颅内脊索样脑膜瘤2例临床病理分析  

Chordoid meningiomas in epencephalon and saddle area: a clinicopathological analysis of two cases

作　　者：孙屏[1] 吕慧[1] 肖燕[1] 张熔熔[1] 

机构地区：[1]南京医科大学附属无锡第二人民医院病理科,江苏无锡214002

出　　处：《诊断病理学杂志》2015年第10期621-624,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨脊索样脑膜瘤的临床病理特征、诊断与鉴别诊断。方法观察小脑及鞍区的2例脊索样脑膜瘤的临床表现、组织学形态及免疫组化特征并复习相关文献。结果 2例患者均为成人,年龄47岁和68岁,肿瘤分别位于小脑和鞍区,因头痛或视力下降伴眼睑下垂就诊。镜下见黏液样基质中有呈分叶状或条索状排列的肿瘤细胞,细胞质淡染或嗜酸性,部分细胞呈液滴状,分布于黏液样基质中,类似脊索瘤样细胞;肿瘤局灶可见典型上皮型脑膜瘤区域。免疫组化:vimentin、EMA及D2-40(+),CKpan、S-100和GFAP(-)。结论脊索样脑膜瘤是一种罕见类型的脑膜瘤,发生在小脑及鞍区尤为少见,需结合临床病理、免疫表型明确诊断。肿瘤易复发,WHO分级Ⅱ级。Objective To study the clinicopathological features, diagnosis and differential diagnosis of chordoid meningioma. Methods The histopathologic,immunohistochemical and clinical features were studied in two cases of chordoid meningioma in epencephalon and saddle area,with review of the related literature. Results Two patients were 47-year-old and 68-year-old adults,respectively,and visited doctors because of the headache or vision loss associated with drooping eyelids. Lobular and strip shaped tumor cells were seen in the mucoid matrix. The cytoplasm was hypochromic or oxychromatric. There were some droplets cells in the mucoid matrix,which were similar to chordoma-like cells. Typical meningioma cell pattern was observed focally. Immunohistochemically,tumor cells were positive for vimentin,EMA and D2-40,but negative for CKpan,S-100 and GFAP. Conclusions Chordoid meningioma is a rare type of meningioma,occurred in epencephalon and saddle area is especially rare. It is important for diagnosis and differential diagnosis to closely combine with medical history,morphological features and immunophenotype analysis. Chordoid meningioma has high relapse rate and belongs to WHO Grade Ⅱ.

关 键 词：脊索样脑膜瘤 小脑及鞍区肿瘤 免疫组化 

分 类 号：R737.14[医药卫生—肿瘤]