中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2013年
6期
526-530
,共5页
罗清礼%李露%陈俊%曾昌洪
囉清禮%李露%陳俊%曾昌洪
라청례%리로%진준%증창홍
眶肿瘤%视神经肿瘤%脑膜瘤%体层摄影术,X线计算机%磁共振成像%免疫组织化学
眶腫瘤%視神經腫瘤%腦膜瘤%體層攝影術,X線計算機%磁共振成像%免疫組織化學
광종류%시신경종류%뇌막류%체층섭영술,X선계산궤%자공진성상%면역조직화학
Orbital neoplasms%Optic nerve neoplasms%Meningioma%Tomography,x-ray computed%Magnetic resonance imaging%Immunohistochemistry
目的 探讨眼眶内视神经脑膜瘤影像学和组织病理形态学特点以及波形蛋白(Vimentin)、细胞角蛋白(CK)、S-100、上皮膜抗原(EMA)抗体在瘤细胞内的表达情况.方法 回顾性系列病例研究.收集1989年1月至2010年12月在四川大学华西医院眼科住院并经手术后病理证实、病例资料完整的48例眼眶内视神经脑膜瘤患者的临床资料.均行CT扫描,17例行MRI扫描.均行组织病理学检查,包括石蜡包埋、切片、HE染色、读片和显微照相.21例用免疫组织化学法检测肿瘤中Vimentin、CK、S-100、EMA的表达情况.结果 CT影像学特点:39例眼眶内视神经脑膜瘤大小不等,边界较清楚,密度不均,其中26例肿瘤充满眼眶,特别是眶尖,“黑三角”消失.3例视神经增粗钙化,可见双轨征,3例视神经肿块近眼球后壁,3例肿块位于眼眶周围.根据组织病理形态学检查结果,将肿瘤分为上皮型35例,混合型8例,纤维型3例和血管型2例.在17例MRI检查中,13例见肿瘤靠后几乎充满眼眶,5例显示肿瘤侵犯视交叉、到达颅内.免疫组织化学染色结果显示,Vimentin阳性率为95％(21例)、EMA阳性率为70％(15例)、CK阳性率为45％(9例)以及S-100阳性率25％(5例).结论 眼眶内视神经脑膜瘤的CT、MRI影像学主要特点是视神经增粗、肿瘤样扩大,多数病例肿瘤达眼眶尖,密度不均,可能出现钙化.组织病理学特点为大部分病例为上皮型.免疫组织化学染色结果显示,Vimentin、EMA阳性比例大.
目的 探討眼眶內視神經腦膜瘤影像學和組織病理形態學特點以及波形蛋白(Vimentin)、細胞角蛋白(CK)、S-100、上皮膜抗原(EMA)抗體在瘤細胞內的錶達情況.方法 迴顧性繫列病例研究.收集1989年1月至2010年12月在四川大學華西醫院眼科住院併經手術後病理證實、病例資料完整的48例眼眶內視神經腦膜瘤患者的臨床資料.均行CT掃描,17例行MRI掃描.均行組織病理學檢查,包括石蠟包埋、切片、HE染色、讀片和顯微照相.21例用免疫組織化學法檢測腫瘤中Vimentin、CK、S-100、EMA的錶達情況.結果 CT影像學特點:39例眼眶內視神經腦膜瘤大小不等,邊界較清楚,密度不均,其中26例腫瘤充滿眼眶,特彆是眶尖,“黑三角”消失.3例視神經增粗鈣化,可見雙軌徵,3例視神經腫塊近眼毬後壁,3例腫塊位于眼眶週圍.根據組織病理形態學檢查結果,將腫瘤分為上皮型35例,混閤型8例,纖維型3例和血管型2例.在17例MRI檢查中,13例見腫瘤靠後幾乎充滿眼眶,5例顯示腫瘤侵犯視交扠、到達顱內.免疫組織化學染色結果顯示,Vimentin暘性率為95％(21例)、EMA暘性率為70％(15例)、CK暘性率為45％(9例)以及S-100暘性率25％(5例).結論 眼眶內視神經腦膜瘤的CT、MRI影像學主要特點是視神經增粗、腫瘤樣擴大,多數病例腫瘤達眼眶尖,密度不均,可能齣現鈣化.組織病理學特點為大部分病例為上皮型.免疫組織化學染色結果顯示,Vimentin、EMA暘性比例大.
