79例毛细胞肿瘤的组织学分类及临床病理分析  

Clinicpathological analysis and histological types of 79 cases of pilocytic glioma

作　　者：马小梅[1] 余宏宇[1] 刘惠敏[1] 夏春燕[1] 黄佳[1] 何金[1] 杨慧玲[1] 刘胜楠[1] 

机构地区：[1]第二军医大学附属长征医院病理科,上海200003

出　　处：《临床与实验病理学杂志》2014年第7期747-750,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的观察中间型毛细胞黏液样肿瘤(intermediate pilomyxoid tumor,IPMT)、毛细胞黏液样星形细胞瘤(pilomyxoid astrocytoma,PMA)和毛细胞星形细胞瘤(pilocytic astrocytoma,PA)的临床病理学特征。方法回顾性分析79例毛细胞肿瘤,按照WHO(2007)中枢神经系统肿瘤分类标准重新诊断,结合其临床病理学特征进行对比分析。结果 67例为典型PA,1例为典型PMA,11例为IPMT。男性患者均多于女性,IPMT患者平均年龄大于PMA,明显小于PA,三者病变部位相似。镜检:PMA由形态单一的双极梭形细胞以血管为中心生长,间质内见大量黏液,未见Rosenthal纤维或嗜酸性颗粒小体;PA均可见Rosenthal纤维和嗜酸性颗粒小体;IPMT则具有PMA的大量黏液,形态单一的双极小肿瘤细胞且呈假菊形团样生长,具有PA的Rosenthal纤维和嗜酸性颗粒小体特征,可见多量微囊。三者均可复发。结论 IPMT确实存在且数量不少,PA、PMA和IPMT在组织学上有联系。Purpose To study the clinical and pathological features of intermediate pilomyxoid tumor （ IPMT）, pilomyxoid astrocytoma （PMA） and pilocytic astrocytoma （PA）. Methods 79 cases of pilocytic glioma were retrospectiv analysis. The rediagnosis and classification was accomplished according to the 2007 WHO classification of tumors of the central nervous system, and its clinical and pathological characteristics were compared. Results According to histological features, patients were divided into classic PA 67 cases, classic PMA 1 case and IPMT 11 cases. Male was more than female in the three type diseases. The average age of IPMT patients was younger than PA, but older than PMA. The position of the three tumors was similar. Histologically, PMA had a prominent mucoid matrix and angiocentric arrangement of monomorphous, bipolar tumor cells, typically without Rosenthal fibers or eosinophilic granular bodies. PA had a biphasic pattern with varying proportions of compacted bipolar cells associated with Rosenthal fibers and loose textured muhipolar cells associated with microcysts and eosinophilic granular bodies. IPMT often involved the qualitative and quantitative assessment of mucoid/myxoid matrix and monomorphous cellularity with angiocentric arrangement which were PMA characters and dense area with Rosenthal fibers or eosinophilic granular bodies which were PMA characters. All the three tumors could relapse. Conclusion IPMT does exist and may be common. They are linked in histology.

关 键 词：中间型毛细胞黏液样肿瘤 毛细胞黏液样星形细胞瘤 毛细胞星形细胞瘤 

分 类 号：R739.4[医药卫生—肿瘤]