脑膜瘤的透射电镜观察

用透射电子显微镜(TEM)观察了6例脑膜肿瘤(脑膜皮瘤型3例、纤维型2例、过渡型1例)。瘤细胞的主要特征是胞质形成复杂的突超。突起中除含有丰富的线粒体外,尚可见到高尔基氏复合体、散在或成束的微丝。突起之间形成大量桥粒。脑膜瘤的这种上皮样结构解释了在光镜下和细胞学涂片上细胞不易分散的原因.根据透射电镜所见,本文认为上述三种脑膜瘤可能超原于蛛网膜颗粒的间皮样细胞,它们在超微结构上不易区别.     

中丝蛋白在脑膜和脑膜瘤上的表达

本文以免疫组化方法研究了中丝蛋白在正常脑膜(蛛网膜颗粒)和脑膜瘤上的表达。脑膜细胞不仅表达了波形蛋白,而且表达了角蛋白、反应了其间皮和上皮的特性。4例上皮型脑膜瘤共同表达了波形蛋白和角蛋白,显示其双相的分化。由于脑膜和脑膜瘤有共同的中丝蛋白表达特征,我们认为脑膜瘤来自脑膜细胞的异常增生。     

Morphological characterization of experimental amebic liver lesions in gerbils.

Gerbils are susceptible to amebic liver abscess (ALA) production under experimental conditions. However, little is known about the histopathological changes that occur during the evolution of the lesion. We analyzed microscopically the sequence of cellular events of ALA in gerbils inoculated intraportally or intrahepatically with E. histolytica. At early stages trophozoites were associated with different degrees of inflammatory reaction. Amebas were also observed in areas devoid of inflammatory cells. Damaged hepatocytes were either related or not to inflammatory reaction. At late stages, lysis of macrophages and epithelioid cells were seen in relation to necrotic tissue and trophozoites. We conclude that amebic liver necrosis in gerbils at early stages may result from lysis of inflammatory cells as shown previously by us in hamsters, but also by direct contact and lytic activity of amebas to hepatocytes. The late destruction and expansion of hepatic tissue necrosis is apparently associated with damage of macrophages and epithelioid cells.     

石棉诱发大鼠间皮瘤的超微结构及免疫组织化学研究

作者对23例大鼠间皮瘤作了超微结构研究,其中7例混合型作了免疫组化研究。结果说明,间皮瘤可能来自间皮下多功能的原始间叶细胞。作者还就本组间皮瘤与人和其他动物的间皮瘤进行了比较,并对电镜及免疫组化在研究间皮瘤中的作用进行了讨论。     

上皮样胃肠道间质瘤43例临床病理学特征分析

目的探讨上皮样胃肠道间质瘤(gastrointestinal stromal tumors,GIST)的临床病理学特征。方法对43例上皮样GIST患者进行常规病理、免疫组化标记。结果本组上皮样GIST患者的男女之比为1.7∶1,平均年龄60岁。肿瘤以胃、腹盆腔为多见,其中复发6例,发生肝转移4例。镜下肿瘤细胞以圆形、卵圆形或短梭形为主,胞浆丰富透明或嗜酸,可见透明空泡状及印戒样细胞。可形成微囊状结构,成片状、巢状,可见纤细或粗大的纤维分隔,部分可见腺管样结构。6例复发病例中有2例原发为梭形细胞型(余不详)。CD117、CD34、DOG1的阳性率分别为79.07%,73.81%,84.85%,3例CD117阴性病例DOG1阳性表达。有4例CD117、DOG1均阴性,CD34却阳性表达。结论上皮样GIST具有上皮样肿瘤的形态学特点,易发生误诊,应予以仔细鉴别。梭形细胞型GIST复发,可发生上皮样的改变。在上皮样GIST中DOG1的阳性率高于CD117,CD117、CD34、DOG1联合应用可提高诊断准确率。     

胃肠道血管周上皮样细胞肿瘤的研究进展

血管周上皮样细胞瘤是一种罕见的间叶组织肿瘤，由组织学和免疫组织化学有独特表现的血管周 上皮样细胞组成，良性多见，好发于成年女性。血管周上皮样细胞瘤主要起源于女性的子宫，可发生于肺、肝、 肾脏、膀胱及胃肠道等部位。血管周上皮样细胞瘤肿瘤家族包括血管平滑肌脂肪瘤、肺及肺外组织的透明细 胞糖瘤、淋巴管平滑肌瘤病及镰状韧带/ 韧带的透明细胞肌黑质细胞瘤。血管周上皮样细胞瘤的临床表现缺 乏特异性，发病机制不明，病理学上具有独特的形态，对肌细胞和黑素细胞标记具有免疫反应性。发生于胃肠 道的血管周上皮样细胞瘤少见，该文就发生于胃肠道的血管周上皮样细胞瘤的临床表现、临床病理特征、诊断、 治疗及预后做一综述。     

