Glioblastoma (WHO Grade 4 astrocytoma) shows which combination of histological features that distinguishes it from lower-grade gliomas?

• A Pseudopalisading necrosis and microvascular proliferation (endothelial hyperplasia) ✓
• B Rosenthal fibers and eosinophilic granular bodies
• C Perivascular lymphocytic cuffing and demyelination
• D Homer Wright rosettes with neuroblastic differentiation

Explanation

Glioblastoma (GBM) is defined histologically by the presence of pseudopalisading necrosis (tumor cells palisading around geographic areas of necrosis) and microvascular proliferation (glomeruloid vascular tufts). These features reflect the aggressive biology including central hypoxia driving angiogenesis via HIF-1alpha/VEGF. Rosenthal fibers are in pilocytic astrocytoma. Perivascular lymphocytes and demyelination suggest primary CNS lymphoma or inflammatory demyelinating disease. Homer Wright rosettes are in medulloblastoma.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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