第七届全国诊断病理学读片会资料1.pptVIP

第七届全国诊断病理学读片会资料 第四军医大学唐都医院病理科 2006.10 南昌 病史摘要 患者男性，46岁，半年前无明显诱因出现左侧肢体无力，尤以左下肢明显，并伴左下肢抽搐，呈间断性震挛发作，影响行走，膝以下无力明显，伴记忆力减退。 查体 左侧肢体肌力减弱（III级）， 右侧肌力正常。 术中所见 于脑表面见肿瘤界限清楚，右侧镰旁及顶叶均为肿瘤组织，肿瘤中心呈鱼肉样，四周呈灰白色，肿瘤组织质地柔软，血供丰富。 影像学资料 头颅MRI示右顶叶有一混杂密度区，约6.2 cm×6.0 cm×4.0 cm，中线移位明显，增强扫描肿瘤呈不规则团、片状强化。 放射片 放射片 放射片 大体所见 灰红碎组织一堆，体积：5.0cm×3.0cm×3.0cm， 切面灰红，质软，局部呈胶冻样。 06-5817 镜下所见 在大片幼稚未分化的间叶性瘤细胞中，散布着小岛屿状的软骨细胞灶。未分化的间叶瘤细胞，呈小圆形或梭形，形态大小一致，核深染，核仁不清楚，胞浆极少。软骨灶大小、形态不一，软骨灶可发生钙化及骨化。 免疫组化及特殊染色 肿瘤细胞表达：S-100（++） 粘液卡红（++） PAS(++) 不表达：CK（-）、EMA（-）、 NF（-）、 GFAP(-)、 CD99(-)、NSE（-）。 HE染色 H.E.stain Small cell area. Mucincarmin stain Mucincarmin stain. Atypical hyaline cartilage +, stain red. Small cell area －. S-100 Stain S-100 Stain S-100 stain 右顶叶间叶性软骨肉瘤 Intracranial mesenchymal chondrosarcoma This is a rare highly aggressive variant chondrosarcoma may impinge upon the nervous system by direct extension from a primary focus in the surrounding skull or spine. Or arise directly from the dura or within brain parenchyma.Up to 2006, there are about 60 cases has been reported in the world literature. Most patients in the first three decades of life. Intracranial mesenchymal chondrosarcoma Mesenchymal chondrosarcomas exhibit an unmistable histologic patter characterized by well-circumscribed islands of atypical hyaline cartilage suspended in a densely cellular field of small cells. La Spina M has reported a case of Intracranial mesenchymal chondrosarcoma with osteoid formation. These cells may be resemble those of hemangiopericytoma in cellular composition. Origin From the clinical data combined the pathologic change, we think our case originated from the dura. * * H.E. stain Small cell area. S-100 stain S-100 stain 病理诊断 *