颅内生殖细胞肿瘤─—附38例临床、光镜、电镜和免疫组化分析

Intracranial germ cell tumors:Clinical,Pathological and Immunohistochemical Aspects of 38 cases

报告３８例原发性颅内生殖细胞肿瘤，好发于松果体区及鞍区，男性多见，平均年龄２０岁，临床主要表现为颅高压，视力受损，尿崩症等。光镜下，２７例为生殖细胞瘤，其中５例伴合体滋养层巨细胞，１２例伴肉芽肿形成；其余为畸胎瘤和混合性生殖细胞肿瘤各５例，单纯内胚窦瘤１例。电镜观察，见生殖细胞瘤之瘤细胞内富含糖原，瘤细胞间之小细胞成分为淋巴细胞。免疫组化标记，合体滋养层巨细胞及绒癌成分为ＨＣＧ阳性，内胚窦瘤为ＡＦＰ和ＣＥＡ阳性，胚胎癌及畸胎瘤之上皮成分为ＣＥＡ阳性，有助于进一步明确此类肿瘤内有无混合成分。

AbstractThirty-eight primary intracranial germ cell tumors are reported.The patients’average age was 20 years,The tumors located mainly at pineal gland region and stiprasllar cistern,and caused increasing of intracranial pressure.The patients presented commonly with headache,nausea and vomiting,Parinatids'sign,visual loss,or diabetes insipidus. Histopathologically,27 cases were gerininomas in which 5 cases were germinoma with HCG-containing syncytiotrophoblastic giant cells,12 cases with granuloma. 5 cases were mixed germ cell tumors and another 5 were teratomas.1 case was pure endedermal sinus tumor.lmmunohistochemical staining showed that syneytiotrophoblastic gaint cells and choriocarcinomas,endodermal sisus tumors,embryonal carcinomas and teratomas were HCG,AFP and CEA positive reaction respectively.Other elements,ineluding gran uloma cells lymphocytes,epithelioid cells and Langhans'cell associated with granuloma,were of negative reaction to all these antibodies.We conclude that signs and symptoms are related、with the site of tumors,that histological classification of primary intracranial germ cell tumors could be quoted from that of the homologous gonadal tumors.AFP,HCG and CEA are useful markers in subdividing germ cell tumors.