脊索样脑膜瘤四例临床病理分析

发布时间：2018-06-22 03:36

本文选题：脊索样脑膜瘤 + 临床病理　；参考：《中华肿瘤防治杂志》2017年16期

【摘要】：目的作为脑膜瘤的一种罕见亚型,脊索样脑膜瘤因不具备典型脑膜瘤的病理特征,常难以同脊索瘤及其他肿瘤区分,易造成误诊。本研究旨在通过探讨脊索样脑膜瘤临床病理特征、免疫表型及MRI特征表现,进一步提高对该亚型脑膜瘤的认识。方法收集兰州大学第二医院2010-10-01—2015-10-25经手术后病理确诊的4例脊索样脑膜瘤患者临床资料,分析临床病理特征及影像资料,结合相关文献进行对比研究。结果光镜下,4例HE染色示组织学类似脊索瘤,瘤组织排列成束状或小梁状分布于黏液样基质中,瘤细胞胞质丰富,嗜酸,并可见胞质内空泡,部分区域为典型脑膜瘤漩涡状、束状、编织状结构,2例瘤组织间可见少量淋巴细胞、浆细胞浸润。免疫表型示,瘤细胞EMA(+)、Vimentin(+)、CKp(-)、S-100(-)、GFAP(-),Ki-67阳性细胞数平均为8%。MRI示,4例均为单发病灶,3例位于顶叶,1例位于额颞叶;2例为实性类圆形,1例呈不规则团块状,1例为囊实性,实性呈结节状附壁生长;2例病灶界限不清,2例边界清晰;4例瘤周水肿明显,邻近脑组织均有不同程度受累;T1WI 4例呈等、略低信号;T2WI 3例呈等、略高信号,1例呈等、略低信号。结论诊断脊索样脑膜瘤,应结合形态学、相应的免疫组化染色及具有一定表现特征的影像学检查,以有效降低误诊率。
[Abstract]:Objective as a rare subtype of meningioma, spinal cord meningioma is often difficult to differentiate from chordoma and other tumors because it does not have the pathological characteristics of typical meningioma. The purpose of this study was to investigate the clinicopathological features, immunophenotype and MRI features of spinal cord like meningioma and to further improve the understanding of the subtype of meningioma. Methods the clinical data of 4 patients with spinal cord like meningioma confirmed by operation from 2010-10-01-2015-10-25 in the second Hospital of Lanzhou University were collected, and the clinicopathological characteristics and imaging data were analyzed. Results under light microscope, HE staining in 4 cases showed that the histology was similar to chordoma, the tumor tissue was arranged in bundles or trabeculae, the cytoplasm of tumor cells was abundant, eosinophilic, and vacuoles in the cytoplasm could be seen, and some areas were typical meningioma whirlpool. A small number of lymphocytes and plasmacytes were infiltrated between tumor tissues in 2 cases with bundles and braided structures. The immunophenotype showed that the average number of GFAP (-) Ki-67 positive cells in tumor cells EMA () Vimentin (-) CK-P (-) GFAP (-) GFAP (-) was 80.MRI showed that all 4 cases were single lesions, 3 cases were located in parietal lobe, 1 case was located in frontotemporal lobe, 2 cases were solid round, 1 case was irregular mass and 1 case was cystic. Solid nodular mural growth was seen in 2 cases. In 2 cases, the boundary of lesion was clearly defined in 2 cases. In 4 cases, edema around tumor was obvious. In 4 cases, the adjacent brain tissues were involved in different degrees on T 1WI in 4 cases, hypointensity on T 2WI in 3 cases, and hyperintense in 1 case, slightly hypointensity in 1 case. Conclusion the diagnosis of chordoid meningioma should be combined with morphology, immunohistochemical staining and imaging examination with certain features in order to effectively reduce the misdiagnosis rate.
【作者单位】：兰州大学第二医院病理科;兰州大学第二医院放射科;兰州大学第二医院神经外科;
【分类号】：R739.45

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