鞍区毛细胞黏液样星形细胞瘤2例临床病理观察

发布时间：2018-03-16 15:26

本文选题：毛细胞星形细胞瘤　切入点：毛细胞黏液样星形细胞瘤　出处：《临床与实验病理学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的探讨鞍区毛细胞黏液样星形细胞瘤(pilomyxoid astrocytoma,PMA)的临床病理特征、诊断、鉴别诊断。方法收集2例鞍区PMA患者的临床资料,并对其进行组织学观察和免疫组化标记。结果例1行肿瘤次全切除,镜下见黏液样背景中,单一形态的双极细胞和血管周围细胞排列,形成假菊形团结构。残余肿瘤于术后2年再次手术切除,镜下可见组织呈双相结构,由致密梭形细胞伴Rosenthal纤维和疏松区多极细胞伴微囊及嗜酸性颗粒小体组成,2次免疫组化提示肿瘤细胞表达GFAP、S-100、Olig-2,不表达Neu-N、EMA。Ki-67增殖指数小于1%。例2合并瘤内出血,镜下可见黏液样背景中瘤细胞围绕血管周围呈放射状排列,间质血管增生明显,瘤组织内见大片出血,免疫组化标记示瘤细胞表达GFAP、Olig-2、Syn均呈弱阳性,Ki-67增殖指数3%。结论 PMA在一定情况下可能转变为毛细胞星形细胞瘤,鞍区PMA可能发生瘤内出血,必要时需急诊手术治疗。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of pilomyxoid astrocytoma (PMA) in Sellar hair cell myxoid astrocytoma. Results in case 1, subtotal resection of the tumor was performed. Under the myxoid background, single bipolar cells and perivascular cells were arranged. The residual tumor was resected again 2 years after operation, and the tissue was biphasic under microscope. The expression of GFAPS-100 Olig-2 in the tumor cells was demonstrated by immunohistochemistry from dense spindle cells with Rosenthal fibers and multipolar cells with microcapsules and eosinophil bodies in loose area. The proliferative index of the tumor cells did not express Neu-Nu EMA.Ki-67 was less than 1%. Case 2 complicated with intratumoral hemorrhage. In the myxoid background, the tumor cells were arranged radially around the blood vessels, the interstitial angiogenesis was obvious, and massive hemorrhage was seen in the tumor tissue. Immunohistochemical staining showed that the expression of GFAP Olig-2Syn in tumor cells showed weak positive proliferative index of Ki-67 and 30.Conclusion PMA may be transformed into hair cell astrocytoma under certain conditions, and PMA in Sellar region may cause intratumor hemorrhage, which should be treated with emergency operation if necessary.
【作者单位】：广西壮族自治区人民医院神经外科;
【分类号】：R739.41

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