微囊型脑膜瘤的临床与病理研究

Clinical-pathological features of microcystic meningiomas

目的探讨微囊型脑膜瘤的临床影像特点、病理特点,研究其特征。方法回顾分析经病理证实的6例微囊型脑膜瘤的临床表现、影像特征和病理特点。结果微囊型脑膜瘤的好发部位和常见脑膜瘤无差别,CT呈现低密度病灶,水肿明显,易和胶质瘤、转移瘤混淆。MRI表现为T1WI低信号,T2WI高信号,强化明显,界限相对清晰,多由脑血管和硬膜血管供血,瘤周多水肿明显。病理以肿瘤细胞旋涡状,排列疏松,瘤细胞突起相互交织构成微囊为特征,囊腔充满囊液,细胞核分裂象少见,EMA、vimentin和PR阳性,GFAP阴性,Ki-67<5%。结论微囊型脑膜瘤发病率低,有特征性,手术首选,预后良好,需要严密观察随访。

Objective To investigate the clinical manifestation, MRI and pathology features of microcystic men- ingiomas. Methods Six patients with pathologically confirmed microcystic meningioma were retrospectively reviewed. Results The common location of mierocystic meningioma was similar to the other type of meningiomas. The tumors fre- quently exhibited low density on CT scan. On the MR scan, the tumor way characterized with non - uniform enhancement on the Gd enhanced T1W1 weighted MR. Moreover, 3 tumors were confirmed to be supplied with both brain and extra- brain vessels. Pathologically, the tumor cells lined gyrately and sparsely, where axons went cross to form various micro- cysts. The nucleolus division was seldom seen and the percentage of positive of Ki - 67 staining was very low. The tumor was featured with positive staining of vimentin and PR, but negative of GFAP. Conclusion Microcystic meningiomas had some distinctive features on CT and MR scan from the other type of meningiomas. Surgical operation is the first line treat- ment for them, and intensive follow - up is warranted.