海绵窦毛细血管瘤临床病理观察  

Capillary hemangioma of the cavernous sinus:a clinicopathological analysis

作　　者：刘路录 宁浩勇 刘有[1] 张美慧 洪超 杨润 邱晓媚 LIU Lu-lu;NING Hao-yong;LIU You;ZHANG Mei-hui;HONG Chao;YANG Run;QIU Xiao-mei(Department of Pathology,Hainan Hospital of the PLA General Hospital,Sanya572013,China)

机构地区：[1]解放军总医院海南医院病理科,海南三亚572013

出　　处：《诊断病理学杂志》2023年第7期635-637,642,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨颅内海绵窦毛细血管瘤的临床病理学特征,提高对其诊断、鉴别诊断及治疗与预后的认识。方法观察1例颅内海绵窦毛细血管瘤的组织学形态及免疫组化,复习相关文献,综合分析其临床病理学特征及治疗与预后。结果本病例首发症状为左眼眼睑下垂及视物重影。MRI提示左侧海绵窦占位1年内由最大径0.8 cm增大至约2.2 cm。术中冰冻切片示肿瘤细胞呈梭形,灶片状分布于硬脑膜下,血管裂隙不明显,异型性小。常规病理见肿瘤由大量分叶状毛细血管构成,常可见引流静脉,内皮细胞核分裂象罕见。免疫组化:内皮细胞表达CD34、CD31、ERG,间质细胞表达SMA和CD68,Ki-67阳性指数约8%。结论颅内海绵窦毛细血管瘤是一种非常罕见的良性肿瘤,术中冰冻时因血管腔挤压不易识别,易误诊为神经鞘瘤、脑膜瘤或孤立性纤维性肿瘤,常规病理结合免疫组化有助于诊断及鉴别诊断。Objective To study the clinical pathology of intracranial cavernous sinus capillary hemangioma and to improve the understanding of its diagnosis,differential diagnosis,treatment and prognosis.Methods The clinical manifestations,histological features and immunohistochemistry were analyzed in one case of intracranial cavernous sinus capillary hemangioma with review of the relevant literatures.Results The first symptoms of this case were eyelid ptosis and double vision in the left eye.MRI indicated that the mass of the left cavernous sinus was increased from the maximum diameter of 0.8 cm to about 2.2 cm within 1 year.The intraoperative frozen sections showed a spindle pattern of tumor cells with foci distributed under the dura mater,with insignificant vascular fissure and less atypia.In conventional pathology,the tumor was composed of a large number of lobulated capillaries,draining veins were often seen,and mitosis was rare in the vascular endothelial cells.Immunohistochemistry showed that endothelial cells expressed CD34,CD31,and ERG,and stromal cells expressed SMA and CD68,with a Ki-67 positive index of 8%.Conclusion Intracranial cavernous sinus capillary hemangioma is a very rare benign tumor.It is difficult to identify due to vascular cavity extrusion during intraoperative freezing,and it is easily misdiagnosed as schwannoma,meningioma or solitary fibrous tumour.Routine pathology combined with immunohistochemistry is helpful for the diagnosis and differential diagnosis.

关 键 词：毛细血管瘤 颅内 海绵窦 中枢神经系统 诊断 

分 类 号：R739.4[医药卫生—肿瘤]