Morphological spectrum of vascular changes in glioblastoma multiforme

ABSTRACT

To determine the frequency of various vascular changes and their associated effects in Glioblastoma Multiforme [GBM]. It was a descriptive study.Pathology Department, Pakistan Institute of Medical Sciences. Islamabad. 30 diagnosed cases of glioblastoma multiforme were analyzed in the study from July 2005 to September 2006. The slides were evaluated for various vascular patterns like vascular proliferation, endothelial proliferation, glomeruloid bodies, necrosis of vessel wall and fibrin thrombi. More than l/3rd blood vessels were blocked by fibrin thrombi in 70% of cases. Vascular occlusion by thrombi involving more than 50% of diameter was seen in 57% of cases. 64% of cases showed endothelial proliferation in the form of glomeruloid bodies, while rest of the cases showed mild to moderate endothelial proliferation. 86% of cases exhibited necrosis whereas pseudopalisaded necrosis was observed in 60% cases. Most of the cases showed edema and extravasation of red blood cells in more than 2/3rd of slide area. All cases of glioblastoma multiforme showed vascular thrombi resulting in destruction as well as leading to endothelial cell damage and proliferation. The resultant vascular damage causes exudation of plasma and extravasation of red blood cells leading to significant cerebral edema