1196例脑膜瘤临床病理、免疫组化和电镜观察

目的　探讨脑膜瘤的病理形态学特征。方法　统计分析了沈阳军区总医院 4 6年间经病理证实的 1196例脑膜瘤 ,参照WHO(2 0 0 0 )分类标准将 1196例分成 14种类型 :合体细胞型、过渡细胞型、纤维型、砂砾体型、血管瘤型、微囊型、分泌型、透明细胞型、脊索样型、富于淋巴细胞型、化生型、黑色素型、非典型和间变型。结果　本组中以合体细胞型为主 (6 12例 ) ,最少见为黑色素型 (3例 )。免疫组化染色结果表明 :各类型脑膜瘤vimentin和EMA多呈 ( )。电镜观察结果提示 ,光镜难以明确诊断的一些特殊类型脑膜瘤 ,如血管瘤型、富于淋巴细胞型、微囊型及化生型脑膜瘤等 ,均有各自独特的超微结构特征。结论　免疫组化染色和超微结构观察在脑膜瘤诊断和鉴别诊断中起着重要的作用。

Clinicopathological, immunohistochemical and electron microscopic features of meningioma: a report of 1196 cases

Objective To discuss the pathological characte ristics of meningioma. Methods 1196 cases of menin gioma confirmed by pathology during 46 years were analysed statistically and div ided into 14 subtypes according to WHO classification standards in 2000: syncyti a l type, transitional type, fibrous type, psammomatous type, angiomatous type, mi crocytic type, secretory type, clear cell type, chonodid type, lymphoplasmacyte - rith type, metaplastic variants type, melanotic type, atypical type and anaplast ic type. Results Syncytial type (612 cases, 51.2%) was the mo st common sub type in this group, and the melanotic was the least (only 3 cases). Immunohistoc hemi cal stains showed that most of these meningiomas were positive for vimentin and E MA. Under electron microscope, some special subtypes of meningiomas which were d if ficult to diagnose under light microscope such as angiomatous, microcytic, lymph op lasmacyte-rich and metaplastic variants types, which their unique ultrastructur al c haracteristics. Conclusion Immunohistochemical stains and ultr astructural observation play important roles in the diagnosis and differenti al diagnosis of meningioma.