脑膜血管瘤病2例临床病理观察

Clinicopathologic features of meningioangiomatosis:two cases report

目的探讨脑膜血管瘤病的临床病理学特征。方法复习2例脑膜血管瘤病的临床资料,对影像学和病理学形态进行观察,并结合相关文献加以分析。结果 2例均以癫为主要症状;病变位于增生的软脑膜下并侵入大脑皮质,小血管及周围梭形细胞增生明显,伴有大量砂砾体形成。免疫组化标记无特异性,vimentin通常(+)。影像学检查示有不同程度钙化,无其他特殊表现。病灶切除后癫控制良好。结论脑膜血管瘤病是一种罕见的颅内良性病变,临床病理表现多样,造成诊断困难。正确的诊断需结合影像学资料及详细的组织学检查,方可避免过度治疗。

Objective To explore the clinicopathological and radiological features of meningioangiomatosis. Methods The clinical data, radiology, and histomorphology were analyzed with review of the related literature. Results The lesion clinically presented with serzures, involving the leptomeninges and cortex, characterized by proliferation of microvessels with cuffs of spindle-cell proliferation and calcifications with psammomma bodies. Immunostaining results were variable among cases, only consistently positive for vimentin. The imaging studies demonstrated the extent of calcification of these lesions, but diverse features. Symptoms disappeared with the complete excision of the lesion. Conclusions Meningioangiomatosis is a rare, benign neoplastic disorder. Preoperative diagnosis is difficult because of its diverse clinical, pathological, and imaging features. It is important to distinguish meningioangiomatosis from other possible cortical lesions in order to avoid further aggressive treatment.