凸面脑膜瘤脑膜尾征的临床意义探讨

Clinical significance of dural tail sign in convexity meningioma

目的探讨凸面脑膜瘤脑膜尾征的临床意义。方法对43例具有脑膜尾征的凸面脑膜瘤的基底缘及周围至少2.0cm硬脑膜,分段行光镜和电镜病理学检查。结果41例(95.3%)肿瘤周围硬脑膜可见血管扩张或增生,40例(93.0%)肿瘤周围硬脑膜有纤维结缔组织增生;16例(37.2%)硬脑膜被肿瘤细胞侵袭,其中8例硬脑膜在肿瘤基底缘即0位置可见到肿瘤细胞侵袭,6例在0.1～0.5cm范围,2例在0.6～1.0cm范围仍见到肿瘤细胞侵袭,而瘤周硬脑膜﹥1.0cm范围未见肿瘤侵袭。结论脑膜尾征对应硬脑膜的组织构成有三种:肿瘤细胞浸润,纤维结缔组织增生,及丰富的血管和血管扩张。肿瘤细胞侵袭脑膜尾征对应硬脑膜主要集中于0～0.5cm范围,少部分集中在0.6～1cm范围,无﹥1.0cm者。

Objective To investigate the clinical significance of dural tail sign in convexity meningioma. Methods Forty-three cases of convexity meningiomas with dural tail sign were enrolled in this study. The basal border and the dural mater at least 2.0 cm around of the meningiomas were resected and sectioned for light microscopy and electron microscopy. Result In the tumor periphery, vascular dilatation or proliferation was found on the dura mater in 41 case （95.3%）, connective tissue proliferation in 40 （93.0%）, and tumor invasion in 16 （37.2%）. Tumor cell invasion was found at the basal border of the tumor （0 point） in 8 cases, in the area 0-0.5 cm in 6, and 0.6-1cm in 2. However, no tumor cell invasion was found at the area beyond 1.0 cm around the tumor. Conclusion Tumor cell invasion, vascular dilatation or proliferation, and connective tissue proliferation can lead to dural tail sign. Tumor cell invasion to the dura mater corresponding to dural tail sign occurs mainly in the 0.1-0.5 cm areas, partially in the regions of 0.6-1.0 cm, could not in the place beyond 1.0 cm.