A 40-year-old man, who rarely had headaches, now has been experiencing headaches for the past 6 months. He
comes to the physician because of a seizure that occurred 1 day ago. On physical examination, there are no remarkable
findings. MRI of the brain shows a solitary, circumscribed 3-cm mass in the right parietal centrum semiovale. The mass
has small cysts and areas of calcification and hemorrhage. Neurosurgery is performed, and the mass is removed.
Microscopically, the mass consists of sheets of cells with round nuclei that have granular chromatin. The cells have a
moderate amount of clear cytoplasm. These cells mark with GFAP by immunohistochemical staining. The patient receives
adjuvant radiation and chemotherapy, and there is no recurrence. Which of the following neoplasms was most likely
present in this patient?
A. Astrocytoma B. Diffuse large B-cell lymphoma C. Germ cell tumor D. Glioblastoma multiforme E. Medulloblastoma F. Metastatic renal cell carcinoma G. Oligodendroglioma
Oligodendroglioma-(g) oligodendrogliomas tend to have a better prognosis than most other glial neoplasms. astrocytomas tend to be less
circumscribed. diffuse large b-cell lymphomas can occur in association with aids; they are negative for glial fibrillary
acidic protein (gfap), but positive for cd19 and cd20. intracranial germ cell tumors are most likely to arise in the pineal
body. glioblastomas are highly aggressive, infiltrative gliomas. medulloblastomas are posterior fossa tumors that occur in
children. renal cell carcinoma has cells with clear cytoplasm, but it is not positive for gfap and often produces multiple
metastases. in rare cases, removal of a solitary metastasis of renal cell carcinoma can be beneficial.
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