脑少突胶质细胞瘤颅外转移临床病理观察

Brain oligodendroglioma with extracranial metastasis:a clinicopathological study

目的探讨脑少突胶质细胞瘤颅外转移的临床和病理学特点。方法对1例脑少突胶质细胞瘤颅外转移病例进行临床和病理组织学观察,并复习相关文献。结果原发性肿瘤的肿瘤细胞中等大小,均匀一致,细胞膜清楚,胞质肿胀、透亮,核圆、位于中央,典型的蜂窝状。转移后的肿瘤细胞呈多形性,部分区域瘤细胞呈上皮样,部分区域胞质透明并伴出血、坏死。免疫组化示肿瘤细胞vimentin、GFAP、MAP-2和nestin弥漫强(+),部分S-100和Syn(+),CK(AE1/AE3)、CD34、desmin、myoglobin和HMB45(+)。FISH技术证实肿瘤细胞有较高的1p/19q杂合性缺失率。结论脑少突胶质细胞瘤预后较好,很少发生颅外转移,随诊至今患者仍然存活。

Objective To study the clinical and pathological features of brain oligodendroglioma with extracranial recurrence and metastasis. Methods One case of brain oligodendroglioma with extracranial recurrence and metastasis was retrospectively analyzed. Results The patient was followed up postoperatively and survival for 26 years after the recurrence and cxtracranial metastasis. Before and after the recurrence and metastasis of tumors the histological features were essentially the same, and tumor cells were medium-sized, uniformity, clear cellular membrane, cytoplasmic swelling or translucence. Round nuclei centrally located in the cells, with typical honeycomb-like characteristics. Immunohistochemical staining showed that the tumor cells were diffusely and strongly positive for vimentin, GFAP, MAP-2 and nestin, partially positive for S-100 and syn, but negative for AE1/AE3, CD34, desmin, myoglobin and HMB45. Tumor cells had a higher rate of loss of heterozygosity lp/19q, noted through FISH. Conclusion The brain oligodendroglioma has a better prognosis, and the patient survives long even after the occurrence of extracranial metastasis.