脑膜与软组织血管外皮瘤的比较研究

Comparative study of meningeal and soft tissue hemangiopericytomas

目的：探讨脑膜血管外皮瘤（ＭＨＰ）的组织发生、性质及软组织血管外皮瘤（ＳＴＨＰ）的关系。方法：应用光镜和免疫组化技术对１７例ＭＨＰ与７例ＳＴＨＰ进行比较观察。结果：ＭＨＰ和ＳＴＨＰ光镜下形态特征及免疫组化反应均相同。主要特征为光镜下薄壁血管十分丰富，遍及全瘤，可找到典型鹿角样分支血管；瘤细胞密集分布于血管周围间隙，有不同程度异形及核分裂象。网状纤维极多，围绕血管并包绕单个或小群瘤细胞呈网络状构型。用１０种抗体作免疫组化染色，瘤细胞仅对ｖｉｍｅｎｔｉｎ呈阳性反应。结论：ＭＨＰ与ＳＴＨＰ实际上为同一种肿瘤。该瘤具侵袭性，复发率高，可发生颅内外转移，属潜在恶性或恶性肿瘤。

Purpose To study the origin and characteristics of meningeal hemangiopericytomas and their relationships with soft tissue hemangiopericytomas. Methods Comparative study was performed on 17 meningeal and 7 soft tissue hemangiopericytomas by light microscopy and by immunohistochemical technique. Results Meningeal hemangiopericytomas displayed the same morphological characteristics under light microscopy and the same immunohistochemical reactions as soft tissue hemangiopericytomas. The main characteristics were as follows: Abundant thin walled blood vessels were distributed throughout the tumors. The tumor cells were distributed in the extravascular spaces around the blood vessels and showed different degrees of nuclear atypia and different mitotic phases. Abundant reticular fibers surrounded the blood vessels and extended outwards to enclose single or small groups of neoplastic cells, forming a network. In immunohistochemical stainings, the tumor cells reacted positively only to vimentin. Conclusion Hemangiopericytomas of meninx and soft tissue are the same. They are aggressive and easy to recur. The biological behavior of the tumors ranges from potential malignancy to malignancy.