难治性癫相关脑肿瘤及瘤样病变42例临床病理研究  

Brain tumors and tumor-like lesions in patients with refractory epilepsy: a clinicopathologic study of 42 cases

作　　者：梁乐[1] 马康平[2] 郭彦科[1] 邢炜[1] 冷慧[1] 遆红娟[1] 付静[1] 

机构地区：[1]北京市海淀医院/北京大学第三医院海淀院区病理科,北京100080 [2]北京市海淀医院/北京大学第三医院海淀院区功能神经科,北京100080

出　　处：《诊断病理学杂志》2016年第8期565-569,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨难治性癫相关脑肿瘤及瘤样病变的临床病理特征。方法对因难治性癫接受致病灶切除术并经病理诊断为脑肿瘤及瘤样病变的患者临床资料进行回顾性研究。结果患者42例,平均发病年龄11.1岁,平均病程10.5年,头颅核磁共振检查多见异常信号表现(95.2%,40/42),多位于颞叶(76.2%,32/42)。组织学分类最多为节细胞胶质瘤(40.5%,17/42),肿瘤常伴有局灶性皮质发育不良(61.9%,26/42)。免疫组化:21例CD34(+)、23例nestin(+)。结论难治性癫相关脑肿瘤及瘤样病变诊断应强调临床、影像和病理学特点的综合判断,nestin免疫组化染色对诊断与鉴别诊断有一定的应用价值。Objective To study the clinicopathologic features of brain tumors and tumor-like lesions with medically refractory epilepsy. Methods The clinicopathologic data of the patients pathologically diagnosed as brain tumors and tumor-like lesions with refractory epilepsy who underwent resection of epileptic focus were retrospectively analyzed. Results In the 42 cases studied, the mean onset age was 11.1 years, and the duration of disease was 10. 5 years. MRI images showed abnormal signals in 95.2% of cases （ 40/42 ）. The majority of the site was temporal lobe （ 32/42, 76. 2% ）. Histological classification showed that ganglioglioma was the most common tumor （ 17/42, 40. 5% ）. The tumors were often accompanied by focal cortical dysplasias （26/42, 61.9% ）. Immunohistochemical staining showed CD34 positive in 21 cases and Nestin positive in 23 cases. Conclusions The diagnosis of brain tumors and tumor-like lesions with medically refractory epilepsy relies on pathological observations combined with clinical features and neuroradiological examinations. Immunohistochemical staining of Nestin can help diagnosis and differential diagnosis.

关 键 词：癫癎 脑肿瘤 神经节细胞胶质瘤 局灶性皮质发育不良 

分 类 号：R742.1[医药卫生—神经病学与精神病学]