神经胶质迷芽瘤10例临床病理观察及分析  

Glial choristoma:a clinicopathologic study of ten cases

作　　者：王庆煜 陈莲 WANG Qing-yu;CHEN Lian(Department of Pathology,Shanghai Children's Hospital,Shanghai Jiaotong University,Shanghai 200062.China;Department of Pathology,Children's Hospital of Fudan Universily,Shanghai 200032,China)

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院病理科,上海200062 [2]上海复旦大学附属儿科医院病理科,上海200032

出　　处：《诊断病理学杂志》2021年第8期614-617,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨神经胶质迷芽瘤的临床病理学特点。方法收集上海交通大学附属儿童医院及上海复旦大学附属儿科医院自2015-08月-2020-05月间确诊的10例神经胶质迷芽瘤患者的临床资料,分析其临床、影像学特点,观察病理组织学形态。结果临床特点:10例患者中,男性6例,女性4例,年龄从16天到三岁,平均年龄11.6个月,平均病程约10.6个月。主要表现为缓慢生长的无痛性实性肿块,病变部位咽部4例,软腭1例,舌背1例,鼻背1例,鼻腔1例,面部皮下1例,右侧颈部胸锁乳突肌后外方1例。CT检查表现为面部皮下、鼻背、舌背类圆形软组织影,右侧胸锁乳突肌后外侧团块影,软腭、鼻腔、鼻咽部富血管性占位性病变。颅底骨质连续,无缺损。病理学检查:10例均为单发肿块,肿瘤大小从1.0 cm×1.0 cm×1.0 cm到3.3 cm×2.9 cm×1.8 cm,周界清楚,无包膜,切面呈灰粉色,实性,质韧。镜下可见病变主要由大量神经胶质组成,混杂在正常组织中。免疫组织化学:本组10例病例中,神经胶质均表达GFAP及S-100,其中4例表达NeuN1。10例患者均行肿物手术切除,术后随访2~60个月,无一例复发和转移。结论神经胶质迷芽瘤常发生于婴幼儿头颈部,手术完整切除后一般不易复发。Objective To investigate the clinicopathological features of glial choristoma. Methods Clinical data of 10 patients diagnosed with glial choristoma in Shanghai Children’s Hospital, Shanghai Jiaotong University and Children’s Hospital of Fudan University from August 2015 to May 2020 were collected, their clinical and imaging characteristics were analyzed, and the histopathological morphology was observed. Results Among the 10 patients, 6 were male and 4 were female, the age ranged from 16 days to 3 years with average 11.6 months, and the average course of disease was 10.6 months. The main manifestations were painless solid mass with slow growth, which was located in pharynx in 4 cases, soft palate in 1 case, dorsal tongue in 1 case, nasal dorsum in 1 case, nasal cavity in 1 case, subcutaneous in the face in 1 case, and posterior external side of sternocleidomastoid in right neck in 1 case. CT examination showed round soft tissue shadows on the right cheek, nasal dorsum and tongue dorsum, posterolateral mass shadow of sternocleidomastoid muscle on the right, and vascular-rich space occupying lesions on the soft palate, nasal cavity and nasopharynx. Bone in the skull base was continuous without defect. Pathological examination showed that all the 10 cases were single mass, the tumor size ranged from 1.0 cm×1.0 cm×1.0 cm to 3.3 cm×2.9 cm×1.8 cm, with clear boundaries, no capsule, gry-pink, solid and tough sections. Microscopically, the lesions were mainly composed of a large amount of glia mixed with normal tissues.Immunohistochemistry showed that GFAP and S100 were positive in all the 10 cases, and NeuN1 was positive in 4 cases.All the 10 patients underwent surgical resection of the tumor, and the patients were followed up for 2-60 months postoperatively, without recurrence or metastasis. Conclusion Glial choristoma often occurs in the head and neck of infants. It is not easy to relapse after complete surgical resection.

关 键 词：神经胶质迷芽瘤 临床病理特征 鉴别诊断 

分 类 号：R739.4[医药卫生—肿瘤]