探讨横纹肌样脑膜瘤的临床病理特点和鉴别诊断.docVIP

精品论文 参考文献 探讨横纹肌样脑膜瘤的临床病理特点和鉴别诊断 南华大学附属第一医院 湖南衡阳 421001 【摘 要】目的探讨横纹肌样脑膜瘤（RM）的临床病理特点和鉴别诊断。方法：选取2010年一2015年间2例病例。患者发病年龄分别为6、16岁，男女各1例。分析RM的临床表现、组织形态学及免疫表型，并复习相关文献。结果：送检标本均为手术切除的肿瘤组织，总体积约为6—28cm。肿物无包膜，灰白至灰褐色，部分区域旱鱼肉状，切面实性，质软，其中1例局灶质韧，1例可见出血及坏死区域。光镜下肿瘤细胞呈横纹肌样特点，嗜酸性胞浆及偏位核。免疫组织化学染色显示肿瘤细胞显示Vim弥漫阳性，EMA弥漫或灶状阳性，INI-1核阳性，p53弱阳性，Ki67阳性表达率大于30%；而GFAP、HMB45和PR阴性，S—100和CK（AE1/AE3）表达不一，或弥漫阳性，或阴性表达；其余抗体偶见弱表达。结论：横纹肌样脑膜瘤非常罕见，具有横纹肌样的细胞形态学特点，免疫组化是正确诊断横纹肌样脑膜瘤的重要依据。 【关键词】横纹肌样脑膜瘤；病理；诊断 [Abstract] Objective：To investigate rhabdoid meningioma（RM）clinical pathological characteristics and differential diagnosis. Methods：2 cases of 2015 cases were selected in 2010. The age of onset was 6，16 years old，1 cases were male and female. To analyze the clinical manifestations，morphology and immune phenotype of RM，and review the related literatures. Results：the specimens were resected tumor tissue，the total volume of about 6 - 28cm. The tumor was not enveloped，gray to gray brown，some areas of dry fish，plane of solid，soft，of which 1 cases of focal ductile，1 cases of bleeding and necrosis of the area. Under the light microscope rhabdoid tumor cells，eosinophilic cytoplasm and partial nuclear. Immunohistochemical staining showed that the tumor cells showed VIM diffuse positive EMA diffusely or focally positive ini-1 nuclei positive for p53 weak positive，the positive expression of Ki67 rate of more than 30%；and GFAP，HMB45 and PR negative，s - 100 and CK（AE1 / AE3）expression is not a，or diffuse and positive or negative expression；the rest of the antibody occasionally weakly expressed. Conclusion：rhabdoid meningioma is very rare，with rhabdoid cell morphological characteristics and immunohistochemical is an important basis for the correct diagnosis of rhabdoid meningioma. [keyword]：rhabdoid meningioma；Pathology；diagnosis 横纹肌样脑膜瘤（rhabdoid meningioma，RM）是脑膜瘤中较为少见的病理亚型，由Perry等[1] 在1988年首次明确提出，并将其定义为具有横纹肌样细胞的脑膜瘤，强调其具有较高的侵袭性。RM 具有很强的增殖活性，2007年世界卫生组织（World Health Or—ganization，WHO）提出的脑膜瘤分类、分级标准，将RM 归为