电镜在中枢神经系统小圆细胞肿瘤诊断中的作用

Role of electron microscopy in the diagnosis of small round cell neoplasms in central nervous system

本文报道９８例中枢神经系统小圆细胞肿瘤电镜诊断资料。常规透射电镜确诊７９例（８０．６％），加免疫组化后确诊１５例（１５．３％），但仍有４例（４．１％）不能确诊。确诊后的肿瘤类型包括胶母细胞瘤、少突胶质细胞瘤、室管膜瘤、髓母细胞瘤、神经母细胞瘤、松果体细胞瘤、原始神经外胚层瘤、恶性淋巴瘤、转移性未分化鳞癌和未分化腺癌、以及黑色素瘤。对上述肿瘤的主要超微结构特征进行了描述，并结合文献阐明了电镜检查对中枢神经系统小圆细胞肿瘤诊断和鉴别诊断有七个方面的作用。

The accurate diagnosis of small round cell neoplasms in central nervous system(CNS) is mostly dependant on a careful ultrastructural examination. This study desc ribes the ultrastructural changes of 98 cases of small round cell tumor in CNS.In this series,79 cases(80 6%) are confirmed by routine transmission electron microscopy,another 15 cases(15 3%) are finally diagnosed with the help of immuno electron microscopy and immuno histochemistry,however,the final diagnoses of the other 4 cases(4 1%) are not obtained.The types of these confirmed tumors include glioblastoma,oligodendroglioma,ependymoma,medulloblastoma,neuroblastoma,pineocytoma,primitive neuroectodermal tumor,malignant lymphoma,metastatic undifferentiated adenocarcinoma and undifferentiated squamous carcinoma,as well as melanoma.The main ultrastructural characteristics of the above neoplasms are carefully described.Combining with lite rature,7 aspects of electron microscopy examination in the diagnosis and differential diagnosis of small round cell neoplasms in CNS are detailed clarified.