case_images: PMC1325054_01
case_images: Figure 1A:  Smear showing abundant cellularity and necrosis (Diff-Quik   stain, X100).    . Figure 1B:  Smear showing atypical cells in loosely cohesive clusters (Diff Quik   stain, X400).   . Figures 1C and 1D:  Smears showing pleomorphic cells with coarsely clumped chromatin, irregular nuclear membranes, prominent nucleoli, atypical mitosis (1C, arrow), intranuclear inclusion (1D, arrow) and cellular processes (Papanicolaou stain X400)
case_images: 1742-6413-2-19-1.jpg
case_images: PMC1325054_01_1742-6413-2-19-1.jpg
case_images: F1
case_images: The smears were abundantly cellular with atypical cells arranged in loosely cohesive clusters, ranging from 5 to 40 cells per cluster, with overlapping nuclei (Fig. 1A-1D). Scattered atypical mitoses were also present (Fig. 1C). A few scattered intranuclear inclusions were present (Fig. 1D).
case_images: Figure 2A:  Cell block showing geographic necrosis (H&E stain, X400). . Figure 2B:  Cell block showing positive staining of malignant cells for glial fibrillary acidic protein (immunostain for GFAP, X400).  . Figure 2C:  Histology of surgical resection showing malignant cells with numerous mitotic figures in a desmoplastic background (H&E stain, X400).. Figure 2D:  Histology of surgical resection showing positive staining of malignant cells for glial fibrillary acidic protein (immunostain for GFAP, X400).
case_images: 1742-6413-2-19-2.jpg
case_images: PMC1325054_01_1742-6413-2-19-2.jpg
case_images: F2
case_images: The cell block showed similar findings as well as characteristic necrotic foci surrounded by palisading spindle-shaped atypical cells (geographic necrosis) (Fig. 2A). Immunohistochemically, the atypical cells displayed strong reactivity for GFAP (Fig. 2B) and vimentin with no reactivity for CD45, cytokeratin, and HMB-45, supporting the diagnosis of GBM. The histological sections from the tumor excised a month later verified the FNA findings of GBM (Fig. 2C-2D).