CAJ | 학술논문

目的探讨脑肿瘤放射性治疗后迟发型放射性脑损伤的临床病理特征.方法对9例行肿瘤术后放射性治疗的迟发型脑损伤手术治疗病例的临床资料、组织病理学以及免疫组织化学染色进行分析.结果 9例迟发型放射性脑损伤患者发病时长6个月至12年,临床主要表现为头痛及肌力减退.MRI表现为轻微占位效应的病变,边缘强化及周围水肿.组织学主要特征为凝固性坏死,坏死中央血管纤维素样坏死、玻璃样变及管腔阻塞,周围反应性胶质细胞增生等.免疫组织化学显示增生的胶质细胞缺氧诱导因子-1α阳性表达.结论放射性治疗后迟发型脑损伤是肿瘤放射性治疗后的非肿瘤性继发性病变,常被误诊为脑肿瘤而行外科手术治疗,组织形态学有时可与高级别胶质肿瘤混淆,正确诊断需结合临床放射病史、影像学资料以及病理学特征等.
목적 탐토뇌종류방사성치료후지발형방사성뇌손상적림상병리특정.방법 대9례행종류술후방사성치료적지발형뇌손상수술치료병례적림상자료、조직병이학이급면역조직화학염색진행분석.결과 9례지발형방사성뇌손상환자발병시장6개월지12년,림상주요표현위두통급기력감퇴.MRI표현위경미점위효응적병변,변연강화급주위수종.조직학주요특정위응고성배사,배사중앙혈관섬유소양배사、파리양변급관강조새,주위반응성효질세포증생등.면역조직화학현시증생적효질세포결양유도인자-1α양성표체.결론 방사성치료후지발형뇌손상시종류방사성치료후적비종류성계발성병변,상피오진위뇌종류이행외과수술치료,조직형태학유시가여고급별효질종류혼효,정학진단수결합림상방사병사、영상학자료이급병이학특정등.
Objective To study the clinicopathologic features of delayed radiation-induced brain injury after radiotherapy for brain tumor.Methods The clinical,histopathologic and immunohistochemical features of 9 cases with delayed radiation-induced injury were evaluated.Results The disease occurred from 6 months to 12 years after radiotherapy and often presented with headache and muscle weakness.Magnetic resonance imaging showed peripheral enhancing lesions with slight mass effect and surrounding edema.Microscopically,the major changcs included coagulative necrosis,fibrinoid necrosis of vessels,vascular hyalinization with luminal stenosis and peripheral reactive gliosis. Immunostaining for hypoxiainducible factors 1α was positive in reactive astrocytes. Conclusions Delayed radiation-induced brain injury is a relatively common complication of radiation therapy.The lesion was frequently misdiagnosed as brain tumor.Correct diagnosis relies on clinical,radiologic and pathologic correlation.