中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (12): 915-921.doi: 10.19401/j.cnki.1007-3639.2018.12.006

• 论著 • 上一篇    下一篇

微囊型脑膜瘤2例临床病理学特征分析并文献复习

冯润林,王 燕   

  1. 昆明医科大学第二附属医院病理科,云南 昆明 650101
  • 出版日期:2018-12-30 发布日期:2019-01-11
  • 通信作者: 王 燕 E-mail: 18988406369@163.com

Microcystic meningioma: a clinicopathologic analysis of two cases and literature review

FENG Runlin, WANG Yan   

  1. Department of Pathology, Second Affiliated Hospital of Kunming Medical University, Kunming 650101, Yunnan Province, China
  • Published:2018-12-30 Online:2019-01-11
  • Contact: WANG Yan E-mail: 18988406369@163.com

摘要: 背景与目的:微囊型脑膜瘤是脑膜瘤的罕见亚型,国内外报道较为少见,且多以个案报道为主。本研究旨在探讨微囊型脑膜瘤的临床病理学特点及鉴别要点。方法:回顾分析2例微囊型脑膜瘤的临床表现、组织学形态及免疫组织化学表型,并复习相关文献。结果:2例均为中年患者,男性和女性各1例,男性患者因外伤引起脑出血就诊;女性患者因头痛就诊,病变分别位于左侧额部和右侧额部,最大径分别为5.75和5.47 cm。影像学改变均示“脑外肿瘤”。镜下瘤细胞排列疏松,形成大小不等的微囊,腔内含粉染之浆液,肿瘤细胞具有空泡状细胞质和细长的细胞质突起,典型的漩涡状结构和砂粒体少见。免疫组织化学示,波形蛋白(vimentin)、上皮膜抗原(epithelial membrane antigen,EMA)和孕激素受体(progesterone receptor,PR)均呈阳性表达,S-100、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、CD34和肌酸激酶(creatine kinase,CK)均呈阴性表达,Ki-67阳性率达3%~5%。2例患者均行手术治疗,术后均随访观察,随访时间为5~6个月,截至2018年1月,2例患者一般情况良好,均未见肿瘤复发。结论:微囊型脑膜瘤为脑膜瘤的特殊亚型,依据病理组织学形态及免疫组织化学可明确诊断。目前治疗主要以手术治疗为主,预后良好。

关键词: 脑肿瘤, 微囊型脑膜瘤, 免疫组织化学, 病理诊断

Abstract: Background and purpose: Microcystic meningioma is a rare subtype of meningiomas, which is rare in domestic and foreign reports, and is mostly reported in cases. This study aimed to explore the clinicopathological features and identification of microcystic meningioma. Methods: We retrospectively analyzed two cases of microcystic meningioma including their clinical manifestations, histological features and immunohistochemical phenotypes, and reviewed the relevant literature. Results: Two cases were middle-aged patients, one male and one female. The male patient was diagnosed as having traumatic brain hemorrhage whereas the female patient was treated for headache. The lesions were located in the left frontal and right frontal areas, the maximum diameters were 5.75 and 5.47 cm respectively. Imaging changes showed “brain tumor”. Microscopically, tumor cells were loosely arranged to form microcapsules of different sizes with the cavity containing powdered slurry, and the tumor cells had vacuolar cytoplasm and slender cytoplasmic processes without typical swirling structures and psammoma body. Immunohistochemistry showed vimentin, epithelial membrane antigen (EMA) and progesterone receptor (PR) were positive, S-100, glial fibrillary acidic protein (GFAP), CD34 and creatine kinase (CK) were all negative, and positive rate of Ki-67 was 3%-5%. Both patients underwent surgical treatment and were followed up for 5-6 months. Before submission of this article in January 2018, both patients were generally in good condition, and no tumor recurrence was observed. Conclusion: Microcystic meningioma is a special subtype of meningiomas, and histopathology and immunohistochemistry can confirm the diagnosis. The current treatment is mainly surgery, and the prognosis is good.

Key words: Brain tumor, Microcystic meningioma, Immunohistochemistry, Pathological diagnosis