목적 탐토안광내시신경뇌막류영상학화조직병리형태학특점이급파형단백(Vimentin)、세포각단백(CK)、S-100、상피막항원(EMA)항체재류세포내적표체정황.방법 회고성계렬병례연구.수집1989년1월지2010년12월재사천대학화서의원안과주원병경수술후병리증실、병례자료완정적48례안광내시신경뇌막류환자적림상자료.균행CT소묘,17례행MRI소묘.균행조직병이학검사,포괄석사포매、절편、HE염색、독편화현미조상.21례용면역조직화학법검측종류중Vimentin、CK、S-100、EMA적표체정황.결과 CT영상학특점:39례안광내시신경뇌막류대소불등,변계교청초,밀도불균,기중26례종류충만안광,특별시광첨,“흑삼각”소실.3례시신경증조개화,가견쌍궤정,3례시신경종괴근안구후벽,3례종괴위우안광주위.근거조직병리형태학검사결과,장종류분위상피형35례,혼합형8례,섬유형3례화혈관형2례.재17례MRI검사중,13례견종류고후궤호충만안광,5례현시종류침범시교차、도체로내.면역조직화학염색결과현시,Vimentin양성솔위95％(21례)、EMA양성솔위70％(15례)、CK양성솔위45％(9례)이급S-100양성솔25％(5례).결론 안광내시신경뇌막류적CT、MRI영상학주요특점시시신경증조、종류양확대,다수병례종류체안광첨,밀도불균,가능출현개화.조직병이학특점위대부분병례위상피형.면역조직화학염색결과현시,Vimentin、EMA양성비례대.
Objective To determine the characteristics of optic nerve meningiomas in medicalimageology (including CT and MRI),histopathology and immunohistochemical expression of Vimentin,CK,S-100,EMA in tumor cells.Methods This was a retrospective study on a serial of clinical cases.Forty-eight cases were collected from the past 21 years at the Department of Ophthalmology,West China Hospital,Sichuan University.All the cases underwent surgery and were confirmed as optic nerve meningiomas by histopathological test,including paraffin imbedded sectioning and HE staining.In addition,all the cases had medical records on CT and 17 cases had MIR scan.Immunohistochemical staining for VIMENTIN,CK,S-100,EMA was performed in the 21 cases.Results Characteristics of the CT scan include that,in 39 cases,among them 26 cases the tumors filled in the orbit especially at the orbital apex,which led to the disappearance of the black triangle.Three cases showed enlargement and calcification of optic nerve and therefore train track sign was seen.Three cases showed that the masses of optic nerve were close to the globe and another three cases showed that the masses were located in the peripheral orbit.Thirteen of 17 cases MRI disclosed the big orbital tumors and 5 cases could better show tumor extension to optic cross or intracranium.Histopathological tests demonstrated meningothelial or syncytial type in 39 cases,transitional or mixing type in 8 cases,fiber or fibroblast type in 3 cases and vascular type in 2 cases.Immunohistochemistry study verified the positive staining rate of VIMENTIN as 90.5％ (21 cases),EMA 66.7％ (15 cases),CK 42.8％ (9 cases) and S-100 23.8％ (5 cases),respectively.Conclusions Characteristics of CT and MRI include enlargement and tumor-like expansion of optic nerve.Most of the tumors reach to orbital apex and show uneven density.Calcification may occur in the tumor.The main pathological type of the tumors is meningothelial.Positive immunohistochemiscal staining for VIMENTIN and EMA may be helpful in diagnosis.
