摘要
目的 探讨中枢神经细胞瘤（centralneurocytoma，cNc）临床病理特点，诊断与鉴别诊断，组织发生与临床预后的关系。方法对37例脑胶质细胞肿瘤，应用免疫组化syn、NsE、GFAP、s-100等检测，检m9例为cNc，7例为伴有分化特性的cNc。结果男6例，女3例，平均38岁。临床表现为头痛、头晕、呕吐、肢体乏力、抽搐、昏迷症状。2例发生在侧脑室，7例发生在脑室外。肿瘤直径3。7．5cm。光镜下瘤细胞均匀一致圆形，胞质少，透明状，核小而圆，染色质均匀，呈点彩状，核居中，核周空晕，形似少突胶质细胞，瘤细胞弥漫密集排列，可见菊花形，无细胞区神经毡样结构，间质少，血管丰富，纤细分枝状，少数出现血管增生、钙化及囊性变。少数病例瘤细胞核有异型性，可见核分裂及灶性坏死。免疫组化：svn（强阳性7，9、阳性2，9），s-100（强阳性4／9、阳性4，9），NsEf弱阳性6／91，GFAP（阳性3／9、弱阳性4／9），Vimentin（强阳性2，9、阳性1，9、弱阳性1，9），Ki67f弱阳性9，9），NF（弱阳性3／9）。随访8例，6例死亡，2例存活。结论cNc形态学表现有多分化特性，既可发生脑室内，也可见于脑室外，易误诊为室管膜瘤、少突胶质细胞瘤、髓母细胞瘤等肿瘤。免疫表型具有分化特性，脑室外cNc可能是一种具有胶质细胞分化基因型的肿瘤，可提示为一种伴有胶质细胞分化的cNc，生物学行为不稳定，临床预后不良。免疫绢化Svn、GFAP对诊断、答别诊断有帮助。GFAP及Ki67高表达．提示临床预后不良。
Objective To investigate the clinical and pathological features of central neurocytoma （CNC）, diagnosis and differential diagnosis, tissue and clinical prognosis. Methods 37 cases of brain glial cell tumors, immunohistochemistry synaptophysin （Syn）, neuron-specific enolase （NSE）, glial fibrillary acidic protein （GFAP）, S-100 detection, detection of 9 cases of CNC. 7 cases were accompanied by differentiation characteristics of CNC. Results 6 cases were male, 3 female, mean age 38. Clinical manifestations of headache, dizziness, vomiting, convulsions, coma symptoms, limb weakness. Location： 2 cases occurred in the lateral ventricles, 7 cases occurred in the external ventricles. The size of the tumor diameter was 3-7.5cm. Light microscopy of tumor ceils with uniform round, less cytoplasm, transparent, nucleus was small and round, chromatin was uniform, stippling, nuclear center, nuclear Zhou Kong halo, resembling the oligodendrocyte, tumor cells diffusely arranged densely, visible with a chrysanthemum shape, cell free zone neuropil like structure, interstitial, abundant blood vessels, slender, branched, a few appeared hyperplasia, calcifications and cystic degeneration. A few cases had nuclear atypia, mitotic and focal necrosis visible. Immunohistochemistry： Syn （strong positive 7/9, positive 2/9）, S-100（strong positive 4/9, positive 4/9）, NSE （weak positive 6/9）, GFAP （ positive 3/9, weak positive 4/9）, Vimentin （strong positive 2/9, positive 1/9, weak positive 1/9）, Ki67（ weak positive 9/9）, NF （ weak positive 3/9）. Follow-up of 8 cases, 6 cases died, 2 cases survived. Conclusions CNC morphologic features have multiple differentiation, which can occur within the ventricles, are also found in the brain of outdoor, misdiagnosed as ependymoma, oligodendroglioma and medulloblastoma tumors. Immune phenotype with differentiation, ventricle external CNC may be a glial cell differentiation gene type of the tumor, but for a prompt accompanied by glial cell differentiation of CNC, with biological behavior instability, poor clinical prognosis. Immunohistochemical Syn, GFAP are helpful to the diagnosis and differential diagnosis. High expression of GFAP and Ki67, suggests poor clinical prognosis.
出处
《国际医药卫生导报》
2013年第8期1065-1070,共6页
International Medicine and Health Guidance News
基金
肇庆市科研基金项目（2010E282）
关键词
脑肿瘤
神经细胞瘤
胶质细胞分化
中枢性
免疫组化
诊断
预后
Brain tumor
Neurocytoma
Glial cell differentiation
Central
hnmunohistochemistry
Diagnosis
Prognosis
