中枢神经细胞瘤的临床病理特点和治疗

Clinicopathologic characteristics and treatment of central neurocytoma

目的 中枢神经细胞瘤 (CNC)是一种分化程度较高的良性神经系统肿瘤 ,好发于青壮年 ,本文报道 3例中枢神经细胞瘤 ,结合文献探讨中枢神经细胞瘤的临床病理特点和治疗。方法 回顾性分析 2 0 0 2年 9月～ 2 0 0 4年 2月我科收治的 3例中枢神经细胞瘤 ,结合文献进行探讨。结果 2例位于侧脑室 ,1例位于透明膈 ;组织学特点为 :肿瘤由密集和均匀一致的少突胶质细胞样小圆细胞及成片的无核纤细原纤维岛间质组成。未见异型增生及坏死。免疫组化 2例突触素 (Syn)阳性 ,1例突触素 (Syn)可疑阳性 ,3例胶质纤维酸性蛋白 (GFAP)阴性。 3例均行显微镜下全切或大部分切除 ,术后行放射治疗。随访至今均未复发。结论 中枢神经细胞瘤是好发于脑室内的分化好的神经元性肿瘤 ,病理形态易误诊为少突胶质细胞瘤、室管膜瘤和神经母细胞瘤。免疫组化检查Syn和GFAP在中枢神经细胞瘤的诊断和鉴别诊断中起重要作用。外科手术和术后放疗是常规的治疗手段 ,预后良好。

Objective The central neurocytoma is akind of well differential neoplasm in central nervous system,especially located in the lateral ventricles of young adults. Three cases of the central neurocytoma were reported and the literature about the clinicopathologic characteristics and treatment of this disease were reviewed.Methods Three cases of central neurocytoma were treated from 2002 to 2004 in our department and retrospective analysis was carried.Results Histologically,the tumor in three cases had the benign histological appearance,the oligodendroglioma-like pattern with honeycomb appearance and the characteristic cell free islands.Immunohistochemically,two cases expressed Syn positive ,three cases expressed GFAP negative. In all three cases ,tumors were totally removed and radiotherapy was applied post operation.No recurrence was found for three cases as far.Conclusions The central neurocytoma is a kind of benign nervous system neoplasm located in the lateral ventricle. Its differential diagnosis excludes oligodendroglioma,ependymoma and neuroblastoma.Positive Syn and GFAP staining results can be used as the specific markers for the diagnosis of central neurocytoma . Therapy for patients with central neurocytoma includes the total resection by microsurgery and radiotherapy post operation .Patients with central neurocytoma commonly have good prognosis.