脑膜血管周细胞瘤临床病理分析  

Clinicopathological features of meningeal hemangiopericytoma

作　　者：张良运[1] 刘芳[1] 郭莉[1] 许欣[1] 罗小平[1] 

机构地区：[1]广东省佛山市第一人民医院病理科,广东佛山528000

出　　处：《临床与病理杂志》2015年第3期357-363,共7页Journal of Clinical and Pathological Research

摘　　要：目的：探讨脑膜血管周细胞瘤（hemangio Pericytoma，HPC）的临床病理特点及鉴别诊断。方法：对9例脑膜HPC患者临床病理资料进行回顾性分析和随访15～95个月，并复习相关文献。结果：脑膜HPC常见症状为头痛头昏、肿瘤压迫和颅内高压；CT／MRI检查见肿瘤与脑膜相连，增强扫描明显强化。光镜下肿瘤细胞丰富，核圆形或卵圆形，核仁不明显；间质富含“鹿角状”血管，网状纤维包绕单个瘤细胞。免疫标记瘤细胞CD34局灶阳性，PR阴性，1例EMA局灶弱阳性。7例随访15-95个月，4例术后复发，复发病例中l例术后35月腰椎转移。结论：脑膜HPC是一种少见肿瘤，确诊需依靠病理学检查。脑膜HPC影像学上与脑膜瘤相似，但其生物学行为、病理组织学及预后不同于脑膜瘤，易复发和远处转移，术后需长期随访。Objective： To investigate the clinicopathological features and differential diagnosis of meningeal hemangiopericytoma （HPC）. Methods： The clinic data and histopathology of nine patients with meningeal HPC were retrospectively analyzed, with follow-up from 15 to 95 months, and review of the literature. Results： The clinical characters commonly manifested as headache, dizzy, oncothlipsis and intracranial hypertension; CT or MR] scanning showed that the tumors connect to the meningeal and obvious enhancement by enhancement scanning. Histologically, the tumors were highly cellularity which shaped with round or oval nuclei, indistinct nucleoli. And numerous vascular patterns with ＂a staghorn configuration＂, the single tumor cell were surrounded by reticular fiber. Immunochemistry stains showed tumor cells focal positive for CD34 and negative for PR, only one case showed focal weakly positive for EMA. Seven cases of HPC were followed up from 15 to 95 months, four cases reappeared and one of the four cases lumbar metastasis found in 38 months after operating.Condusion： Meningeal HPC is an uncommon tumor and the finial diagnosis depends on pathological studying. Meningeal HPC is similar to the meningioma on CT or MR/scanning, but its biological behaviors, pathology features and prognosis differs from that of meningioma, with a high tendency for both local recurrence and distant metastasis, so that long time follow-up is necessary.

关 键 词：脑膜血管周细胞瘤 临床病理学 病理特征 脑膜瘤 鉴别诊断 

分 类 号：R739.45[医药卫生—肿瘤]