论文部分内容阅读
目的探讨室管膜下巨细胞型星形细胞瘤的临床病理特征及预后。方法回顾性分析18例室管膜下巨细胞型星形细胞瘤的临床资料、光镜下特征和免疫组织化学染色(EnVision法)的特点。结果患者18例,平均年龄(18.2±12.4)岁(7~54岁),男∶女=2∶1;部位以侧脑室占绝大多数(16例,88.9%);11例(61.1%)伴有结节硬化症,以面部血管纤维瘤多见(8例,44.4%);症状以头痛、呕吐(11例,61.1%)最常见,其次为视力下降(3例,16.7%)。CT7例呈高密度,5例增强后强化;MRIT1WI等信号63.6%(7/11),T2WI高信号90.9%(10/11),增强后强化81.8%(9/11)。82.4%(14/17)获手术全切。随访4例,均存活,平均随访期3.5年(1~5年)。镜下见肿瘤细胞主要有核偏于一端、胞质丰富红染的梭形细胞,呈瓜子形的胖细胞以及节细胞样瘤细胞。免疫组织化学染色示梭形细胞以神经胶质标记如胶质纤维酸性蛋白(GFAP)为主(18/18,100%),而神经元标记如突触素主要在胖细胞、节细胞样瘤细胞表达(14/18,77.8%),16例(88.9%)MIB-1标记指数≤1%。结论室管膜下巨细胞型星形细胞瘤是具有独特组织病理学特点的良性肿瘤。好发于青少年。手术全切预后好。
Objective To investigate the clinicopathological features and prognosis of subependymal giant cell type astrocytomas. Methods The clinical data of 18 cases of subependymal giant cell type astrocytomas were retrospectively analyzed. The characteristics of light microscopy and immunohistochemical staining (EnVision method) were retrospectively analyzed. Results 18 patients (mean age 18.2 ± 12.4 years old (7 to 54 years old, male to female = 2: 1; the majority of lateral ventricles were found in 16 cases (88.9%); 11 cases (61.1% Accompanied by nodular sclerosis, facial fibrovascular tumors more common (8 cases, 44.4%); symptoms of headache, vomiting (11 cases, 61.1%) the most common, followed by decreased visual acuity (3 cases, 16.7%). CT7 cases showed high density and enhancement in 5 cases. MRIT1WI and other signals were 63.6% (7/11) and T2WI high signals were 90.9% (10/11), enhanced and enhanced 81.8% (9/11). 82.4% (14/17) were surgically cut. All patients were followed up for 4 years, all of whom survived with an average follow-up of 3.5 years (1-5 years). Microscopically see the tumor cells are nuclear deviated to one end, the cytoplasm rich red stained spindle cells, the melon-shaped fat cells and cell-like tumor cells. Immunohistochemical staining showed that spindle cells were mainly glial markers such as glial fibrillary acidic protein (GFAP) (18/18, 100%), while neuron markers such as synaptophysin were mainly expressed in fat cells and oncocytoma cells (14 / 18,77.8%), 16 cases (88.9%) MIB-1 labeling index ≤1%. Conclusion Subependymal giant cell type astrocytoma is a benign tumor with unique histopathological features. Occur in adolescents. Surgical removal of good prognosis.