囊性脑膜血管瘤病临床病理观察及文献复习  

Clinicopathological observation and literature review of cystic meningioangiomatosis

作　　者：谢丽梦 卢德宏[1] 朴月善[1] 樊晓彤[2] 滕梁红[1] 张屾 付秀玲 王丹丹[1] Xie Limeng;Lu Dehong;Piao Yueshan;Fan Xiaotong;Teng Lianghong;Zhang Shen;Fu XiulingWang Dandan(Department of Pathology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Neurosurgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院病理科,北京100053 [2]首都医科大学宣武医院神经外科,北京100053

出　　处：《中华神经科杂志》2020年第2期110-114,共5页Chinese Journal of Neurology

摘　　要：目的总结囊性脑膜血管瘤病的临床病理学特征。方法分析1例经病理确诊的囊性脑膜血管瘤病患者的临床表现、影像学及病理学特征,并复习相关文献。结果患者男性,16岁,因"发作性肢体抽搐3个月余"入首都医科大学宣武医院;头颅MRI显示左侧额叶囊性占位,长T1长T2信号。于神经外科行额上回局部的扩大切除,病变切开后呈囊状,含无色半透明液体。术后病理检查显示脑组织局部皮质内血管数量增多,呈分支状,血管周围围绕增生的梭形细胞,呈同心圆排列,血管间散在胶质细胞及砂砾体样钙化,相邻白质多发囊腔形成。免疫组织化学染色显示:血管周围梭形细胞及囊壁波形蛋白阳性,网织纤维丰富。术后随访10个月,患者一般情况良好,无癫痫发作,影像复查肿瘤未见复发。结论囊性脑膜血管瘤病MRI呈囊性占位,病理检查可见典型脑膜血管瘤病结构及囊腔形成,手术切除,预后良好。Objective To summarize the clinicopathological features of cystic meningioangiomatosis.Methods The clinical manifestations,imaging characteristics and pathological features of a case of cystic meningioangiomatosis were analysed,and the relevant literature was reviewed.Results A 16-year-old male patient from Xuanwu Hospital,Capital Medical University had a history of epileptic seizures for more than three months.Magnetic resonance imaging(MRI)demonstrated a cystic mass in the left frontal lobe with long T1 and long T2 signals.Extensive resection of the upper frontal gyrus was performed.The excised lesion presented with a cystic shape after incision and contained colorless translucent liquid.Microscopic examination of the lesion showed that the number of blood vessels in the local cortex of the brain tissue was increased and the vessels appeared to be branching.The blood vessel walls were surrounded by proliferative spindle cells,which were arranged in concentric circles.Immunohistochemical study revealed that those spindle cells and the cyst wall were vimentin positive.These cells had a rich reticular fibers.Ten months after the operation,the general condition of the patient was good,no epileptic sei?ure was observed,and the follow-up MRI did not reveal any residual lesion.Conclusions MRI of cystic meningioangiomatosis shows cystic space occupying.Pathological findings show typical features of meningioangiomatosis and cystic space formation.Cystic meningioangiomatosis has good prognosis after surgical resection.

关 键 词：脑膜肿瘤 癫痫 脑膜血管瘤病 

分 类 号：R73[医药卫生—肿瘤]