脊索瘤样脑膜瘤的临床与病理特点  

Clinical and pathological features of chordoid meningioma

作　　者：朱海青[1] 沈静[1] 张巧全[1] 梁为俭[1] 周金宝[1] 

机构地区：[1]南京医科大学附属脑科医院病理科,210029

出　　处：《中国现代神经疾病杂志》2008年第4期353-356,共4页Chinese Journal of Contemporary Neurology and Neurosurgery

摘　　要：目的探讨脊索瘤样脑膜瘤的临床与病理特点。方法应用组织病理学、组织化学以及免疫组织化学方法对1例脊索瘤样脑膜瘤患者进行观察,结合文献分析其临床与病理特点。结果脊索瘤样脑膜瘤在临床上可以伴有或不伴有Castleman综合征。以黏液样基质中有呈分叶状或条索状排列的肿瘤细胞为病理学特点,细胞质呈淡染或嗜酸性染色,部分细胞呈液滴状,分布于黏液样基质中,类似脊索瘤样细胞;肿瘤组织中亦可见由典型脑膜皮细胞型脑膜瘤细胞组成的区域。组织化学方法过碘酸雪夫染色呈阳性反应。免疫组织化学染色显示,肿瘤细胞上皮膜抗原、波形蛋白及表皮生长因子受体表达阳性,细胞角蛋白、S-100蛋白呈灶性阳性反应,癌胚抗原表达阴性,Ki-67抗原标记指数<1%,35%肿瘤细胞p53蛋白表达阳性。结论脊索瘤样脑膜瘤为临床罕见的特殊类型脑膜瘤,通过临床病史、组织病理学、组织化学和免疫组织化学检测可以明确诊断。预后尚有待进一步观察。Objective To study the clinical and pathological features of chordoid meningioma. Methods One case of chordoid meningioma was investigated. In this case histopathology, histoehemistry and immunohistochemistry were studied. The clinical and pathological features were explored and related literatures were reviewed. Results Chordoid meningioma may or may not associate with Castleman syndrome. Lobular- and strip-shaped tumor cells were seen in the mucoid matrix. The cytoplasm was hypochrnmie or oxychromatic. There were some droplets cells in the mueoid matrix which were similar to chordoma-like cells. Typical meningiomatous pattern was observed focally. The histoehemieal examination showed periodic acid schiff （PAS） staining positive. Immunohistochemical examination showed positive for epithelial membrane antigen （EMA）, vimentin and epidermal growth factor receptor （EGFR）, focal positive for cytokeratin （CK） and S-100 protein, negative tbr carcinoembryonic antigen （CEA）. Ki-67 antigen labeling index was low （〈 1%）. p53 protein expression positive was seen in 35% tumor cells. Conclusion Chordoid meningioma is a rare variant of meningioma. The confirmed diagnosis can be made by clinical data, and histopathological, histochemical and immunohistochemical examination. The prognosis needs to be studied further.

关 键 词：脑膜瘤 脊索瘤 免疫组织化学 病理学 

分 类 号：R739.4[医药卫生—肿瘤]