中枢神经细胞瘤临床病理分析

目的:探讨中枢神经细胞瘤(CNC)的临床及病理特征,以提高对此瘤的认识,避免误诊。方法:应用光镜检查观察了4例CNC的组织病理特点,应用免疫组织化学染色观察了突触素(Syn)、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)和嗜铬蛋白A(CgA)在CNC中的表达情况。结果:本组病例年龄16～33岁,平均22.75岁。肿瘤均发生于侧脑室。CNC组织学特点:瘤细胞由一致的小圆形细胞组成,胞浆透明,呈分房状结构,特征性改变为出现无核纤维岛。免疫组织化学染色Syn、NSE阳性反应。结论:免疫组织化学和电镜对确诊CNC很重要,本瘤治疗以手术全切为首选,预后良好,是分化好的神经元细胞形成的良性肿瘤。     

中枢神经细胞瘤的临床、病理及影像学表现

目的探讨中枢神经细胞瘤(CNC)的临床、病理、影像学表现,提高治疗效果。方法回顾性总结5例中枢神经细胞瘤的临床表现、病理特点、影像学资料及显微外科手术治疗效果。结果4例肿瘤位于侧脑室内的前中部及室间孔附近,1例位于侧脑室后部。CT表现为等或稍高密度肿块,其内有多个低密度小坏死灶,未见钙化;MR表现为T1WI等或稍低信号,T2WI不均匀稍高信号,增强后呈轻、中度强化。免疫组化神经元特异性烯醇化酶(NSE)标记均为阳性;突触素(Syn)4例阳性,1例可疑;胶质纤维酸性蛋白(GFAP)4例阴性,1例阳性。全部病例经显微手术治疗,全切除3例,大部分切除1例,部分切除1例。术后对2例残留的肿瘤进行放射治疗,随访3个月至4年,效果良好。结论CNC主要发生在脑室前部或近室间孔附近,其影像学表现有一定的特征性,显微手术切除肿瘤可有效减少致残率和死亡率,术后放疗可减少本病复发。     

中枢神经细胞瘤的影像学分析

目的 研究中枢神经细胞瘤（CNC）的影像学特点。方法 回顾性分析5例经手术病理证实为CNC的影像学资料。结果 肿瘤均位于透明隔及侧脑室，CT表现为等或稍高密度肿块，多见钙化。MRI表现为T1WI及T2WI均为与皮层灰质相等或略高信号，边缘清楚，体积较大，边缘及内部可见多发囊泡，增强后肿瘤轻、中度强化。结论 CNC主要发生在透明隔及侧脑室，其影像学表现有一定特征性，当此区发生肿瘤时，要考虑CNC的可能。     

中枢神经细胞瘤的影像特征及显微手术治疗 （附11例报告）

目的 探讨中枢神经细胞瘤（CNC）的影像学特征及显微手术治疗。方法 回顾性分析2006年1月至2014年5月经显微手术后病理证实的11例CNC的临床及影像学资料。本组病例术前均行CT及MRI检查,术后常规进行放射治疗,所有病例均行显微手术治疗。术后随访8例,随访时间1~8年。结果 影像学检查显示多数肿瘤均位于侧脑室透明隔,并跨透明隔生长,邻近Monro孔,肿瘤均具有不规则形态;MRI表现为等或稍长T1和T2信号,多呈混杂信号影,特征性的表现为丝瓜觚样改变及“索条征”,增强呈轻至屮度强化,呈“冒泡征”,肿瘤实质CT在平扫多呈等密度及稍高密度,多伴散在钙化灶。肿瘤全切除6例,次全切除3例,大部分切除2例。随访期内未见肿瘤复发。结论 CNC是好发于脑室内的分化较好的神经元性肿瘤,其影像表现具有一定的特征性,结合临床症状可初步诊断,依靠病理学诊断可确诊,应用显微手术结合术后放疗可获得良好疗效。     

中枢神经细胞瘤的诊断和治疗(附8例报告)

