摘要
背景与目的:原发于脑脊膜的血管外皮瘤临床少见。本文回顾分析我院收治的20例,探讨其临床病理特征、组织学发生及生物学行为。方法:结合临床资料、运用组织病理学和免疫组化方法观察20例原发于脑脊膜的血管外皮瘤,并对其中4例进行透射电镜观察。结果:本病中位年龄42.4岁,男女之比1.2∶1。临床上多以头痛等症状就诊。肿瘤可发生在颅内脑脊髓表面的任何部位。大体上:肿瘤多似有包膜,质地韧,部分呈鱼肉样。组织学:肿瘤组织内血管丰富,可见典型的“鹿角样”血管,血管周围为短梭形的肿瘤性外皮细胞,沿血管呈放射状分布,瘤细胞异形,见核分裂像。网状纤维染色:嗜银纤维围绕单个瘤细胞、并沿血管呈放射状分布。免疫组化标记:瘤细胞除Vim阳性外,其余S-100蛋白、FⅧ、EMA、GFAP和CD34均阴性。电镜:瘤细胞中见丰富的10nm的中丝,细胞外基膜明显,并围绕单个瘤细胞分布。随访:获随访的17例病人中8例复发(占47.1%)。结论:脑脊膜的血管外皮瘤为起源于脑脊膜间叶组织、低度恶性的肿瘤,组织学形态、免疫表型和超微结构类似于软组织的血管外皮瘤。
Background and Objectives:Meningeal hemangiopericytoma is an uncommon tumor. This study was designed to investigate the clinicopathological and biology behavior of primary meningeal hemangiopericytoma. Methods:Clinical data, combined with histopathology and immunohistochemistry of 20 cases of meningeal hemangiopericytoma were reviewed,in which 4 specimens were examined with electron microscope. Result:The average age of patients with primary meningeal hemangiopericytoma was 42 4 year old (21-69 years). The ratio of male to female was 1 2∶1. Most of the patients went to hospital for the symptoms of central nervous system such as headache. The tumor could occur on any locus of the cranial or spinal dura. Grossly, many of the tumors had capsule, whose testure were tenacious, and part of them looks like fish meat. Histopathologically, the small vascular spaces in the tumor were rich, the typical antler liked vessel could be found, the short spindle tumor cells were around the vessel, and distributed by radiation shape. The tumor cells were pleomorphic and atypical,and could be found mitotic activity. Staining of argyrophilic fiber: the argyrophilic fiber surrounded single tumor cell,and distributed by radiation shape around vessel. Immunohistochemistry showed negative for S 100 protein, FⅧ, EMA, GFAP and CD34,while Vim was positive. Electron microscopically, the rich bundles of 10nm long intermediate filaments could be found in tumor cells. The exobasallamina, of cells were evidenced, and distributed around single cell. Follow up, 8 of 17 cases were relapsed (47.1%). Conclusion:Meningeal hemangiopericytoma is a low malignant tumor original from meningeal mesenchymal tissue. The features of histopathology, immunphenotype and ultrastructure are similar to hemangiopericytoma of the soft tissue.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2002年第10期1116-1119,共4页
Chinese Journal of Cancer
