眼眶脑膜瘤27例临床病理特征分析  

Analysis of clinicopathological features of orbital meningioma in 27 cases

作　　者：王佳 蔡凤梅 赵荧 张鸽 钱薇 李元朋 郅玲然 王卉芳 WANG Jia;CAI Fengmei;ZHAO Ying;ZHANG Ge;QIAN Wei;LI Yuanpeng;ZHI Lingran;WANG Huifang(Department of Pathology,Xi’an People’s HospitalXi’an Fourth Hospital,Shaanxi Province,Xi’an710000,China)

机构地区：[1]西安市人民医院西安市第四医院病理科,陕西西安710000

出　　处：《中国医药导报》2023年第34期105-110,共6页China Medical Herald

基　　金：陕西省重点研发计划项目(2022SF-504)。

摘　　要：目的探讨眼眶脑膜瘤的临床病理学特征。方法收集2015年10月至2021年6月西安市人民医院收治的27例眼眶脑膜瘤患者,回顾性分析其临床病理学特征,并复习相关文献。结果27例眼眶脑膜瘤患者中位年龄50岁,发病部位右眼眶11例,左眼眶16例。临床症状大多以眼痛眼胀、视物不清及眼球突出或眼部包块为主。脑膜上皮细胞型17例、纤维型1例、过渡型5例、非典型性3例、透明细胞型1例。27例患者术后随访1~68个月,平均18.5个月,其中4例复发,其余恢复良好。免疫组织化学结果显示所有患者生长抑素受体2、孕激素受体、波形蛋白、上皮膜抗原均阳性,极低分子量角蛋白CAM5.2、神经胶质纤维酸性蛋白全部阴性;淋巴管内皮标志物D2-40阳性25例;S-100钙结合蛋白灶状阳性2例;24例Ki-67增值指数为1%~2%,3例为3%~8%。结论眼眶原发脑膜瘤组织形态主要以脑膜上皮细胞型为主,肿瘤相关抗体生长抑素受体2、孕激素受体、波形蛋白、上皮膜抗原、淋巴管内皮标志物D2-40的标记有助于协助诊断。Objective To investigate the clinicopathologic features of orbital meningioma.Methods A total of 27 patients with orbital meningioma admitted to Xi’an People’s Hospital from October 2015 to June 2021 were collected,the clinicopathological features of the patients were analyzed retrospectively,and relevant literatures were reviewed.Results The median age of 27 patients with orbital meningioma was 50 years old,with 11 cases occurring in the right orbit and 16 cases in the left orbit.Most clinical symptoms were mainly eye pain,bloating,unclear vision,and protruding eyeballs or eye masses.There were 17 cases of meningeal epithelial cell type,one case of fibrous type,five cases of transitional type,three cases of atypical,and one case of clear cell type.A total of 27 patients were followed up for 1-68 months after surgery,with an average of 18.5 months.Among them,four cases recurred and the rest recovered well.Immunohistochemical results showed that somatostatin receptor-2,progesterone receptor,vimentin,and epithelial membrane antigen were positive in all patients,extremely low molecular weight keratin CAM5.2 and glial fibrillary acidic protein were negative in all patients.There were 25 cases of D2-40 positive,two cases of S-100 focal positive.Ki-67 appreciation index was about 1%-2%in 24 cases and 3%-8%in three cases.Conclusion The histological morphology of primary orbital meningioma is mainly meningeal epithelial cell type.The markers of tumor-related antibodies somatostatin receptor-2,progesterone receptor,Vimentin,epithelial membrane antigen,and D2-40 are helpful for diagnosis.

关 键 词：眼眶肿瘤 脑膜瘤 病理 诊断 

分 类 号：R737.9[医药卫生—肿瘤]