颅内巨细胞胶质母细胞瘤  

Intracranial giant cellular glioblastomas

作　　者：李南云 张泰和[1,2] 钱源澄 严小娟[1,2] 印洪林 陈海薇[1,2] 

机构地区：[1]南京大学医学院临床学院 [2]南京军区南京总医院

出　　处：《南京大学学报（自然科学版）》1998年第2期196-200,共5页Journal of Nanjing University（Natural Science）

摘　　要：目的：为探讨巨细胞胶质母细胞瘤的临床病理特征、组织发生学及预后，观察了１１例巨细胞胶质母细胞瘤，占１７２１例ＣＮＳ肿瘤的０．６４％。方法：采用电镜观察和胶质纤维酸性蛋白（ＧＦＡＰ）、Ｓ－１００蛋白（Ｓ－１００）、波形细丝蛋白（ＶＩＭ）等免疫组化染色，研究了此类肿瘤的病理、电镜、免疫组化及临床特点。结果：本病好发于年轻人的脑表浅部位，界限清楚。组织学特征是瘤细胞多形性，巨大奇异，在基质中有大量的网状纤维。巨细胞最大者达１０００μｍ，并发现巨细胞常伴有丰富的淋巴细胞浸润和伸入运动。结论：观察证明，此肿瘤起源于星形细胞，同时发现淋巴细胞浸润及伸入运动，提示宿主强烈的免疫反应以及有较好的预后，表明淋巴细胞浸润可能对预后起重要作用。Objectives: To study the clinicopathological features, histogenesis and prognosis, 11 cases of giant cellular glioblastoma were reported representing 0.64% of a series of 1 721 patients undergoing biopsy for CNS tumors. Methods: The pathological,electron microscopical,immunohistochemical and clinical features of giant cellular glioblastoma were studied by electron microscopical examination and immunohistochemical stain for glial fibrillary acidic protein(GFAP),S100 protein (S100) and Vimentin(VIM). Results: These tumors were more frequent in young subjects and presented as a superficially located, often sharply circumscribed mass.The predominant histological features were cellular plemorphism,bizarre giant cells,and large amounts of reticulin fibers in the stroma.The giant cells measured up to 1 000 μm in the greatest dimension.The authors noted that the presence of a rich lymphocytic infiltration and emperipolesis was often associated with the dominating giant monstrous cells. Conclusions: The astrocytic origin of the tumor was confirmed.The lymphocytic infiltration and emperipolesis would imply a stronger immune response by the host and a better clinical course could thus be expected.Influence of lymphocytes seem to play a major prognostic role.

关 键 词：胶质母细胞瘤 淋巴细胞浸润 颅内肿瘤 巨细胞 

分 类 号：R739.41[医药卫生—肿瘤]