富于淋巴浆细胞型脑膜瘤8例临床病理研究  

Lymphoplasmacyte-rich meningoma: a clinical and pathological study of 8 cases

作　　者：董莉[1] 董驰[1] 周俊林[2] 刘建莉[2] 张虹[1] 

机构地区：[1]兰州大学第二医院病理科,兰州730030 [2]兰州大学第二医院放射科,兰州730030

出　　处：《诊断病理学杂志》2014年第8期476-479,共4页Chinese Journal of Diagnostic Pathology

基　　金：兰州市科技计划项目(编号:2009-1-54)

摘　　要：目的了解富于淋巴浆细胞型脑膜瘤的临床病理特征、免疫表型和MRI特征,以进一步提高对该亚型的认识。方法综合分析8例经手术病理证实的富于淋巴浆细胞型脑膜瘤的临床病理特征及MRI影像资料,并结合相关文献进行对比研究。结果 MRI示8例均为单发病灶,7例病灶沿脑膜匍匐性生长,1例位于侧脑室旁;6例呈不规则斑片状,未形成具体瘤结节,2例为不规则分叶状;8例病灶均界限不清,瘤周水肿明显,邻近脑组织均有不同程度受累。8例镜下组织学成分多样。瘤细胞排列成编织状、束状、旋涡状或席纹状,其间可见大量淋巴细胞、浆细胞浸润,局灶可形成淋巴滤泡。免疫组化示瘤细胞EMA和vimentin(+),S-100和GFAP(-);淋巴细胞LCA(+),T淋巴细胞CD3(+),B淋巴细胞CD20(+),浆细胞CD138和CD38(+);Ki-67阳性细胞数为15.4%。结论富于淋巴浆细胞型脑膜瘤的诊断应在形态学的基础上结合相应的免疫组化及具有一定表现特征的影像学检查,以确保诊断的准确性并有效降低误诊率。Objective To investigate the clinical and pathological characteristics, immunophenotypes and MRI manifestations of lymphoplasmacyte-rich meningioma which is the rare subtype of meningioma in order to improve the existing understanding about it. Methods The clinical and pathological characteristics and MRI data of 8 cases of lymphoplasmacyte-rich meningioma proved by surgical pathology were comprehensively analyzed and the comparative study was carried out by combining with relative literatures. Results MRI imaging showed that all lesions in 8 cases were solitary. The tumors crawled along meninges in 7 cases and in 1 case the lesions located in the area near the lateral ventricles. The lesions without meningloma nodules presented with irregular patchy in 6 cases and the tumors appeared as irregular lobulated shape in 2 eases. The boundary of all of the tumors was unclear with heavy peritumoral brain edema and the neighbouring brain tissue invasion was noted in different degrees in 8 eases. Pathological results showed the diverse histological components in the 8 cases and tumor cells arranged in weaving, bunchiness, swirls or storiform with massive lymphocytic and plasmocytic infiltration and lymphoid follicular formation was identified in local focus.Immunohistochemical examination showed that the tumor ceils were positive with EMA （ ＋ ）, vimentin （ ＋ ）, lymphocyte with LCA（ ＋ ）. T lymphocyte with CD3（ ＋ ） ,B lymphocyte with CD 20（ ＋ ）, plasmocytic with CD138（ ＋ ） and CD38 （ ＋ ）, but negative with S-100（ - ） and GFAP（ - ） and the average proportion of Ki-67 positive cells was 15.4%.Conclusions For the diagnosis of lymphoplasmacyte-rich meningloma, morphological analysis, immunohistochemical examination and MRI manifestation should be combined to increase the diagnostic accuracy and decrease misdiagnosis rate.

关 键 词：富于淋巴浆细胞型脑膜瘤 鉴别诊断 临床病理 免疫组化 核磁共振成像 

分 类 号：R739.45[医药卫生—肿瘤]