《Slide 162.》Glioblastoma multiforme, Cerebrum. A. Brief Descriptions：. Astrocytic tumors: tumors composed predominantly of neoplastic astrocytes.《Slide162.》Glioblastomamultiforme,CerebrumA.BriefDescriptions：Astrocytictumors:tumorscomposed predominantlyofneoplasticastrocytes.WHOgrading:diffuseastrocytoma(WHOgradeII),anaplasticastrocytoma(WHOgradeIII),glioblastoma (WHOgradeIV).Glioblastomamultiforme:highagressive,poorprognosis(meansurvival1year),andirregularinfiltrativelesion.B.GrossFindings：可以同時觀察到firmwhiteareas和yellowsofternecroticareas，甚至有時可以看到cysticchange和出血區。

C.MicroFindings：Necrosisandpseudopalisading.Endothelialproliferation&anaplasticastrocytes.Hypercellularity，bazarrenuclei，multinucleatedcells，mitoses(varyconsiderably).D.Others:GBM可以視為uniformlyundifferentiatedglioma，通常可以局部混有astrocytoma，甚至是oligodendroglioma，或是ependymoma，不過罕見。

Lowergradeglioma隨著時間一久可以進展到glioblastoma，可能與染色體第10對的基因缺損有關。

 GBM好發的位置常在supratentorial，也可能在brainstem發現，cerebellum和spinalcord的發生雖然也可能，不過罕見。

E.Reference:RobbinsPathologicBasisofDisease,6thed. P.1343-1348.  【Fig.162-1(LP)】Infiltratedborderinjunctionofnormalpart(left)andtumor(right).　  【Fig.162-2(LP)】Hypercellulartumorwithnecrosisandperinecroticpseudopalisading.　　 【Fig.162-3(LP)】Atypical(ring-shaped)mitosis andthe vascularproliferationwithendothelialcellhyperplasiawerenoted.　 【Fig.162-4(LP)】Vascularproliferationwithendothelialcellhyperplasia.　 【Fig.162-5(LP)】　  【Fig.162-6(HP)】　  【Fig.162-7(HP)】Tumorgiantcellsinthecenter.