诊断病理学杂志
診斷病理學雜誌
진단병이학잡지
CHINESE JOURNAL OF DIAGNOSTIC PATHOLOGY
2010年
1期
27-30
,共4页
脑肿瘤%神经细胞瘤%免疫组化%临床病理学
腦腫瘤%神經細胞瘤%免疫組化%臨床病理學
뇌종류%신경세포류%면역조화%림상병이학
Brain tumor%Neurocytoma%Immunohistochemistry%Clinical pathology
目的 探讨非典型脑室外神经细胞瘤的临床病理特征.方法 对1例非典型脑室外神经细胞瘤的临床表现、影像学、组织形态、免疫组化等进行分析并复习相关文献.结果 患者男性,32岁.间断癫NFDA1发作2年余.术前MRI提示右侧颞叶巨大囊实性占位.组织学上,瘤细胞为弥漫一致的中等大小透明细胞,其间可见小片状分布的神经毡样结构,细胞有一定异型性,核分裂象5个/10HPF,可见血管增生及栅栏样坏死.免疫组化显示瘤细胞Syn和S-100弥漫(+),少数瘤细胞GFAP、nestin和Neu-N(+),而Oligo-2、EMA、neurofilament和p53均(-),Ki-67约为20%.结论 非典型脑室外神经细胞瘤临床上罕见,组织学形态上类似间变性少突细胞瘤、间变性室管膜瘤及多形性胶质母细胞瘤等,易误诊.特征性的组织学特点及免疫表型有助于鉴别.
目的 探討非典型腦室外神經細胞瘤的臨床病理特徵.方法 對1例非典型腦室外神經細胞瘤的臨床錶現、影像學、組織形態、免疫組化等進行分析併複習相關文獻.結果 患者男性,32歲.間斷癲NFDA1髮作2年餘.術前MRI提示右側顳葉巨大囊實性佔位.組織學上,瘤細胞為瀰漫一緻的中等大小透明細胞,其間可見小片狀分佈的神經氈樣結構,細胞有一定異型性,覈分裂象5箇/10HPF,可見血管增生及柵欄樣壞死.免疫組化顯示瘤細胞Syn和S-100瀰漫(+),少數瘤細胞GFAP、nestin和Neu-N(+),而Oligo-2、EMA、neurofilament和p53均(-),Ki-67約為20%.結論 非典型腦室外神經細胞瘤臨床上罕見,組織學形態上類似間變性少突細胞瘤、間變性室管膜瘤及多形性膠質母細胞瘤等,易誤診.特徵性的組織學特點及免疫錶型有助于鑒彆.
목적 탐토비전형뇌실외신경세포류적림상병리특정.방법 대1례비전형뇌실외신경세포류적림상표현、영상학、조직형태、면역조화등진행분석병복습상관문헌.결과 환자남성,32세.간단전NFDA1발작2년여.술전MRI제시우측섭협거대낭실성점위.조직학상,류세포위미만일치적중등대소투명세포,기간가견소편상분포적신경전양결구,세포유일정이형성,핵분렬상5개/10HPF,가견혈관증생급책란양배사.면역조화현시류세포Syn화S-100미만(+),소수류세포GFAP、nestin화Neu-N(+),이Oligo-2、EMA、neurofilament화p53균(-),Ki-67약위20%.결론 비전형뇌실외신경세포류림상상한견,조직학형태상유사간변성소돌세포류、간변성실관막류급다형성효질모세포류등,역오진.특정성적조직학특점급면역표형유조우감별.
Objective To explore the clinicopathologic characteristics of atypical extraventricular neurocytoma. Methods The clinical manifestations, image, histopathological features and immunohistochemical results were analyzed in one case of atypical extraventricular neurocytoma, with review of the related literatures. Results A 34-year-old man presented with two-year-long history of intermittent epileptic seizure. MRI scan revealed a large solid-cystic mass in right temporal lobe. Histologically, the tumor was composed of uniform medium-sized clear cells with small neuropil-like structures. The nucleus had slightly heteromorphism and the mitoses were about 5 per 10 high power field. Pseudopalisading necrosis and microvascular hyperplasia were also noticed. Immunohistochemically, the tumor cells were positive for synaptophysin and S-100, focally positive for GFAP, Nestin and Neu-N, while negative for EMA, neurofilament, TP53 and Oligo2. The MIB-1 proliferative index was 20%. Conclusion Atypical extraventricular neurocytoma is a rare tumor, which is difficult to be distinguished histopathologically from anaplastic oligodendroglioma, glioblastoma and anaplastic ependymoma, and so on. The characteristic histopathological features and immunohistochemical findings may help for differential diagnosis.
