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Fig. 1 | Acta Neuropathologica Communications

Fig. 1

From: Dramatic response of BRAF V600E-mutant epithelioid glioblastoma to combination therapy with BRAF and MEK inhibitor: establishment and xenograft of a cell line to predict clinical efficacy

Fig. 1

Clinicopathologic features of the patient. Preoperative (a) and postoperative (b) brain MR images of the lesion. Spinal cord MR images before (d) and after (e) combination therapy with BRAF and MEK inhibitor. Histopathologic features of the surgical (c, f, g, h, i; frontal lobe) and autopsy (j; second segment of the cervical cord) samples. T1-weighted gadolinium-enhanced image demonstrating enhancement of the well circumscribed tumor in the left frontal lobe (a) and confirming the subtotal resection except for enhancement of the lateral ventricle (b). Before targeted treatment, thick leptomeningeal dissemination (arrow) and syringomyelia are evident in the upper cervical cord on post-contrast MR images and T2-weighted images (d). After 4 weeks of treatment, T1-weighted gadolinium-enhanced images and T2-weighted images (e) reveal a dramatical radiological response to the therapy. The tumor cells are composed of discohesive, rounded cells with rhabdoid morphology, showing brisk mitotic activity (c). MIB-1 labeling index 36% (f). Positive immunoreactivity for BRAF V600E (g) and nuclear positivity for pERK (h). Ultrastructure of the tumor cells. A few foot processes (arrow) are not interwoven (i). Spinal cord invasion by the tumor cells with leptomeningeal dissemination (j). Scale bars c: 20 μm; f-h: 150 μm, i: 2 μm, j: 500 μm

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