纵隔原发性室管膜瘤临床病理观察  

Primary ependymoma of the mediastinum: a clinicopathological study

作　　者：叶伟标[1] 徐咏强 梁远秋 何建芳[1] 杨湘玲[2] YE Wei-biao;XU Yong-qiang;LIANG Yuan-qiu;HEJlcm-fang;YANG Xiang-ling(Dongguan Hospital of Southern Medical University, Guangdong 523059, China;The Sixth Affiliated Hospital of Sun Yat-sen University, Gaangdon9 510655, China)

机构地区：[1]南方医科大学附属东莞人民医院病理科,广东东莞523059 [2]中山大学附属第六医院中心实验室,广州510655

出　　处：《诊断病理学杂志》2018年第5期354-357,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨纵隔原发性室管膜瘤的临床病理特点、诊断和鉴别诊断。方法对1例纵隔原发性室管膜瘤进行组织形态学观察和免疫表型分析,并复习相关文献。结果患者为中年女性,因胸背部不适半年余,CT发现纵隔肿物3天入院。术中见肿物位于右后纵隔脊椎旁,边界相对清晰,肿物大小6 cm×5 cm×3 cm,切面灰黄色,质软。镜下见肿瘤组织形态结构多样,以乳头、假乳头结构为主,可见囊性变、小梁状和筛孔状结构;局部脉管内见肿瘤浸润;肿瘤细胞呈立方状或高柱状,胞质嗜酸性,核圆形或卵圆形,核仁不明显,核分裂象少见。免疫组化示肿瘤细胞表达vimentin、GFAP、CD56、ER、PR均(+)。结论纵隔原发性室管膜瘤极为罕见,临床及影像学上容易误诊,熟悉其组织形态、免疫组化和超微结构特征有助于诊断与鉴别诊断。Objective To investigate the clinicopathological characteristics,diagnosis and differential diagnosis of primary mediastinal ependymoma（ PME）. Methods We reported a case of PME in a 35-year-old woman. The histomorphologic,immunohistochemical and ultrastructural features of this tumor were summarized. Related literature were reviewed. Results A relatively well-circumscribed gray-yellow mass measuring 6 cm × 5 cm × 3 cm was located in the posterior mediastinum.Microscopically,the tumor was composed of cuboidal or columnar cells arranged predominately in a papillary or pseudopapillary architecture. Other growth patterns included cystic,trabecular and cribriform. The tumor cells were immunohistochemically positive for vimentin,GFAP,CD56,ER and PR. Conclusion PME is a very rare tumor with only few cases reported in the literature. Its clinical misdiagnosis is due mainly to the limited awareness of this disease. Recognizing its histomorphologic,immunohistochemical,and ultrastructural features might facilitate its diagnosis and differential diagnosis.

关 键 词：室管膜瘤 纵隔肿瘤 组织病理学 免疫组化 

分 类 号：R734.5[医药卫生—肿瘤]