颅内血管外膜细胞瘤与血管瘤型脑膜瘤的超微病理鉴别

Ultrapathological Differential Diagnosis of Intracranial Hemangiopericytoma and Angiomatous Menigioma

目的对颅内血管外膜细胞瘤及血管瘤型脑膜瘤的超微结构进行鉴别诊断。方法对6例颅内血管外膜细胞瘤和6例血管瘤型脑膜瘤的手术活检标本进行光学显微镜及电子显微镜观察,分析其组织学和超微结构的特点。结果颅内血管外膜细胞瘤的瘤细胞为梭形或多边形并围绕血管呈灶状或非典型的旋涡状分布,在细胞游离的一侧可见不连续的基底膜,细胞膜表面可见少量吞饮小泡及致密斑。血管瘤型脑膜瘤细胞为梭形或不规则形,呈旋涡状分布在血管周围,其细胞突起细长并呈指状相互交织,胞质内可见中间丝,相邻胞膜之间有明显的桥粒连接,肿瘤间质内有大量血管结构。结论血管外膜细胞瘤是与中胚叶相关的恶性肿瘤,而血管瘤型脑膜瘤是来源于蛛网膜上皮细胞的良性肿瘤,两者的组织学来源及超微结构特点有本质的区别。电镜检查可以对血管外膜细胞瘤及血管瘤型脑膜瘤进行鉴别。

Objective To investigate the ultrastructural characteristics of hemangiopericytoma and angiomatous menigioma under the electron microscope. Methods Biopsy specimens of 6 cases with hemangiopericytoma and 6 cases with menigioma were analyzed with light and electron microscope combined with the clinical features. Results Intracranial hemangiopericytoma cells as spindle and polygonal cells are arranged characteristically in a palisade around a capillary. The cells are focally attached to one another and they are separated by basal lamina that is both discrete and diffuse. There were some dense bodies and pinocytotic vesicles around the tumor cell membrane. Angiomatous menigioma cells are distributed in the forms of whirlpool or bundle and have long interdigitating cellular processes,numerous cytoplasmic intermediate filaments and prominent desmosomes. Conclusion These observations confirm that the hamangiopericytoma is a malignant tumor and associated with intermediate mesoderm. While the meningioma may come from arachnoid epithelium which is a benign tumor. Each of the tumors had distinct source of histogenesis and the ultrastructural features have an essential Difference. Electron microscopy may help differential diagnosis between these two diseases.