文章摘要

中枢神经细胞瘤13例临床病理分析并文献复习

作者: 1刘颖, 1姜晨霞, 1王燕, 1张青
1 南通大学附属医院病理科,江苏 南通 226001
通讯: 张青 Email: ntrdzhangqing@126.com
DOI: 10.3978/j.issn.2095-6959.2020.08.004

摘要

目的:探讨中枢神经细胞瘤的临床病理特征、诊断与鉴别诊断及预后情况。方法:回顾性总结13例中枢神经细胞瘤的临床病理资料并进行文献复习。结果:13例患者肿瘤均发生于脑室,男7例,女6例,发病年龄18~60(中位29)岁,临床症状主要为头晕、头痛。影像学检查:CT平扫示等密度影或稍高密度影,伴有钙化7例,囊性变8例,增强后轻度强化;MRI显示T1低信号,T2呈稍高信号或高低混杂信号,增强后实性部分轻中度强化。组织学表现为肿瘤组织由单一的圆形细胞排列成蜂窝状构成,血管呈分枝状,1例示核分裂活跃,1例可见灶性坏死;免疫组织化学示瘤细胞Syn,NSE及NeuN阳性,IDH-1,Olig-2和EMA阴性,GFAP和S100灶性阳性,11例Ki-67指数<2%,2例Ki-67指数5%~10%;13例患者均行显微外科肿瘤切除术,6例术后放射治疗,随访8个月~5年,1例复发。结论:中枢神经细胞瘤是一种少见的中枢神经系统肿瘤,预后较好,诊断需结合病变部位、组织学特征及免疫标志,手术全切除是治疗的最好方式,术后联合放射治疗,化学药物治疗效果有待进一步研究。
关键词: 中枢神经细胞瘤;病理;Syn;NeuN

Clinical and pathological analysis of 13 cases of central neurocytoma and literature review

Authors: 1LIU Ying, 1JIANG Chenxia, 1WANG Yan, 1ZHANG Qing
1 Department of Pathology, Affiliated Hospital of Nantong University, Nantong Jiangsu 226001, China

CorrespondingAuthor: ZHANG Qing Email: ntrdzhangqing@126.com

DOI: 10.3978/j.issn.2095-6959.2020.08.004

Abstract

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis, and prognosis of central neurocytoma (CNC). Methods: The clinical manifestations of 13 cases of CNC were analyzed retrospectively and the literature were reviewed. Results: All the tumors in 13 patients were in the brain chamber, including 7 males and 6 females. The age of onset was 18–60 (median 29) years old. Dizziness and headache were the most commonly presenting symptoms. CT showed equal density or slightly higher density, with 7 cases of calcification, 8 cases of cystic change, mild enhancement after enhancement; MRI showed T1 low signal, slightly T2 high signal or high and low mixed signal, light and moderate reinforcement of the solid part after reinforcement. Histologically, the tumor tissue consisted of a single round cell arranged in a honeycomb shape, the blood vessels were branched, 1 case showed a slightly active mitotic division, 1 case showed focal necrosis; immunohistochemistry showed that Syn, NSE and NeuN of tumor cells were positive, while IDH-1, Olig-2 and EMA were negative, GFAP and S100 were focally positive. 11 cases had a Ki-67 index <2%, and 2 cases had a Ki-67 index 5%~10%. All 13 patients underwent microsurgical tumor resection. Six patients underwent postoperative radiotherapy, followed up for 8 months to 5 years, and 1 case relapsed. Conclusion: CNC is a rare central nervous system tumor with good prognosis. The diagnosis needs to be combined with lesions, histological features and immunological markers. Total surgical resection is the best way to treat CNC, post-operative combined radiotherapy and chemotherapy can reduce the recurrence rate, but the effect also needs to be further studied.
Keywords: central neurocytoma; pathology; Syn; NeuN