目的探讨提高中枢神经细胞瘤(CNC)诊疗水平的策略和方法。方法回顾性分析2004年8月至2009年8月我院收治的8例CNC患者的临床表现、影像学表现、病理学特征及显微外科手术治疗效果。结果肿瘤位于侧脑室前部或室间孔附近,呈宽基底与侧脑室壁或透明隔相连。肿瘤边缘及内部可见多发囊泡,常见钙化,核磁共振检查T1WI、T2WI相均表现为等或略高信号,增强后呈轻至中度强化。免疫组织化学染色均显示神经突触素阳性。显微外科手术治疗8例,其中肿瘤全切除6例,次全切除2例,1例死于术后并发症,7例随访至今未复发。结论CNC发病率低,影像学表现缺乏特征性,其确诊依赖于术后病理检查结果。显微手术切除肿瘤是其最佳的治疗手段,预后较好。     

中枢神经细胞瘤的诊断和治疗(附三例报告)

目的 探讨中枢神经细胞瘤的临床特征、诊断及治疗方法.方法 回顾性分析2001年5月～2004年8月我科收治的3例中枢神经细胞瘤患者的临床资料,总结其临床表现、诊断方法及显微外科手术效果.结果 手术治疗3例,其中2例完全切除,1例近全切切除,术后因经济原因未予放疗;随访18～28个月,2例效果良好,1例肿瘤复发再次手术,术后建议放疗.结论 显微手术切除肿瘤并辅助放疗是中枢神经细胞瘤的一种有效治疗策略.     

中枢神经细胞瘤1例报告

患者，男，27岁，因阵发性头痛、呕吐、视物模糊伴精神不振6d入院。入院时查体：神志清楚，精神萎靡，双眼视力1．0，视野正常，双侧视盘边界模糊，A：V=1：2，其他颅神经未见明显异常。四肢肌张力、肌力、腱反射正常，双侧Babinski征阴性。颅脑CT检查示双侧额顶近中线处可见囊状类圆形低密度影．周边可见颗粒样钙化，双侧脑室扩大，其前角和底部受压，增强后病灶有不均匀强化。头颅MRI示T1为等低混杂信号，T2为高信号改变．透明隔被肿瘤占据并向右移位。[第一段]     

中枢神经细胞瘤的磁共振影像学分析

目的探讨中枢神经细胞瘤（CNC）的MRI影像学特点，提高对该病的认识。方法回顾性分析经手术病理证实的6例CNC的MRI资料。结果本组病例均位于侧脑室前中部及Monro孔附近，5例与透明隔呈宽基底相接，1例仅有粘连；MRI信号不均，实性部分T1WI呈等或稍低信号，周围可见多发囊变及等信号条索样结构与脑室壁及透明隔粘连；增强后轻度至明显不均匀强化。1例肿瘤出血。结论对于年轻患者，MBI显示位于侧脑室前中部及Monro孔附近占位性病变，可提示为CNC。     

脑室内少突胶质细胞瘤与中枢神经细胞瘤的临床病理分析

目的 总结发生于脑室内的少突胶质细胞瘤与中枢神经细胞瘤的临床病理特点。方法 选取同期发生于侧脑室内的6例少突胶质细胞瘤和5例中枢神经细胞瘤进行回顾性研究,对各自的临床病理特点进行分析,探讨二者的鉴别诊断要点。结果。发生于脑室内的少突胶质细胞瘤与中枢神经细胞瘤在临床表现、神经影像学和光镜下的病理学表现均十分相似。结论 目前认为光镜下出现无核原纤维岛、免疫组织化学显示突触素阳性表达、电镜超微结构检查证实肿瘤细胞有神经元分化证据为诊断中枢神经细胞瘤的金标准,也是鉴别少突胶质细胞瘤与中枢神经细胞瘤的重要依据。     

中枢神经细胞瘤诊断和治疗(附五例报告)

一、临床资料本组男4例,女1例;年龄最小19岁,最大42岁,平均年龄是32.4岁。病史2个月-1年。4例首发症状头痛、呕吐,1例记忆障碍。全部患者检查均有视乳头水肿。5例患者均经头颅CT及MRI检查证实,肿瘤最大径在3.8cm×4.6cm,3例位于侧脑室前部靠近monro氏孔附近,1例位于透明膈附近,1例位于侧脑室三角区,全部病例均伴有脑积水,4例可见不同程度的钙化斑。二、治疗方法与结果打开硬膜后均在显微镜下操作,5例全切。手术入路经纵裂胼胝体入路3例,经三角区经皮质入路1例,额叶皮质造瘘侧脑室前角入路1例。4例获随访1.5-6年,CT复查,恢复良好,肿瘤无复…     

Central neurocytoma: a clinical, radiological and pathological study of nine cases

