Anaplastic strocytoma

Case contribution: Dr Radhiana Hassan


  • A 49 years old man
  • No known medical illness
  • Presented with headache and fitting episode
  • Developed one episode of status epilepticus
  • No fever, no meniningism, muscle weakness involving left side of body
  • Urgent non-contrast CT scan brain done was reported as cerebral infarction
MRI of brain in axial planes
MRI brain in axial planes hemo sequences

MRI findings:

  • Abnormal signal seen involving right temporal, frontal and parietal lobe
  • It is hypointense on T1, hyperintense on T2/FLAIR with minimal enhancement post contrast
  • Cortex expansion is also noted
  • Mass effect with midline shift and compression to ipsilateral lateral ventricles
  • No restricted diffusion
  • Blooming artefacts within the lesion on hemo sequences
  • MRS shows choline peak, decreased NAA

Diagnosis: Anaplastic astrocytoma (awaiting HPE result)


  • Anaplastic astrocytoma is a diffusely infiltrating malignant astrocytoma
  • It involves white matter with variable enhancement
  • commonly involves the frontal and temporal lobe
  • may involve and expand the cortex
  • presence of flow voids or blooming artefact may be suggestive of progression to GBM
  • Typically shows no restricted diffusion
  • variable enhancement, but ring enhancement is suspicious of GBM
  • MRS show elevatee Cho/Cr ratio, decreased NAA
Author: radhianahassan