原发性松果体区混合性生殖细胞肿瘤病理特点及其起源探讨.pdfVIP

2011;31(3) 南方医科大学学报（J South Med Univ ） ·429 · ·临床研究· 原发性松果体区混合性生殖细胞肿瘤病理特点及其起源探讨 肖 罡，方陆雄，邱炳辉，漆松涛 南方医科大学南方医院神经外科，广东广州510515 摘要：目的通过影像学表现、术中所见及病理成分探讨松果体区混合性生殖细胞肿瘤的起源。方法 回顾分析我院2000 年1月致2010 年9 月间经术后病理证实的15例松果体区混合性生殖细胞肿瘤的术前影像学表现和病理标本。结果 影 像学表现，12例存在钙化，10例含有囊变，5例含有脂质。矢状位类圆或类椭圆状6 例，边缘均较光滑，不规则形状9 例，边 缘多突起；术中所见，所有肿瘤均位于大脑大静脉蛛网膜袖套包绕形成的松果体隐窝内；病理成分，13例含有生殖细胞成 分，9 例含有畸胎瘤成分，4 例含有胚胎性癌成分，3 例含有绒癌成分，7 例含有卵黄囊瘤成分，3 例含有横纹肌瘤成分。在7 例标本边缘发现生殖细胞瘤，10例患者生殖细胞瘤成分与其余成分相互穿插或被其它成分包绕。结论 松果体区混合性 生殖细胞肿瘤起源于松果体周围残余生殖细胞，其极有可能来自单一的原始生殖细胞。 关键词：松果体区；混合性生殖细胞肿瘤；影像；病理 中图分类号：R73; R81 文献标志码：A 文章编号：1673-4254（2011）03-0429-05 Pathological features and origin of primary pineal mixed germ cell tumors XIAO Gang, FANG Lu-xiong, QIU Bing-hui, QI song-tao Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515 ，China Abstract: Objective To investigate the origin of mixed germ cell tumors in the pineal region based on the image data, surgical findings and pathological examination of the tumor. Methods The preoperative CT and magnetic resonance imaging (MRI) findings and tumor specimens were retrospectively analyzed in 15 cases of pineal mixed germ cell tumors confirmed by postoperative histological examination between January 2000 and September 2010. Results Radiographic examination of the tumor revealed calcification in 12 cases, cystic changes in 10 cases, and the presence of lipid in 5 cases. On the anteroposterior images, the tumors appeared round or elliptic with smooth edge in 6 cases, and showed irregular shape with multiple processes on the edge in 9 cases. Surgical exploration found all the tumors located in the the suprapineal recess enclosed by the arachnoidal envelope of t