上皮样胶质母细胞瘤的病理及影像学研究进展

Research progress in pathological and radiologic diagnosis in epithelioid glioblastoma

上皮样胶质母细胞瘤(epithelioid glioblastoma,E-GBM)是胶质母细胞瘤的一种新亚型。E-GBM具有发病部位表浅,易囊性变,囊壁不光整且厚薄不均,但肿块边界清楚,易侵犯邻近脑膜并出现脑膜尾征,可发生脑脊液播散转移等影像学特点。形态学上,肿瘤细胞体积大,似上皮样,胞质嗜酸性,染色质空泡状,核仁明显,并出现类似横纹肌样细胞,微血管增生明显,可见栅栏状坏死。因E-GBM与其他脑肿瘤具有相似的影像学特点和形态学特征,应提高认知,减少误诊误治。E-GBM的治疗方式主要为手术切除加术后辅助放、化疗。靶向治疗将成为新型治疗手段。

Epithelioid glioblastoma(E-GBM)is a rare kind of glioblastoma.E-GBM has superficial lesions,easily cystic change,uneven cyst wall and uneven thickness,but the boundary of the mass is clear,adjacent meninges are easily affected with meningeal tail sign,and cerebrospinal fluid dissemination and metastasis are likely to occur.Morphologically,the tumor cells are large in size,epithelioid,eosinophilic in cytoplasm,vacuolated chromatin,nucleoli are obvious,and rhabdoid-like cells appear,with obvious proliferation of microvessels,and fence-like necrosis.Since E-GBM has similar imaging and morphological characteristics with other cerebral tumors,cognition should be improved to reduce misdiagnosis and mistreatment.The current treatment is mainly surgical resection plus postoperative adjuvant radiotherapy and chemotherapy.Targeted therapy will be a new therapeutic approach.