Coronal gross brain
section. There is gross expansion of the left cerebral hemisphere. This is
caused by infiltration of a diffuse low-grade (WHO Grade 2) fibrillary
astrocytoma. Most of this infiltration has occurred nondestructively. This
is similar to the concept of "gliomatosis
cerebri". In addition, the superior surface of the expanded hemisphere has a
discoloration from a local area of transformation from Grade 2 into a Grade 4
astroctyoma (Glioblastoma Multiforme or GBM). This is a natural progression,
from low-grade to high-grade. Approximately 30 - 50% of GBM's are thought to
arise from a pre-existing lower grade astrocytoma (WHO Gr 2 or
3).