分泌型脑膜瘤临床与病理特点分析

目的探讨分泌型脑膜瘤的临床病理免疫表型及超微结构特征。方法对沈阳军区总医院1955—2004年19例分泌型脑膜瘤手术切除标本分别进行苏木精伊红(HE)、过碘酸-希夫染色(PSA)、奥尔新兰染色以及波形蛋白(Vimentin)、细胞角蛋白(CK)、上皮细胞膜抗原(EMA)、胶质纤维酸性蛋白(GFAP)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、α-抗糜蛋白酶(α-ACT)免疫组化染色,其中5例进行了超微结构观察。结果肿瘤细胞胞质内可见大小不等、均匀一致的嗜酸性透明状包涵体,电镜观察发现此包涵体为瘤细胞胞质内微腺泡的腔内分泌物。PAS和奥尔新兰染色阳性,免疫组化染色结果显示全部病例Vimentin、EMA、CEA均为阳性或弱阳性,15例CK阳性,而GFAP、NSE、α-ACT均为阴性。结论免疫组化染色及超微结构观察对分泌型脑膜瘤的诊断及鉴别诊断具有重要意义。

Clinicopathological study on secretory meningioma

Objective To study the clinicopathological characteristics and ultrastructural features of secretory meningioma.Methods A total of 19 cases of secretory meningioma were studied by clinicopathology,immunohistochemical and ultrastructural observation.Results Eosinophilic hyaline inclusions with different sizes were found in cytoplasm of tumor cell,which were positive to PAS and alcian blue stains.These inclusions were secreted by microvesicles in cytoplasm of tumor cell under electron microscopy.Conclusion Immunohistochemistry and ultrastructural observation play important roles in the diagnosis and differential diagnosis of this tumor.