视神经原发性肿瘤临床病理分析(附17例)  

Clinical and pathological analysis of primary optic nerve tumor(17 cases)

作　　者：杨亚丽 张琦[1] 赵霓姗 杨严丽 周虹[1,2] 岳梨蓉 YANG Yali;ZHANG Qi;ZHAO Nishan;YANG Yanli;ZHOU Hong;YUE Lirong(Department of Pathology,Affiliated Hospital of Yunnan University(The Second People's Hospital of Yunnan Province,Yunnan Eye Hospital),Yunnan Kunming 650021,China;Department of Teaching Affairs,Affiliated Hospital of Yunnan University(The Second People's Hospital of Yunnan Province,Yunnan Eye Hospital),Yunnan Kunming 650021,China;Department of Radiography,Affiliated Hospital of Yunnan University(The Second People's Hospital of Yunnan Province,Yunnan Eye Hospital),Yunnan Kunming 650021,China)

机构地区：[1]云南大学附属医院(云南省第二人民医院,云南省眼科医院)病理科,云南昆明650021 [2]云南大学附属医院(云南省第二人民医院,云南省眼科医院)教学管理科,云南昆明650021 [3]云南大学附属医院(云南省第二人民医院,云南省眼科医院)放射影像科,云南昆明650021

出　　处：《现代肿瘤医学》2024年第2期261-266,共6页Journal of Modern Oncology

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项(编号:202001AY070001-086);云南省心血管超声创新团队(编号:202305AS350021)。

摘　　要：目的:分析视神经原发性肿瘤的临床和病理组织学特点,病理诊断和鉴别诊断。方法:收集我院病理科2005年-2022年期间原发性视神经肿瘤患者的病例资料,回顾性分析其临床特征、病理组织学特征、免疫组化特点,并复习国内外相关文献。结果:视神经原发性肿瘤17例中视神经胶质瘤4例、视神经脑膜瘤13例,二者都好发于女性、患者均单眼发病,平均发病年龄视神经胶质瘤为18岁、视神经脑膜瘤为42.4岁,症状都主要表现为眼球突出伴视力下降,视神经胶质瘤对视力危害尤显著。组织学上,视神经胶质瘤(Verhoeff分型)分为粗网型、细网型和粗纤维型,各有其特点;视神经脑膜瘤组织形态与颅内原发脑膜瘤相似,但可见肿瘤包绕压迫视神经。结论:视神经原发性肿瘤少见,最常见的病理组织类型是视神经脑膜瘤和视神经胶质瘤。Verhoeff分型能较好反应视神经胶质瘤独特的组织学特点;视神经脑膜瘤和颅内原发的脑膜瘤的组织学特点相似,但具有肿瘤包绕压迫视神经的特点;诊断时需结合临床、影像和免疫组化与一些组织形态类似的病变进行鉴别。Objective:To describe the clinical and histopathological features,pathological diagnosis anddiferential diagnosis of primary optic nerve tumor.Methods:The cases of primary optic nerve tumor in our hospital between the year 2005 to 2022 were collected to analyze the clinical,histopathological and immunohistochemical characteristics retrospectively,and a literature review were carried out in this report.Results:17 cases of primary optic nerve tumor were classified.It is found that 4 cases were optic nerve glioma(ONG)and 13 cases were optic nerve meningioma(OPM).Both ONG and OPM attacked female dominantly.All cases were unilateral and not a single bilateral case was appeared.The median patient age at diagnosis was 18 years in ONG while 42.4 years in OPM.Proptosis and vision loss were most common presentation for ONG and OPM.However,visual effects were particularly prominent in ONG.Histologically,ONG were classified into coarsely reticulated,coarsely fibrillated,and finely reticulated pattern according to their characteristics respectively by Verhoeff.The histological characteristics of OPM were similar to those of intracranial primary meningiomas,except that optic nerve were surrounded and compressed by tumors in the former.Conclusion:Among these primary optic nerve tumors,OPM is the most common histopathological type,ONG accounted for less common subtype,other tumors type of optic nerve were seldom seen.Histological features of OGN were summarized finely by Verhoeff,while meningiomas of optic nerve were similar as that of intracranial and intraspinal histologically except they surround and compress the optic nerve.Pathological diagnosis should be combined with clinical evidence,imaging examination and immunohistochemistry to identified with mimic lesions.

关 键 词：视神经肿瘤 组织学特点 视神经胶质瘤 Verhoeff分型 视神经脑膜瘤 

分 类 号：R739.4[医药卫生—肿瘤]