脑转移性肿瘤临床病理研究

Clinicopathological study of metastatic brain tumors

目的 :分析脑转移性肿瘤的临床病理特点 ,为临床寻找肿瘤原发灶提供线索。 方法 :总结和分析 5 6例脑内转移性肿瘤的临床和病理特点 ,其中 2 0例用 S-P法作免疫组化标记。 结果 :本组脑转移癌大部分来源于肺 ,其次是结肠癌和乳腺癌。临床特点是以病程短、颅内高压为主要症状 ,好发于中年男性 ,CT扫描常示高低密度混合杂影。脑转移性肿瘤光镜所见共性是瘤组织内血管较丰富、壁厚 ,纤维组织增生 ,坏死较明显 ,常有泡沫细胞和炎细胞反应。而不同组织器官来源的脑转移性肿瘤又各有特征 ,免疫组化标记和电镜观察有助于进一步揭示各种特征。 结论 :根据光镜下揭示的共性 ,可提示为脑转移性肿瘤 ;而光镜。

Objectives: To study the clinical and pathologic features of metastatic brain tumors(MBT) in order to find out clues of primary sites. Methods: The clinical and pathological features of 56 cases of MBT were reviewed and summarized over a 14-year period in Jinling Hospital. In selected cases, immunohistochemical stains(S-P method) and electron microscopy were used. Results: The lung was the predominant site of origin of MBT in this series, followed by colon and breast carcinoma. Proliferating fibrovascular tissue, marked necrosis, foamy cell and inflammatory cell reactions were the common pathologic features of MBT under light microscope, while each MBT originating from different sites had its own characteristics, and more features could be revealed by immunohistochemical stains and electron microscopic examination. Conclusions： The common pathologic features under light microscope suggest a diagnosis of MBT, while their own characteristics revealed by light microscope, immunohistochemical stains and electron microscope supply clues of the origination of the unknown MBT.