高级别星形母细胞瘤1例临床病理学分析

Clinicopathologic features of high grade astroblastoma:a case report and the review of the literatures

目的探讨高级别星形母细胞瘤临床病理特点及病理鉴别诊断、免疫组织化学表型。方法报道1例高级别星形母细胞瘤,对其进行临床病理学分析及文献复习。结果1例高级别星形母细胞瘤呈结节状和囊性生长,包膜完整,边界清楚。组织学特征显示高级别星形母细胞瘤瘤细胞胞体呈放射状围绕在血管周围构成假菊形团结构,瘤细胞密度增高,血管壁周围的细胞增生成多层,异型性显著,核分裂象易见,无血管壁的玻璃样变性。结论星形母细胞瘤为罕见的、来源未明的胶质瘤。组织学类型可分为低级别和高级别星形母细胞瘤,需与其他神经上皮肿瘤鉴别。低级别星形母细胞瘤预后要好于高级别星形母细胞瘤,而且低级别星形母细胞瘤手术完全切除后存活期较长。然而,高级别星形母细胞瘤术后需要进行辅助治疗(放疗和/或化疗)和密切随访。

Purpose To explore the clinicopathological characteristics, differential diagnosis, and its immunohistochemical expression of high grade astroblastoma. Methods One case of high grade astroblastoma was reported, with review of relevant literature. Results One case of high grade astroblastoma is a well-cireumscribed, nodular and cystic change. Histological features were characterized by a typical perivascular pseudorosettes pattern of tumor cells with broad, non-tapering processes radiating towards a central blood vessel and cellularity with multiple cell layers piled upon the vascular walls, cellular atypia, high mitotic rate without significant hyalinization of the vascular walls. Conclusions Astroblastoma is one of the very unusual type of tumors, whose histogenesis has not been clarified. Astroblastomas are classified into low grade and high grade according to histological features and supposed to be distinguished from other neuroepithelial neoplasms. The so-called low-grade astroblastomas are thought to have better prognosis than those with high- grade histological features. In addition, low-grade astroblastomas have long-term survival for gross total removal. Adjuvant therapy （radiotherapy and/or chemotherapy） can be considered in high-grade astroblastomas, with a close follow-up for all cases.