非典型脑室外神经细胞瘤临床病理观察

Atypical extraventricular neurocytoma: a clinicopathologic observation

关键词:  神经细胞瘤  脑室外  脑肿瘤

Key words:  neurocytoma  extraventricular  brain tumor

摘要:

［目的］探讨非典型脑室外神经细胞瘤临床病理特征，以提高对该肿瘤的认识。［方法］对1例非典型脑室外神经细胞瘤进行形态学和免疫组化观察，并结合临床资料复习相关文献。［结果］镜下可见肿瘤由一致的小至中等大小的圆或类圆形细胞构成，细胞质量中等空亮淡染，部分细胞胞质粉染，核圆或卵圆、居中。部分区域细胞密集并出现一定异型性，核分裂5个/10HPF，并可见病理性核分裂。可见单细胞坏死及神经节样细胞。血管增生明显。免疫组化：瘤细胞Syn、S-100及NSE弥漫（+），p53和GFAP灶状（+），ki-67>30%，CD3、CK、CD20、LCA、actin、desmin、HMB45、melan-A、Cg-A、EMA、nestin、NF及Vimentin均（-）。［结论］非典型脑室外神经细胞瘤非常罕见，诊断关键在于形态学特点结合免疫组化结果。

Abstract:

［Objective］To investigate the clinicopathological characteristics of atypical extraventricular neurocytoma and to make the acquaintance of it.［Methods］One case of atypical extraventricular neurocytoma was observed with the morphorlogical method, clinical data analysis and review of the related literature. ［Results］Morphologically, the tumor was composed of uniform small-to-medium-sized cells with clear and partly eosinophilic medium cytoplasm and oval to round and central located nuclei. There were mild-to-moderate nuclear pleomorphism and focal anaplasia with increased mitotic activity, up to 5 per 10 HPF, as well as the pathologic mitosis. Single-cell necrosis and ganglionic differention were also noticed. Vascular hyperplasia was present. Immunohistochemically, the tumor cells were positive for syn,S-100 and NSE, focally positive for GFAP and p53, while negtive for CD3,CK,CD20,LCA,actin,desmin,HMB45,melan-A,Cg-A,EMA,nestin,NF and Vimentin. The MIB-1 proliferative index was over 30%. ［Conclusioin］Atypical extraventricular neurocytoma is extremely rare. The definite diagnosis depends on the histopathological features and immunohistochemical findings.