Glioblastoma (WHO grade 4 diffuse astrocytoma, IDH-wildtype) is distinguished pathologically from lower-grade gliomas by which histological features?
- A Presence of Rosenthal fibers and eosinophilic granular bodies
- B Perinuclear halos (fried-egg appearance) and chicken-wire vasculature
- C Microvascular proliferation (glomeruloid vessels) and/or geographic necrosis with pseudopalisading tumor cells ✓
- D Homer-Wright rosettes and high N/C ratio with absent stroma
Correct answer: C. Microvascular proliferation (glomeruloid vessels) and/or geographic necrosis with pseudopalisading tumor cells
Explanation
Glioblastoma (GBM) is defined by microvascular/glomeruloid proliferation and/or pseudopalisading necrosis — tumor cells palisading around central areas of necrosis. These features confer WHO grade 4. Rosenthal fibers are seen in pilocytic astrocytoma and reactive gliosis. Fried-egg appearance with chicken-wire vessels characterizes oligodendroglioma. Homer-Wright rosettes are in medulloblastoma/neuroblastoma.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
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