小脑血管母细胞瘤2例临床病理分析  

A clinicopathological analysis of 2 cases of erebellum hemangioblastoma

作　　者：白石[1] 张坤[1] 郑艳[1] Bai Shi;Zhang Kun;Zheng Yan(Department of Pathology,Zhongwu Hospital of Suqian,Jiangsu Suqian 223800,China)

机构地区：[1]宿迁市钟吾医院病理科

出　　处：《现代肿瘤医学》2019年第15期2662-2664,共3页Journal of Modern Oncology

摘　　要：目的:探讨小脑血管母细胞瘤(HB)临床影像学表现、病理学特征及免疫组化特点,为鉴别诊断的准确率提供依据。方法:回顾性分析2015年10月至2017年4月诊治的2例HB患者临床资料、影像学表现、病理学特征及免疫组化特点并复习相关文献。结果:2例HB患者均以头痛为首发症状,影像学检查提示小脑半球囊实性和实质性占位,镜下肿瘤主要以大间质细胞和丰富的毛细血管网构成,并根据间质细胞的丰富程度分为细胞亚型,其肿瘤组织内含大量的间质细胞,细胞呈圆形或多角形,胞浆丰满呈空泡状;网状亚型,肿瘤组织内含大量的毛细血管,网织染色示有丰富的网状纤维。HB间质细胞中Vimentin、S-100蛋白、Inhibin-a、CD56表达均阳性且NSE、VEGF高表达,EMA、CD34、CD31、GFAP、EGFR均呈阴性。血管内皮细胞均表达内皮细胞标记物CD34、CD31及FⅧAg。Ki-67增殖指数标记阳性率<5%。结论:HB是临床较为少见的中枢神经系统良性肿瘤(WHOⅠ级),影像学表现具有一定的特异性,结合病理学特征及免疫组化特点,有助于提高诊断的准确率。Objective:To investigate the clinical imaging findings,pathology feature and immuno histochemistry characteristics of cerebellum hemangioblastoma(HB) and to provide evidence for the accuracy of differential diagnosis. Methods:Retrospectively analyse the clinical data of2 patients with HB from October2015 to April 2017 in imaging findings,histopathological features and immunohistochemistry,pathology feature and relevant literature was reviewed. Results:Headache was the first symptom in all patients with HB,and imaging examinations revealed solid cystic and substantial tumor occupancy in the cerebellar hemisphere,microscopically tumors consisted of large interstitial cells and a rich network of capillary vessels,and they were classified into cell subtypes according to the abundance of interstitial cells.The cells were round or polygonal,and the cytoplasm was full showed vacuole-shape.For reticulon subtype,tumor tissue contained a large number of capillaries,reticular fiber staining showed rich reticular fibers.The HB interstitial cells were positive for Vimentin,S-100 protein,Inhibin-a and CD56,and were highly expressed NSE and VEGF.EMA,CD34,CD31,EGFR and GFAP were negative.Vascular endothelial cell expressed endothelial markers CD34,CD31 and FVⅢAg.The positive rate of Ki-67 proliferation index was<5%. Conclusion:HB is a clinically rare benign tumor of the central nervous system(WHO level Ⅰ).Imaging performance has a certain degree of specificity.Combined with pathological features and immunohistochemical features,it contributes to the accuracy of diagnosis.

关 键 词：小脑 血管母细胞瘤 病理学特征 免疫组化 鉴别诊断 

分 类 号：R739.41[医药卫生—肿瘤]