中枢神经细胞瘤16例临床病理分析  

Central neurocytoma: clinical and pathological analyses of 16 cases

作　　者：李俊芝[1] 张琰[1] 葛金莲[2] 苗娜[1] 张巍[1] LI Jun-zhi;ZHANG Yan;GE Jin-lian;MIAO Na;ZHANG Wei(Department of Pathology,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Center of Laboratory,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院病理科,乌鲁木齐830054 [2]新疆医科大学第一附属医院检验中心,乌鲁木齐830054

出　　处：《诊断病理学杂志》2020年第11期804-807,共4页Chinese Journal of Diagnostic Pathology

基　　金：新疆维吾尔自治区自然科学基金(2017D01C315)。

摘　　要：目的探讨中枢神经细胞瘤临床病理特点、诊断及鉴别诊断。方法收集16例中枢神经细胞瘤,分析其临床特点,观察其病理组织学形态及免疫表型特征、临床及影像学资料,进行回顾性分析并随访;结果患者年龄25~44岁,平均年龄35岁,男性11例,女性5例,病变均位于侧脑室。中枢神经细胞瘤好发于中青年,无性别差异,临床表现为头痛、呕吐等颅内高压症状为主,部分表现为视物模糊、视力下降失明、记忆力减退等症状;病理组织学由中等大小的圆形、卵圆形细胞构成,肿瘤细胞胞质常形成核周空晕,瘤细胞间质见纤细的分支状血管,血管周围可见无细胞核的基质岛网状结构;免疫组化Neu-N均呈强(+)(16/16),Syn(14/16)、NSE(13/16)、S-100(10/16)在细胞间无核原纤维岛区呈弥漫(+),少许瘤细胞胞质(+),14例GFAP(-),2例肿瘤细胞胞质可见GFAP散在(+),肿瘤细胞Ki-67 1%~3%(+)。结论中枢神经细胞瘤是分化好的神经元细胞组成的良性肿瘤,好发于中青年脑室内。结合组织学形态、免疫组化、肿瘤发生部位及典型的影像学表现,这些特点对中枢神经细胞瘤的诊断具有重要鉴别诊断意义,手术全切患者预后良好,次全切除患者可以辅助放射治疗延缓肿瘤的生长与复发。Objective To explore the clinicopathological features, diagnosis and differential diagnosis of central neurocytoma. Methods Sixteen cases of central neurocytoma were collected,their clinical characteristics were analyzed;their histopathological morphology and immunophenotypic characteristics, clinical and imaging data were observed,retrospectively analyzed and followed up. Results The patients were 25 to 44 years old,with an average age of 35. 0 years,11 males and 5 females. All of the tumors were located in the lateral ventricle. Central neurocytoma most commonly occured in young and middle-aged people without gender difference. Its clinical manifestations included headache,vomiting and other symptoms of intracranial hypertension;some of they presented with blurred vision,decreased vision,blindness and memory loss. Histologically,the tumor was composed of round cells of medium size and oval shape. The cytoplasm of tumor cells often had a halo arround the nuclei. Immunohistochemically,tumor cells were strongly positive for neu-n( 16/16),Syn( 14/16),NSE( 13/16);S-100 was diffuse positive in the intercellular non-nucleofibrillary island region( 10/16),and a few tumor cell cytoplasm was also positive;14 cases were negative for GFAP,2 cases were positive for GFAP,and ki-67 index was 1%-3%. Conclusion Central neurocytoma is a benign tumor composed of differentiated neurons,which is usually found in the human brain. Histological morphology,immunohistochemical characteristics,tumor sites and typical imaging manifestations are of great significance for the diagnosis of central neurocytoma. The prognosis of patients with complete surgical resection is good.

关 键 词：中枢神经细胞瘤 鉴别诊断 预后 

分 类 号：R739.4[医药卫生—肿瘤]