PURPOSE: Central neurocytoma is a rare intraventricular brain tumor that affects young adults and presents with increased intracranial pressure secondary to obstructive hydrocephalus. Typically, it has a favorable prognosis after adequate surgical intervention, but in some cases the clinical course is more aggressive. In this report, we describe the diagnosis and treatment of central neurocytoma in a series of patients at our institution. PATIENTS AND METHODS: Our series of nine patients (M:F=2:7, mean age, 28.2 years) with ventricular tumors showed typical radiological, histologic and immunohistochemical features of central neurocytoma. Most patients received craniotomy with removal of the tumor through transcallosal or transcortical approach. The surgical and histopathologic data of these patients were reviewed and analyzed. RESULTS: The prognosis is generally favorable. Although most patients were alive and well at the last follow-up, two developed recurrence. Typical histologic features of recurrent neurocytoma include high proliferative activity (MIB-1 labeling index: 2.0-6.8%), prominent vascular proliferation and remarkable synaptophysin expression. Two patients (non-recurrent) died during follow-up due to sepsis or central failure. The MIB-1 labeling indices were as high as 2.2-5.4% for these two patients. CONCLUSION: Although central neurocytoma is generally a benign neoplasm, some variant forms of recurrence are also present. Complete resection provides favorable long-term prognosis in most cases. Recurrent tumors are often local and the patients seem to recover well after a second resection followed by radiotherapy. Histologic features such as tumor proliferation (MIB-1 labeling index), vascular proliferation, and synaptophysin expression are often prominent in the recurrent tumor. We recommend that these histologic features be considered for tumor recurrence during treatment and follow-up of these patients.     

中枢神经细胞瘤5例报告及文献复习

目的探讨提高中枢神经细胞瘤诊疗水平的策略和方法。方法回顾分析2004年8月至2006年4月我院收治的5例中枢神经细胞瘤，总结其临床表现、影像学表现、病理学特征及显微外科手术治疗效果。结果肿瘤位于侧脑室前部或室间孔附近，呈宽基底与侧脑室壁或透明隔相连。肿瘤边缘及内部可见多发囊泡，常见钙化，MRI检查T1WI、T2WI相均表现为等或略高信号，增强后呈轻至中度强化。免疫组织化学染色均显示神经突触素阳性。显微外科手术治疗5例，其中全切除4例，次全切除1例，1例死于术后并发症，4例随访至今未复发。结论中枢神经细胞瘤影像学表现具有一定特征，是术前诊断的重要参考。显微手术切除肿瘤是最佳的治疗手段，预后良好。     

松果体区表皮样囊肿的临床、影像学和病理学特点

目的探讨松果体区表皮样囊肿的临床、影像学和病理学特点。方法回顾性分析手术治疗的5例松果体区表皮样囊肿患者的临床资料。结果 CT平扫呈均匀一致似脑脊液样低或等密度病灶,形态不规则,沿脑池生长。MRI T1WI为不均匀低信号,T2WI为不均匀高信号,病变呈分叶状,边界清楚,囊内容物及囊壁均未见明显强化。病理表现为珍珠样颗粒结晶,囊内含较多蛋白、脂类物质、胆固醇结晶。5例松果体区表皮样囊肿中,4例全切,1例近全切。术后随访3~12个月,平均5.8月,肿瘤无复发。结论松果体区表皮样囊肿临床少见,全切预后较好。     

中枢神经细胞瘤临床分析

目的分析颅内中枢神经细胞瘤（CNT）的临床表现特点及诊断治疗。方法回顾性分析经病理证实的28例CNT病人的临床表现、影像学特征、病理特点和治疗方式,并进行随访。结果肿瘤全切除20例,大部分切除8例。术后3个月GOS评分5分12例,4分12例,3分2例,1分2例。术后行标准放疗24例,随访12～120个月,平均38个月,GOS评分均达4-5分,无肿瘤进展和复发。结论CNT好发于侧脑室室间孔附近,具有较特征性的影像学表现,病理特征显著,手术切除加术后放疗为最佳治疗方式,总体预后较好。     

Neuronal and glial characteristics of central neurocytoma: electron microscopical analysis of two cases

