Fig. 2

Histopathological examinations. Legend: histopathological examination of the primary brain lesion after the second and third surgery (A, B,), of the lymph node biopsy (C), and bone marrow biopsy performed at the right iliac wing (D). A, Astrocytoma shows slight to focally moderate hypercellularity composed of dark angulated nuclei without nucleoli and uneven cell distribution. Mitoses are very rare (A1, HE 20x). Neoplastic cells show cytoplasmic and nuclear staining for IDH1 (A2, 20x) and are immunoreactive for GFAP (A3, 20x). B, Glioblastoma shows hypercellularity, composed of highly pleomorphic cells with hyperchromatic nuclei, high mitotic index, endothelial proliferation and extensive areas of necrosis (B1, HE 20x). These cells are immunoreactive for IDH1 (B2, 20x) and OLIG2 (B3, 20x). C, the lymph node is complete compromised by a neoplasm composed of small and medium cells with hyperchromatic and pleomorphic nuclei and mitoses (C1, HE 20x). These cells show positivity to IDH1 (C2, 20x) and OLIG2 (C3, 20x). D, in the bone marrow neoplastic cells are similar to those observed in the primary tumor and in the lymph node (D1, HE 20x) with similar immunohistochemical stains to IDH1 (D2, 20x) and OLIG2 (D3, 20x)