摘要
目的探讨黏液乳头型室管膜瘤的临床病理特征、鉴别诊断及治疗与预后。方法回顾性分析9例黏液乳头型室管膜瘤病人的临床资料,行组织学观察及免疫组织化学分析。结果 9例肿瘤均发生于脊髓圆锥、马尾终丝区,典型病理形态为立方形或梭形肿瘤细胞,以乳头放射状结构排列在血管黏液样间质轴心周围,大量黏液聚集在血管和瘤细胞之间或微囊内,伴血管壁增厚、玻璃样变;瘤细胞大小、形态较一致,核分裂像少见或无。免疫组织化学显示肿瘤细胞胶质纤维酸性蛋白(GFAP)、vimentin及S-100阳性,细胞角蛋白(CK)及上皮膜抗原(EMA)阴性。病人均手术全切,术后辅助放疗2例。6例随访17个月～5年,MRI复查仅1例复发。结论黏液乳头型室管膜瘤特征性发病部位、形态学特征及免疫表型是其诊断和鉴别诊断要点,肿瘤全切后预后良好。
Objective To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of myxopapillary ependymoma.Methods Clinical data of 9 patients with myxopapillary ependymoma were analyzed retrospectively.The tumors were observed by histology and immunohistochemistry.Results The tumors of 9 patients localized in the conus medullaris,cauda equina or filum terminale of the spinal cord.The typical pathological changes were arrangement of cuboidal or spindle-shaped tumor cells around vascularized and myxoid stromal cores in a papillary-radial type.A large quantity of mucus accumulated between tumor cells and vessels or within microcysts,accompanied by vascular thickness and hyalinization.The size and shape of tumors were uniform,and mitotic figures were uncommon or vacant.Immunohistochemistry results showed that tumor cells were positive for glial fibrillary acidic protein（GFAP）,vimentin and S-100,and negative for cytokeratin（CK） and epithelial membrance antigen（EMA）.Total resection was achieved in 9 patients and adjuvant radiotherapy was performed in 2.Six patients were followed up for 17 months to 5 years and recurrence was detected only in 1 patient by MRI.Conclusions The typical location,morphological features and immunophenotype are the essential points of diagnosis and differential diagnosis of myxopapillary ependymoma.The patients who underwent total removal can obtain a good outcome.
出处
《中国微侵袭神经外科杂志》
CAS
2012年第2期70-73,共4页
Chinese Journal of Minimally Invasive Neurosurgery
