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目的:探讨脊索瘤样脑膜瘤(chordoid meningiomas,CM)的临床与病理特点。方法:应用组织病理学、组织化学以及免疫组织化学方法对1例CM进行观察,同时复习相关文献进行讨论。结果:CM病理特点为黏液样基质中有呈分叶状或条索状排列的肿瘤细胞,细胞质呈淡染或嗜酸性染色,部分细胞呈液滴状,分布于黏液样基质中,类似脊索瘤样细胞;肿瘤细胞中亦可见典型脑膜上皮细胞区域。组织化学染色阿尔辛蓝-过碘酸-Schiff反应(alcian blue and peridic acid-schiff’sreacyion,AB/PAS)呈阳性反应。免疫组织化学染色显示:肿瘤细胞波形蛋白(vimentin)、上皮膜抗原(epithelial membrane antigen,EMA)表达阳性,孕激素受体(progesterone receptor,PR)灶状阳性,广谱细胞角蛋白(pan cytokeratin,CKpan)、S-100钙结合蛋白(S-100 calcium binding protein,S-100)表达阴性。结论:CM是发生于颅内的较少见的脑膜瘤亚型,需要与脊索瘤、黏液性软骨肉瘤及转移性黏液腺癌等鉴别。
Objective: To investigate the clinical and pathological features of chordoid meningioma (CM). Methods: One case of CM was observed by histopathology, histochemistry and immunohistochemistry, and the related literatures were reviewed. Results: The pathological features of CM were tumor cells with lobular or cord-like arrangement in myxoid-like matrix. The cytoplasm showed light or eosinophilic staining. Some of the cells were in the form of droplets distributed in the mucoid matrix, similar to chordoma Like cells; tumor cells can also be seen in the typical area of the meningeal epithelial cells. Histochemical staining showed that alcian blue and peridic acid-schiff ’s reacyion (AB / PAS) were positive. Immunohistochemical staining showed that the expression of vimentin, epithelial membrane antigen (EMA), positive staining of progesterone receptor (PR), pan cytokeratin CKpan), S-100 calcium binding protein (S-100) expression was negative. Conclusion: CM is a rare subtype of meningioma occurred in the brain and needs to be differentiated from chordoma, mucinous chondrosarcoma and metastatic mucinous adenocarcinoma.