乳头状胶质神经元肿瘤的CT、MRI表现及病理分析  

CT,MRI Manifestation and Pathological Analysis of Papillary Glioneuronal Tumor

作　　者：朱建彬[1] 于昊[1] 王显龙[1] 杜勇兴 邹天宇[1] 蒋春秀[1] 席建东[1] 温志波[1] ZHU Jianbin;YU Hao;WANG Xianlong(Deportment of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong Province 510280, P. R. China)

机构地区：[1]南方医科大学珠江医院放射科

出　　处：《临床放射学杂志》2018年第4期568-572,共5页Journal of Clinical Radiology

摘　　要：目的分析乳头状胶质神经元肿瘤（PGNT）的影像表现及病理特征。方法回顾性分析经手术病理证实的5例PGNT的临床、CT、MRI影像学资料和病理学特点,并作文献复习。结果 4例位于幕上,其中颞叶2例,额叶及脑室各1例;1例主要位于皮层区,3例位于脑室周围白质区。1例位于幕下小脑蚓部-小脑半球。肿瘤可呈囊实性（2/5）、囊带壁结节样（1/5）、囊性（1/5）及实性（1/5）4种形态。CT示病变实性部分呈等或稍高密度,其中2例可见钙化。2例MRI检查示病变呈以稍长T_1、稍长T_2信号为主的混杂信号,增强扫描呈明显强化。5例均表现轻度水肿。病理镜下均见特征性假乳头状结构。结论 PGNT在CT、MRI表现上有一定特点,多表现为幕上脑室周围白质区囊带壁结节或囊实性肿块,罕见发生于幕下,界清且瘤周水肿轻,常伴钙化,极少出现出血,病理形态学及免疫组织化学可以明确诊断。Objective To analyze the imaging and pathological features of papillary glioneuronal tumor（ PGNT）.Methods The clinical,neuroimaging findings and pathological features of 5 cases of papillary glioneuronal tumor proved by surgery and histopathology were investigated retrospectively and literature was reviewed. Results 4 masses located in supratentorial compartment,2 masses in temporal lobe,1 mass in the frontal lobe and 1 mass in the ventricles. 1 located primarily in cortical gray matter and 3 in the periventricular area. One mass was subtentorial cerebellar vermis-cerebellar hemisphere. All masses could be classified into 4 patterns： cystic and solid（ n = 2）,cystic with mural nodule（ n = 1）,cystic（ n= 1） and solid（ n = 1）. The solid portion of lesions showed slightly high density or isodensity with calcification in 2 cases.Two cases of MRI scans showed the signals of tumors were confounding but mainly presented as mildly hypointense on T_1 WI and mildly hyperintense on T_2 WI and all of them showed obvious enhancement. All masses showed mild peritumoral edema. Histopathologically,characteristic pseudopapillary architecture was observed by light microscopy in all cases. Conclusion There are some characteristics in CT and MRI images of PGNT,which demonstrated more a large mass with cyst with mural nodule or cystic and solid appearance in supratentorial periventricular area,rarely located in infratentorial compartment. The tumors were well-demarcated with mild peritumoral edema and calcification; hemorrhage was rarely seen. Histopathological and immunohistochemistry examination could provide the definitive diagnosis.

关 键 词：脑肿瘤 乳头状胶质神经元肿瘤 体层摄影术 X线计算机 磁共振成像 病理 

分 类 号：R445.2[医药卫生—影像医学与核医学] R730.44[医药卫生—诊断学] R739.4[医药卫生—临床医学]