Lipoglioblastoma: a lipidized glioma radiologically and histologically mimicking adipose tissue

Received 30 June 2009; accepted 16 July 2009. published online 15 October 2009.
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Abstract

Background

We report the case of a man with glioblastoma containing a component radiologically and histologically mimicking adipose tissue.

Case Description

A 48-year-old man recently complaining of headaches and difficulty with speech presented with a cystic peripherally enhancing left temporoparietal mass with focal intrinsically (precontrast) bright nodules in fluid attenuated inversion recovery and T1-weighted images similar to adipose tissue. Histologically, the enhancing component was classic glioblastoma, whereas the bright nodules comprised tumor cells that in aggregate closely resembled adipose tissue.

Conclusions

The case illustrates the extent to which lipidized central nervous system tumors of glial origin, or components thereof, can radiologically and histologically resemble adipose tissue. However, immunohistochemical staining and electron microscopy can eliminate diagnostic confusion.

Abbreviations: CNS, central nervous system, EMA, epithelial membrane antigen, FLAIR, fluid attenuated inversion recovery, GBM, glioblastoma, GFAP, glial fibrillary acidic protein, MRI, magnetic resonance imaging, PXA, pleomorphic xanthoastrocytoma

Keywords: Glioblastoma, Lipidization, Lipoglioblastoma, Lipoastrocytoma, Adipose tissue

a Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

b Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA

c Greensboro Pathology Associates, PA Greensboro, NC 27415-3508, USA

Corresponding author. Department of Pathology, Baltimore, MD 21287, USA. Tel.: +1 410 955 8378; fax: +1 410 614 9310.

PII: S0090-3019(09)00655-7

doi:10.1016/j.surneu.2009.07.036