胶质肉瘤的影像表现与病理特征分析

发布时间：2018-03-26 00:51

本文选题：胶质肉瘤　切入点：影像学表现　出处：《临床放射学杂志》2017年08期

【摘要】：目的探讨胶质肉瘤的影像表现和病理学特征。方法回顾性分析13例胶质肉瘤患者的临床和影像学资料,并分析其病理学特征。结果 13例胶质肉瘤均为幕上单发肿块,多跨脑叶生长。12例为原发性,1例继发性。囊性伴壁结节1例,囊实性3例,实性为主7例,完全实性1例,其他类型1例。6例实性为主胶质肉瘤呈脑膜瘤样外观,位于大脑凸面,瘤周水肿轻或无;1例实性为主和3例囊实性胶质肉瘤呈胶质母细胞瘤样外观。CT可见4例伴出血,MRI增强可见4例脑膜侵犯,其中1例破坏颅骨。光镜所见肿瘤细胞部分为圆形、肥胖形或多形性细胞弥漫排列,部分为胶原纤维样基质内梭形细胞不规则束网状排列,部分可见骨组织分化。免疫组织化学染色IDH1 R123H为阴性(3/3),1p/19q无杂合性缺失(2/2),其中1例IDH基因测序阴性。Ki-67增值指数15%~75%,平均43%。结论胶质肉瘤以间叶成分为主时,影像学表现具有一定的特征性,但确诊仍有赖于病理检查。
[Abstract]:Objective to investigate the imaging and pathological features of gliosarcoma. Methods the clinical and imaging data of 13 patients with gliosarcoma were retrospectively analyzed and their pathological features were analyzed. Results 13 cases of gliosarcoma were single supratentorial mass. Multiple translobar growth was secondary in 1 case, cystic with wall nodule in 1 case, cystic solid in 3 cases, solid in 7 cases, complete solid in 1 case, and other type in 6 cases, gliosarcoma presented meningeomatous appearance. Located on the protruding surface of the brain, the edema around the tumor was mild or no solid in 1 case, and 3 cases of the cystic solid gliosarcoma showed glioblastoma like appearance. 4 cases of meningeal invasion could be seen in 4 cases with enhanced MRI with hemorrhage on CT. One of them destroyed the skull. The tumor cells were partially circular, obesity-shaped or pleomorphic cells were distributed, and some of them were irregular bundle reticular arrangement of spindle cells in collagen-like matrix. Bone tissue differentiation was observed in some cases. Immunohistochemical staining showed that IDH1 R123H was negative for 3 / 3 / 1p / 19q and had no heterozygosity loss of 2 / 2%. One case of IDH gene sequencing negative. Ki-67 value-added index 1575 and the average 43 ~ 3.Conclusion when gliosarcoma is mainly composed of mesenchymal components, Imaging findings are characteristic, but the diagnosis still depends on pathological examination.
【作者单位】：第四军医大学西京医院放射科;
【分类号】：R445.2;R730.44;R739.41

【相似文献】