论文部分内容阅读
目的:探讨椎管恶性孤立性纤维性肿瘤的临床病理特征、鉴别诊断及治疗和预后。方法:报道1例椎管内恶性孤立性纤维性肿瘤的临床病理资料并复习文献。结果:患者女性,80岁。因“反复颈部疼痛1年,加重伴四肢麻木乏力2个月余”入院。CT示颈3至颈5平面椎管内髓外硬膜下3.0 cm×1.5 cm×1.0 cm占位。结果考虑为脊膜瘤行手术。镜检可见肿瘤由短梭形或卵圆形细胞组成,排列成束状、漩涡状,富于胶原纤维,部分区呈血管外皮瘤样结构,瘤细胞有异型性,核分裂象多见(≥4个/10 HPF)。免疫表型检查示,肿瘤细胞波形蛋白、CD34弥漫阳性,CD99、bcl-2阳性。病理诊断,颈3至颈5椎管内低度恶性孤立性纤维性肿瘤。结论:椎管内恶性孤立性纤维性肿瘤非常罕见,确诊主要依靠病理形态学及免疫组织化学标记,并应与椎管内其他梭形细胞肿瘤进行鉴别。
Objective: To investigate the clinicopathological features, differential diagnosis, treatment and prognosis of spinal cord malignant solitary fibrous tumor. Methods: One case of malignant solitary fibrous tumor of the spinal cord was reviewed and reviewed. Results: Female patient, 80 years old. Because of “repeated neck pain 1 year, aggravating numbness with limbs more than 2 months ” admission. CT showed neck 3 to neck 5 spinal canal medullary extradiscal 3.0 cm × 1.5 cm × 1.0 cm space. The results considered for meningioma surgery. Microscopic examination showed that the tumor consisted of short fusiform or oval cells arranged in a bundle, swirling, rich in collagen fibers, some areas of vascular endothelial tumor-like structure, tumor cells atypia, mitotic common more (≥ 4 / 10 HPF). Immunophenotype examination showed that tumor cell vimentin, CD34 diffuse positive, CD99, bcl-2 positive. Pathological diagnosis, cervical 3 to 5 low intraocular spinal canal solitary fibrous tumor. Conclusions: Malignant solitary fibrous tumor in the spinal canal is very rare. The diagnosis mainly depends on pathomorphology and immunohistochemical markers and should be differentiated from other spinal spindle tumors.