脊索样脑膜瘤临床病理分析

A clinicopathological analysis of chordoid meningioma

目的：研究脊索样脑膜瘤的临床与病理特征，以提高其早期诊断率。方法：运用组织病理学及免疫组化标记（Ｓ－Ｐ法）对３例脊索样脑膜瘤进行临床病理学和组化（ＰＡＳ）、免疫组化（ＥＭＡ、Ｖｉｍ、Ｓ－１００、ＣＫ）及电镜观察。结果：组织学瘤细胞胞浆内外均见粘液，在粘液基质背景中有成簇或成行的类液滴样细胞，瘤组织中有典型的脑膜上皮漩涡结构，组化及免疫组化示ＰＡＳ（＋）、ＥＭＡ（＋）、Ｖｉｍ（＋）、Ｓ－１００（＋）、ＣＫ（－）；电镜下提示上皮结构并有分泌活性。结论：脊素样脑膜瘤是罕见类型的脑膜瘤，需根据临床病理学。

Purpose To investigate 3 cases of chordoid meningioma and analyze their manifestations and pathological features and improve the clinicopathological diagnosis of chordoid meningioma. Methods Histopathology and electron microscope observation were used to study the morphological characteristics of chordoid meningioma. The immunohistochemical determination of PSA, EMA, Vim and S 100 in the rotine paraffin samples of 3 cases with chordoid meningioma was carried out using S P method. Results Histologically, The tumor was characterized with large amounts of myxoid substance in the entra intracytoplasm and a tendency to form chains of eosinophilic, occasionally vacuolated 'physaliferous' cells in myxoid stroma. Such tumors usually showed focal meningothelial or transition features. Histochemically and immunohistochemically, the tumors cells were positive for PAS, EMA, Vimentin, S 100 protein and were negative for CK. The electron microscopic examination showed there were epithelial structure features and secretivity. Conclusion Chordoid meningioma is a rare pattern of meningioma. The diagnosis of chordoid meningiomais established by cliniopathological, immunohistochemical and ultrastructural studies.