脑室内少突胶质细胞瘤与中枢神经细胞瘤的临床病理分析

Analysis of Clinichopathological Features of Intraventricular Oligodentroglioma and Central Neurocytoma

目的 总结发生于脑室内的少突胶质细胞瘤与中枢神经细胞瘤的临床病理特点。方法 选取同期发生于侧脑室内的6例少突胶质细胞瘤和5例中枢神经细胞瘤进行回顾性研究,对各自的临床病理特点进行分析,探讨二者的鉴别诊断要点。结果。发生于脑室内的少突胶质细胞瘤与中枢神经细胞瘤在临床表现、神经影像学和光镜下的病理学表现均十分相似。结论 目前认为光镜下出现无核原纤维岛、免疫组织化学显示突触素阳性表达、电镜超微结构检查证实肿瘤细胞有神经元分化证据为诊断中枢神经细胞瘤的金标准,也是鉴别少突胶质细胞瘤与中枢神经细胞瘤的重要依据。

Objective To summarize the clinicopathologic features of oligodendroglioma and central neurocytoma originated from the lateral and/or the third ventricles. Methods The data of six cases of the oligodendrogliomas and five cases of the central neurocytomas originated from the lateral and/or the third ventricles within the same period were reviewed retrospectively. The clinicopathologic features and the outlines for differential diagnosis were discussed simultaneously. Results The clinical manifestations, imaging features and pathological findings under light microscope in the oligodentrogliomas are quite similar to those in the central nerurocytoma. Conclusions It is considered that the fibrillary areas mimicking neuropil under the light microscope, positive expression of synaptophysin shown by the immunochemical technique, and the evidence of neuronal differentiation under the electronic microscope are the golden criteria for diagnosing the central neurocyloma and also the main clues to differentiate the central neurocytoma from the odendroglioma.