中枢神经细胞瘤临床病理研究.docVIP

中枢神经细胞瘤临床病理研究[摘要] 目的 研究中枢神经细胞瘤(CNC)的临床病理特征,提高对此瘤的认识,避免误诊。方法 分析6例CNC的临床病理特征,应用免疫组织化学染色方法检测其本质。结果 本组病例肿瘤均发生于侧脑室。组织学特点:肿瘤由密集一致的小圆形细胞组成,瘤细胞有明显的核周空晕,呈蜂窝状结构。特征性改变为无核神经原纤维基质岛。免疫组织化学显示神经元核抗原NeuN及突触素Syn阳性;胶质纤维酸性蛋白GFAP及神经纤维细丝蛋白NF阴性。结论 CNC是神经元形成的良性肿瘤,一般预后良好,免疫组织化学对确诊CNC很重要。 [关键词] 中枢神经细胞瘤; 临床病理; 免疫组织化学 [中图分类号] R739.41 [文献标识码] A [文章编号] 1673-9701(2009)27-14-02 Central Neurocytoma:Analysis of Clinical Pathology QIAO Dongfang1 ZHANG Zhihong2 ZHANG Weiming2 1.Department of Pathology,Lianshui County People’s Hospital,Lianshui 223400,China;2.Department of Pathology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China [Abstract] ObjectiveTo study the clinicopathological characteristics of central neurocytoma(CNC) so as to further realize the tumor and avoid misdiagnosis. MethodsWe analyzed the features of six cases by histopathological and immunohistochemical methods. ResultsThe age of the six cases ranged from 17 to 36(average 25.8 years) with all tumors localized in the lateral ventricles. Histologically,all tumors were composed of small uniform round cells with clear cytoplasm and had a honeycomb pattern. The cell-free island of neuropil matrix was the most dominant feature. Immunohistochemical study demonstrated strong positive for NeuN and Syn,and negative for GFAP and NF. ConclusionCNC is a well-differentiated neuronal tumor. Its clinical behavior is considered benign and its prognosis is usually favorable. The importance of immunohistochemical for its diagnosis is emphasized. [Key words]Central neurocytoma; Clinicopathology; Immunohistochemical 中枢神经细胞瘤(central neurocytoma,CNC)是一种比较少见的神经元良性肿瘤,由Hassoun等首先描述并命名[1],1993年WHO正式将其列为中枢神经系统肿瘤中神经元肿瘤的新类型。2000年WHO把它归入神经元和混合性神经元-胶质肿瘤[2],分级为WHOⅡ级。本病好发于年轻人侧脑室内,其临床表现、治疗和预后都有其特点,以往常与少突胶质细胞瘤或室管膜瘤混淆,研究其临床病理特征有利于正确诊断和判断预后。 1 资料与方法 1.1 一般资料 收集南京医科大学第一附属医院病理科2003～2007年脑肿瘤手术标本,经病理确诊为CNC 6例。临床资料:男性5例,女性1例,年龄17～36岁。术前病程30d～3年,主要症状和体征为头痛、恶心、呕吐、视力下降、复视及行走不稳等。所有病例全部经CT或MRI证实,肿瘤均位于左、右侧脑室处,直径大小约3～7