非典型性脑膜瘤临床病理学、超微结构和免疫组化观察

Atypical meningioma:clinicopathological,ultrastructural and immunohistochemical studies of 95 cases

目的探讨非典型性脑膜瘤(atypical meningioma,AM)临床病理特征及其与典型性脑膜瘤及间变性脑膜瘤的鉴别诊断。方法采用光镜、电镜和免疫组化SP法对95例AM进行临床病理分析。结果 AM的光镜、电镜及免疫表型特征与典型性脑膜瘤及间变性脑膜瘤不同。结论 AM临床症状不典型,主要靠病理检查明确诊断。有些病例的病理诊断与典型性脑膜瘤和间变型脑膜瘤及某些转移瘤易混淆,电镜超微结构及免疫表型有助于鉴别诊断。对该类脑膜瘤进行病理诊断时需谨慎,避免误诊,使患者在临床上得到正确治疗和准确的预后评价。

Purpose To investigate the clinicopathological features of atypical meningioma and differential diagnosis of typical meningi- oma from anaplastic meningioma. Methods Pathological features of 95 cases of atypical meningioma were analyzed by light microsco- py, electron microscopy and immunohistochemical staining. Results There were significantly different features under light micro- scope, electron microscope and by immunohistochemical staining between atypical meningioma, classic mcningioma and anaplastic meningioma. Conclusion The clinical symptoms of atypical meningioma are not typical, and identifying the type of meningioma is mainly depended on pathological examination. Differential diagnosis between typical meningioma and anaplastic meningioma is difficult and easily confused with metastatic carcinoma in some cases, and electron microscopy and immunohistochemistry are helpful in the as- pect. Pathological diagnosis of the meningioma should be careful, so that patients can get proper treatment and accurate evaluation of prognosis.