室管膜下瘤临床病理分析  

Clinicopathological features of subependymoma

作　　者：李金燕 陈小明 张宇 LI Jin-yan;CHEN Xiao-ming;ZHANG Yu(Department of Pathology,Xinqiao Hospital,Chongqing 400037,China;Department of Pathology,Chenjiaoqiao Hospital,Chongqing 401331,China;Department of General Surgery,Chenjiaoqiao Hospital,Chongqing 401331,China)

机构地区：[1]陆军军医大学第二附属医院病理科,重庆400037 [2]重庆市沙坪坝区陈家桥医院 [3]重庆市沙坪坝区陈家桥医院病理科,重庆401331 [4]重庆市沙坪坝区陈家桥医院普外科,重庆401331

出　　处：《诊断病理学杂志》2023年第1期21-23,29,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨室管膜下瘤(subependymoma,SE)的临床特点、病理诊断及鉴别诊断、治疗与预后。方法回顾性分析6例SE的临床资料、组织学形态和免疫组化标记,并复习相关文献。结果肿瘤由成簇细胞增生组成,嵌入胶质细胞突起的致密纤维基质中,可见稀疏区、密集区,有大的无细胞区,偶见轻微的假菊形团结构及小灶出血,均见微囊形成。肿瘤边界清楚,瘤细胞多呈裸核,大小一致,圆形或卵圆形,细胞温和、异型性不明显,未见核仁,无明显核分裂象及坏死。例4、例5微囊结构显著。例3、5局部见玻璃样变性的血管及钙化。免疫组化示6例SE肿瘤细胞中GFAP、S-100呈弥漫阳性,Olig-2、CD34、P53、IDH1、NeuN阴性,2例ATRX阳性,Ki-67增殖指数约1%。结论SE少见,其临床特征及影像学检查无明显特异性,确诊主要依靠病理学检查,该肿瘤虽属WHO1级,但可复发,应对其进行长期密切随访。Objective To study the clinical features,pathological diagnosis,differential diagnosis,treatment and prognosis of subependymoma(SE).Methods The clinicopathological and immunohistochemical features were reevaluated in 6 cases of SE,with review the relevant literature.Results The tumor consisted of clusters of cell proliferation embedded in the dense fibrous matrix of glial processes.Sparse and dense areas,large acellular areas,slight pseudochrysanthemum structure and small focal bleeding were seen,and microcapsule was observed in all cases.The tumor boundary was clear.Most tumor cells were naked,round or oval,mild form,no obvious atypia.There were no nucleolus,no obvious mitotic figure and necrosis.The microcapsule structure was significant in cases 4 and 5.Vitreous degeneration and calcification were locally noted in cases 3 and 5.Immunohistochemistry showed that GFAP and S-100 were diffusely positive,but Olig-2,CD34,p53,IDHl and NeuN were negative,ATRX was positive in 2 cases,and Ki-67 index was about 1%.Conclusion SE is rare.Its clinical features and imaging examination have no obvious specificity.The diagnosis mainly depends on pathological examination.Although the tumor belongs to WHO grade I,it can relapse.It should be closely followed up for a long time.

关 键 词：室管膜下瘤 临床病理 鉴别诊断 

分 类 号：R739.41[医药卫生—肿瘤]