We have identified two central neurocytomas which contained cells co-expressing glial fibrillary acidic protein and synaptophysin defined by double-label immunostaining. Dual-positive cells were mostly polygonal in shape and with a morphological appearence similar to that of reactive astrocytes. This distinct morphology could be used to distinguish cells expressing glial fibrillary acidic protein from cells with round and clear cytoplasm which did not express glial fibrillary acidic protein and which composed the majority of the tumor. Samples containing polygonal cells were selected for electron microscopy from toluidine blue-stained semithin sections. Ultrastructural findings were similar in both neurocytomas, with both being composed predominantly of round cells with clear cytoplasm corresponding to the clear cells identified by light microscopy. Dense-core vesicles and clear vesicles were frequently observed in the cell processes. Apart from these clear cells, polygonal cells with electron-dense cytoplasm were noted. Paralleling the results of double immunostaining, these polygonal cells contained both dense-core vesicles and intermediate, presumably glial filaments. Microtubules and lipofuscin granules were also observed. These results suggest that cells expressing glial fibrillary acidic protein in central neurocytoma include tumor cells with both neuronal and glial characteristics. Received: 25 January 1995 / Revised: 9 June 1995 / Revised, accepted: 1 December 1995     

中枢神经细胞瘤的影像学分析与鉴别诊断

目的探讨中枢神经细胞瘤（central neurocytoma,CNC）的影像学特征,提高术前诊断准确率。方法回顾性分析21例经手术病理证实的中枢神经细胞瘤的CT及MRI表现,分析中枢神细胞瘤的影像特点。结果肿瘤多位于侧脑室前中部室间孔区,常跨透明隔生长,CT平扫多呈等密度及较高密度,常散在钙化灶,MRI表现为T1WI上呈不均匀等信号或稍低信号,T2WI上呈不均匀稍高信号,病灶边缘可见多发小囊状影及病灶和侧脑室边缘相连的丝网状影,病灶内较常见血管流空信号,增强后病灶不均匀明显强化。结论中枢神经细胞瘤影像学表现具有一定特异性,其特征性有助于提高术前诊断正确率。     

Central neurocytoma: long-term follow-up of a paediatric case

In order to gain a better understanding of the clinical and histological features of central neurocytoma and the role of radiotherapy in the treatment of these tumours, we present an unusual paediatric case and review the pertinent literature.Most patients present in the second and third decade of life, rarely in the teenage years and exceptionally in children. Our patient was treated by a combined surgical and radiation therapy treatment for a central neurocytoma at the age of 7 years, but the tumour had been diagnosed when she was 3 years old. At a 38-year follow-up, she is well with no evidence of tumour progression.This patient seems to be the youngest histologically proven case of central neurocytoma and with the longest recorded survival.     

Central neurocytoma: its differentiation from intraventricular oligodendroglioma

Two patients with intraventricular tumours are presented. Both had similar features on light microscopic examination. On the basis of the specific immunohistochemical staining patterns and the ultrastructural findings, one was diagnosed as a central neurocytoma while the other was diagnosed as an intraventricular oligodendroglioma. The possibility of central neurocytoma should be considered in all young patients including children presenting with an intraventricular lesion. Definitive diagnosis requires electron microscopic and immunohistochemical studies.     

中枢神经细胞瘤的诊断和显微手术治疗

目的探讨中枢神经细胞瘤（CNC）诊断及治疗经验。方法回顾性分析16例CNC的诊断及显微手术治疗情况。采取纵裂-胼胝体-脑室入路5例,经皮质造瘘侧脑室入路9例,经枕下正中小脑蚓部入路1例,直接开颅切除1例。术后3例行放射治疗。结果术前误诊率62．5％。病理分级：WHOⅡ级7例,Ⅱ-Ⅲ级3例,Ⅲ级1例,未定级5例。病变全切除10例,次全切除4例,部分切除2例。除1例失访和1例复发外,其他病例恢复良好。结论CNC多数位于脑室系统,在影像学上有其特点。选择适当的手术入路行显微手术治疗预后良好。     

中枢神经细胞瘤相关研究进展

中枢神经细胞瘤(CNC)是位于脑室内的一种罕见的神经上皮肿瘤,目前起源尚不清楚,好发于中青年群体,其在影像学上有一定的特征性表现。但由于中枢神经细胞瘤的罕见性,目前临床上对其的认识仍然存在不足,治疗方式的选择及其预后相关的影响因素也存在着较大的争议。本文结合最近的文献报道就中枢神经细胞瘤临床及流行病学特征、影像及病理学特点、治疗方式的选择及其相关预后因素、与脑室外神经细胞瘤的关系等方面的研究进展作一综述。