原发性中枢神经系统黑色素细胞瘤2例临床病理分析.pdfVIP

中国临床神经科学 2015 年第 23 卷第 4 期 ·428 · Chin J Clin Neurosci 2015, 23 (4), 428~432 论 著 2 巴晓群，任国平 (浙江大学医学院附属第一医院病理科 310003) 关键词　中枢神经系统；原发性黑色素细胞瘤；黑色素细胞病变；诊断 摘要 目的　探讨中枢神经系统原发性黑色素细胞瘤的临床病理特点、免疫表型、诊断及鉴别诊断要点。方法　收集 2011年收治的2 例中枢神经系统原发性黑色素细胞瘤患者的临床资料，对病理组织学及免疫表型进行分析。 　2 结果 例患者临床上均为单发肿块，无皮肤色素性肿瘤病变。1 例发生于鞍区，1 例发生于椎管内，均表现为局部缓慢生长 的软组织肿块，术前病程分别为3 年及 10 年。手术时肿瘤大体检查肿块呈褐色、质实。病理检查镜下表现为梭形及 卵圆形肿瘤细胞漩涡状、巢状分布，细胞胞质内见不同程度的黑色素沉着，核分裂罕见，平均计数1 个/10 HPFs 。 免疫组化学检测示肿瘤细胞S-100 蛋白、HMB45 蛋白、波形蛋白均阳性；细胞角蛋白、上皮细胞膜抗原、胶质纤维 酸性蛋白均阴性；1 例神经元特异性烯醇化酶局部阳性表达。 　发生于鞍区及脊髓腰段的中枢神经系统原发性黑 结论 色素细胞瘤较少见，具有一定的组织病理学特点。肿瘤虽然生长缓慢，但可局部复发，甚至可恶变，需长期随访。 Primary Melanocytoma of Central Nervous System: A Clinicopathologic Analysis of Two Cases BA Xiao-qun, REN Guo-ping Department of Pathology, the First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China KEY WORDS central nervous system; melanocytoma; melanocytic lesions; diagnosis ABSTRACT Aim To analyze the clinicopathologic and immunohistochemical features, diagnosis, differential diagnosis of primary melanocytoma of central nervous system. Methods Two cases of primary melanocytoma of CNS in 2007 and 2014 were collected and the clinicopathologic and immunohistochemical data were analyzed. Results Two patients presented without melanocytic tumour of the skin. The tumours were solitary and located in sella area and intraspinal canal with slow-growing. The duration of disease onset was 3 years and 10 years respectively. Generally the tumours were brown and solid, histologically slightly spindled or oval tumour cells containing variable melanin arranged