摘要
目的:探讨中枢神经细胞瘤的临床病理特征、诊断与鉴别诊断及预后情况。方法:回顾性总结13例中枢神经细胞瘤的临床病理资料并进行文献复习。结果:13例患者肿瘤均发生于脑室,男7例,女6例,发病年龄18~60(中位29)岁,临床症状主要为头晕、头痛。影像学检查:CT平扫示等密度影或稍高密度影,伴有钙化7例,囊性变8例,增强后轻度强化;MRI显示T1低信号,T2呈稍高信号或高低混杂信号,增强后实性部分轻中度强化。组织学表现为肿瘤组织由单一的圆形细胞排列成蜂窝状构成,血管呈分枝状,1例示核分裂活跃,1例可见灶性坏死;免疫组织化学示瘤细胞Syn,NSE及NeuN阳性,IDH-1,Olig-2和EMA阴性,GFAP和S100灶性阳性,11例Ki-67指数<2%,2例Ki-67指数5%~10%;13例患者均行显微外科肿瘤切除术,6例术后放射治疗,随访8个月~5年,1例复发。结论:中枢神经细胞瘤是一种少见的中枢神经系统肿瘤,预后较好,诊断需结合病变部位、组织学特征及免疫标志,手术全切除是治疗的最好方式,术后联合放射治疗,化学药物治疗效果有待进一步研究。
Objective:To investigate the clinicopathological features,diagnosis and differential diagnosis,and prognosis of central neurocytoma(CNC).Methods:The clinical manifestations of 13 cases of CNC were analyzed retrospectively and the literature were reviewed.Results:All the tumors in 13 patients were in the brain chamber,including 7 males and 6 females.The age of onset was 18–60(median 29)years old.Dizziness and headache were the most commonly presenting symptoms.CT showed equal density or slightly higher density,with 7 cases of calcification,8 cases of cystic change,mild enhancement after enhancement;MRI showed T1 low signal,slightly T2 high signal or high and low mixed signal,light and moderate reinforcement of the solid part after reinforcement.Histologically,the tumor tissue consisted of a single round cell arranged in a honeycomb shape,the blood vessels were branched,1 case showed a slightly active mitotic division,1 case showed focal necrosis;immunohistochemistry showed that Syn,NSE and NeuN of tumor cells were positive,while IDH-1,Olig-2 and EMA were negative,GFAP and S100 were focally positive.11 cases had a Ki-67 index<2%,and 2 cases had a Ki-67 index 5%~10%.All 13 patients underwent microsurgical tumor resection.Six patients underwent postoperative radiotherapy,followed up for 8 months to 5 years,and 1 case relapsed.Conclusion:CNC is a rare central nervous system tumor with good prognosis.The diagnosis needs to be combined with lesions,histological features and immunological markers.Total surgical resection is the best way to treat CNC,post-operative combined radiotherapy and chemotherapy can reduce the recurrence rate,but the effect also needs to be further studied.
作者
刘颖
姜晨霞
王燕
张青
LIU Ying;JIANG Chenxia;WANG Yan;ZHANG Qing(Department of Pathology,Affiliated Hospital of Nantong University,Nantong Jiangsu 226001,China)
出处
《临床与病理杂志》
2020年第8期1949-1954,共6页
Journal of Clinical and Pathological Research
