第三脑室脊索样胶质瘤1例报道并文献复习  

Chordoid giloma of third ventricle:a case report and review of literatrue

作　　者：杨聪颖[1] 吴波[1] 金行藻[1] 周晓军[1] 孟奎[1] 

机构地区：[1]南京军区南京总医院病理科,南京210002

出　　处：《诊断病理学杂志》2004年第4期246-248,I065,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的　第三脑室脊索样胶质瘤是一种新的发生在蝶鞍区或第三脑室周围的肿瘤 ,通过对其临床、病理学特征、免疫表型及鉴别诊断的阐述 ,提高对第三脑室脊索样胶质瘤的认识。方法　对 1例脊索样胶质瘤进行组织形态学、组织化学及免疫组化、超微结构研究 ,并进行文献复习。结果　第三脑室脊索样胶质瘤细胞产生大量黏液 ,构成脊索样结构 ,肿瘤边界清楚 ,很少向周围脑组织浸润。所有肿瘤细胞表达GFAP和vimentin ,部分细胞表达S 10 0和EMA ,但不表达CK ,Ki 6 7指数 <5 %。组织化学染色PAS阳性 ,肿瘤内网织纤维呈巢状分布。结论　第三脑室脊索样胶质瘤是一种罕见的有特殊形态结构及免疫表型的肿瘤 ,组织学发生尚不明确 ,光镜及电镜检查无特异性 ,病理诊断须依靠免疫组化。Objective Chordoid glioma is a new clinicopathologic entity that occurs in the region of the hypothalamus or anterior third ventricle.The aims of this study were to describe its morphologiy,immunophenotype and ultrastructural features,and increase clinicians' and pathologists' awareness of this newly described tumor. Methods A case was reported,and histochemical,immunohistochemical and electromicroscopic studies were performed in this case. Results Microscopically, it consisted of clusters and strands of epithelioid cells in a mucoid matrix.Its margins were remarkably discrete and showed little tendency to infiltrate surrounding brain parenchyma.The majority of neoplastic cells were GFAP and vimentin positive,whereas EMA and S-100 protein labeled only individual cells.The percentage of Ki-67 positive cells was generally low (<5%).Stains for cytokeratin were nonreactive. Conclusion The findings show that the tumor arises from neural tissue of the lamina terminalis,and has no contact with the choroid plexus,tela choroidea,or velum interpositum.The histological and ultrastructural features are not definitive,and the immunochemical staining is advantageous to determine the diagnosis and differential diagnosis.

关 键 词：肿瘤 胶质瘤 第三脑室 文献复习 免疫表型 免疫组化 细胞表达 脊索 组织化学 特异性 

分 类 号：R730.264[医药卫生—肿瘤] R739[医药卫生—临床医学]