胚胎发育不良性神经上皮瘤的临床病理分析

Clinicopathologic Analysis of Dysembryoplastic Neuroepithelial Tumor

目的探讨胚胎发育不良性神经上皮瘤的临床病理特点、影像学特征、诊断及鉴别诊断。方法采用苏木精-伊红(HE)染色法,免疫组化方法,结合影像学特征对13例胚胎发育不良性神经上皮瘤进行观察分析。结果 13例患者均以癫痫发作为主要临床表现,影像学检查显示病灶均呈T1WI低信号,T2WI高信号。肿瘤组织黏液变明显,多见囊腔形成,肿瘤细胞主要由少突胶质样细胞、神经元和星形细胞组成,可见单个神经元漂浮在微囊的黏液样基质中。免疫组化检测显示S-100(+),Syn(+),GFAP(+),Ki-67呈阳性表达,且均呈低增殖活性(<2%)。结论胚胎发育不良性神经上皮瘤属于良性肿瘤(WHOⅠ级),可通过临床表现、影像及病理形态学特点结合免疫组化检测明确诊断。

Objective To investigate the clinicopathologic and imaging features,diagnosis and differential diagnosis of dysembryoplastic neuroepithelial tumor（DNT）.Methods Thirteen cases of DNT were analyzed based on the results of HE staining and immunohistochemistry,and imaging features.Results The 13 patients predominantly presented with epilepsy.Imaging examination showed all lesions were hypointense on T1-weighted images and hyperintense on T2-weighted images.Tumor tissue had obvious mucoid and microcystic degeneration.Tumor cells were mainly composed of oligodendrocyte-like cells,neurons and astrocytes;neurons often drifted in the mucoid matrix of the microcysts.Immunohistochemistry showed that the expressions of S-100,synaptophysin and glial fibrillary acidic protein were positive.Ki-67 was weakly expressed（2%）.Conclusion DNT usually is a benign tumor（WHO Ⅰ）.The diagnosis of DNT is definitely established based on the combination of clinical manifestations,imaging features,morphological characteristics,and immunohistochemical results.