that suggests edema.

 

Figure 3
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  		Figure 3.  Image from single-voxel MR spectroscopy (echo time = 288 msec) demonstrates decreased levels of NAA and elevation of the choline-to-creatine ratio to more than 3:1, findings that suggest an aggressive neoplastic process. Red box indicates the site of interrogation.

 

Figure 4
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  		Figure 4.  Photograph of the coronally sectioned gross pathologic brain specimen demonstrates an ill-defined, heterogeneous mass centered in the left temporal lobe. Areas of hemorrhage and necrosis are present, and the adjacent tissue is edematous.

 

Figure 5A
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  		Figure 5a.  Photomicrographs of the lesion (b [original magnification, x600; hematoxylin-eosin stain] is a magnified view of the boxed area in a [original magnification, x100; hematoxylin-eosin stain]) demonstrate regions of necrosis (white arrows) surrounded by rings of pseudopalisading tumor cells (black arrows), which are in turn surrounded by abundant microvascular hyperplasia (arrowheads).

 

Figure 5B
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  		Figure 5b.  Photomicrographs of the lesion (b [original magnification, x600; hematoxylin-eosin stain] is a magnified view of the boxed area in a [original magnification, x100; hematoxylin-eosin stain]) demonstrate regions of necrosis (white arrows) surrounded by rings of pseudopalisading tumor cells (black arrows), which are in turn surrounded by abundant microvascular hyperplasia (arrowheads).

 




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