4例透明细胞脑膜瘤临床病理观察  

Clinical pathological study on 4 cases with clear cell meningioma

作　　者：李旻 王鹰 王小冰[2] 沈立红 余树林 

机构地区：[1]龙华新区人民医院病理科,深圳518109 [2]广东省人民医院病理科

出　　处：《临床神经外科杂志》2014年第5期347-349,共3页Journal of Clinical Neurosurgery

摘　　要：目的探讨透明细胞脑膜瘤(CCM)的临床病理特征。方法所有病例经免疫组化标记EMA、GFAP、Vimentin及ki67,并行PAS染色。结合文献讨论其临床病理特征及预后相关因素。结果 3例患者病灶全部切除,1例患者次全切除后行术后放、化疗。平均随访时间为30个月,随访3例患者无瘤存活,1例伴脑浸润的患者复发。4例CCM均表达EMA和vimentin,GFAP为阴性,PAS染色4例CCM肿瘤胞浆呈玫红色,Ki67平均指数为4.55,4例CCM的组织病理学具有胞浆透明、片状生长、细胞密度增大等共性。结论CCM是脑膜瘤的罕见亚型,具有发生于年轻人的趋势,易于复发。免疫组化有助于鉴别CCM和其它原发和转移性透明细胞肿瘤。脑组织侵犯、ki-67指数及切除的程度可能可以预测复发。Object To investigate the clinical pathological features of clear cell meningioma （CCM）.Methods Immunohistochemistry detections for epithelial membrane antigen （ EMA）, vimentin and glial fibrillary acidic protein （ GFAP） were applied, and the ki67 labeling index was calculated in all cases .Here we present a series of 4 patients with CCM .Results 3 patients had total removal and 1 patient underwent subtotal removal .The mean follow-up period was 30 months.1 patient with brain invasion recurred ,the others survived without recurrence .EMA and vimentin were 100%positive,and GFAP was 100%negative.The mean ki67 labeling index was 4.55.All 4 cases showed positive PAS stain .Histological features showed clear cytoplasm ,sheet-like architecture and increased cellularity .Conclusions CCM is a rare subtype of meningioma with a tendency to present in younger patients and a propensity to recur .Immunohistochemistry is helpful to differentiate CCM from other primary and metastatic clear cell tumors .Brain invasion , ki67 labeling index and the extent of resection might likely predict the recurrence .

关 键 词：透明细胞脑膜瘤 免疫组化 预后 

分 类 号：R739.45[医药卫生—肿瘤]