脊索样脑膜瘤及脊索样胶质瘤临床病理诊断对比分析及文献复习

The comparative analysis of clinical pathologic diagnosis between chordoid meningioma and chordoid glioma

目的探讨脊索样脑膜瘤及脊索样胶质瘤各自临床病理学特征及两者的鉴别诊断要点,提高诊断的准确性。方法对两组病例进行光镜、免疫组化观察,分析患者的临床及相关影像学资料,并复习两种疾病的相关文献。结果脊索样脑膜瘤及脊索样胶质瘤病理形态相同点为:不同区域可表现为脊索瘤样组织学改变,黏液样背景中出现条索状或簇状排列的肿瘤细胞,同时见大量淋巴细胞、浆细胞等炎细胞浸润。不同点为:脊索瘤样脑膜瘤往往部分区域见有脑膜瘤细胞特征,而脊索样胶质瘤瘤细胞常可见胶质细胞分化,并有胶质纤维突起。免疫组化显示EMA、PR、GFAP等抗体在两种肿瘤细胞中表达不同。结论两种肿瘤的组织形态相似,容易混淆,需要结合临床资料、组织学形态及免疫表型综合诊断。

【Objective】To study the respective clinical pathologic features and differential diagnosis between chordoid meningioma and chordoid glioma,improved the level accuracy of diagnosis.【Methods】These cases were reported, light microcopy and immunohistochemical studies,and the clinical and radiological data analysis were performed in these cases.【Resluts】Chordoid meningioma and chordoid glioma pathological similarities： chordoma-like histological changes can be showed in different regions, the tumor cells with cords or clustered arrangement were showed in the myxoid background.At the same time a large number of lymphocytes, plasma cells and inflammatory cells infiltrated. Different point： chordoma meningioma always could observation the part of the characteristic regional with meningioma cells, while chordoid glioma tumor cells often visible glial cell differentiation, and visible glial fibrillary processes.Immunohistochemistry showed that EMA,PR,GFAP and other antibodies in two tumor cells express different.【Conclusion】Two types of tumors had some similar in pathological tissue morphology, confused easily,so required a combination of clinical, histopathological and immunohistochemical phenotype diagnosis.