脉络丛乳头状瘤13例临床病理分析

Clinicopathological characteristics of the choroid plexus papilloma a report of 13 cases

目的 探讨脉络丛乳头状瘤的临床病理学特征、诊断、鉴别诊断、治疗及预后。方法 收集2003年5月至2012年8月间13例脉络丛乳头状瘤,观察其临床特征、病理学表现和免疫学表型,并结合文献进行讨论。结果 13例脉络丛乳头状瘤,男性8例,女性5例,年龄1.5~51岁,中位年龄31岁。发病部位分别为第四脑室（7例）、侧脑室（4例）、左桥脑小脑角（2例）。光镜下肿瘤组织呈乳头状结构,由单层立方形或假复层柱状上皮围绕纤维血管轴心形成。肿瘤细胞异型性小,细胞核圆形或卵圆形,位于上皮基底部,核分裂象未见或偶见。其中4例有钙化,2例有黏液变性,1例有骨化,1例有纤维化。结论 脉络丛乳头状瘤为中枢神经少见的良性肿瘤,明确诊断依赖于病理组织学及免疫组化标记。需与脑膜瘤、髓母细胞瘤、室管膜瘤、神经鞘瘤和转移性乳头状癌等相鉴别。外科手术完整切除,预后良好。

Objective To study the clinicopathological characteristics,diagnosis,differential diagnosis and prognosis of choroid plexus papilloma. Methods Data including clinical characteristics,histopathological changes and immuno-histochemical findings were analyzed in 13 cases of choroid plexus papilloma.Data was from May,2003 to Aug.,2012,and was reviewed together with related literatures. Results Among 13 cases of choroid plexus papilloma,there were 8 males and 5 females.The age ranged from 1.5 to 51 years old （median 31）.The tumors located in the fourth cerebral ventricle （7 cases）,the lateral cerebral ventricle （4 cases）,and the left cerebellopontine angle （2 cases）,respectively.Tumor tissue had a papillary structures covered with a single layer uniform cuboidal or pseudostratified to columnar epithelial cells around the delicate fibrovascular connective tissue in the microscope.The nucleus were round or oval shape,located on the bottom of the cells and had basically no atypia.Mitotic activity was extremely low.In the 13 cases of choroid plexus papilloma,there were four cases with calcification,two cases with mucinous degeneration,one case with ossification,one case with fibrosis. Conclusions Choroid plexus papilloma is a rare benign tumor of the central nervous system （CNS）.The diagnosis mainly relies on the expression of histopathology and immunohistochemistry.Differential diagnosis includes meningioma,medulloblastoma,ependymoma,schwannoma,metastatic papillary carcinoma of the CNS and so on.It can be cured completely by surgical excision.