细胞增殖特性与良性脑膜瘤复发的关系

目的 :探索良性脑膜瘤的复发与肿瘤细胞增殖能力的关系 ,并寻找能预测其复发的指标。　方法 :对 1 5例复发的良性脑膜瘤和 2 2例非复发的良性脑膜瘤共 4 9份标本分别进行增殖细胞核抗原 (PCNA)和Ki 6 7的免疫组化染色 ,计数阳性细胞数的比率即标记指数 (LI) ,比较各组间的PCNALI和Ki 6 7LI。　结果 :复发的良性脑膜瘤的PCNALI和Ki 6 7LI均显著高于未复发组 (P <0 .0 5 ) ;复发组中同一患者前后两次手术标本的PCNALI和Ki 6 7LI均无显著差异 (P >0 .0 5 )。　结论 :复发的良性脑膜瘤的细胞增殖性高于未复发组 ,当PCNALI>2 .0 %时 ,提示肿瘤有复发倾向。良性脑膜瘤复发后其增殖特性无明显改变     

近端型上皮样肉瘤4例临床病理分析

目的:探讨近端型上皮样肉瘤的临床病理特征、诊断要点和鉴别诊断.方法:分析4例近端型上皮样肉瘤的临床病理资料,观察其组织病理学形态及免疫表型特征,对其进行随访.结果:女3例,男1例.发病年龄33～58 岁.位于会阴部2例,胸壁1例,背部1例.临床均表现为无痛性生长的坚实性孤立性结节状肿块.瘤细胞呈圆形或卵圆形,含有均质的嗜酸性胞质,胞核位于一侧,核仁明显,常见横纹肌样细胞,少见肉芽肿样改变.瘤细胞波形蛋白(Vim)、细胞角蛋白(CK)、CD34、上皮膜抗原(EMA)阳性例数分别为4/4、4/4、2/4、1/4,均不表达MyoD1、S-100蛋白、SMA、HMB-45、desmin.2例死于发病后8个月以内,1例发病4个月后出现肝转移灶,12个月死亡,另1例随访14个月仍生存.结论:近端型上皮样肉瘤的组织病理学特征是:瘤细胞有弥漫性深染嗜酸性癌样胞质,核大,空泡状,核仁明显,常见横纹肌样细胞;瘤细胞共同表达Vim和CK,半数病例瘤细胞表达CD34,部分病例瘤细胞表达EMA;诊断需与一些具有上皮样细胞形态的良恶性肿瘤相鉴别;其生物学行为高度恶性.     

肾上皮样血管平滑肌脂肪瘤3例的临床病理分析

目的探讨肾上皮样血管平滑肌脂肪瘤(EAML)的病理诊断要点、鉴别诊断及预后意义。方法对3例肾上皮样血管平滑肌脂肪瘤(EAML)患者的个案包括临床资料、光镜观察、免疫组化及随访结果进行分析。结果 3例患者其中1例无症状,2例主诉为腰部疼痛;1例术前考虑为错构瘤,2例疑为肾癌,镜下肿瘤主要成分为上皮样细胞,呈巢状分布,局部血管周围见少量平滑肌增生,肿瘤边缘见极少量脂肪组织。免疫组化:上皮样肿瘤细胞黑色素瘤相关抗原HMB45,Melan-A均呈表达阳性,局灶表达SMA,不表达CK、CK7、CK20、RCC、CD10、CD68、S-100、CgA。3例患者随访8～24个月均未见复发。结论肾上皮样血管平滑肌脂肪瘤易与肾细胞癌及其他恶性肾肿瘤相混淆,免疫组化有助于鉴别。     

Perivascular epithelioid cell tumor of the cecum: a case report and review of literatures

Perivascular epithelioid cell tumors （PEComas） are a group of rare mesenchymal neoplasms which composed of histologically and immunohistochemically distinctive perivascular epithelioid cells （PECs）. In recent years, PEComas have been manily reported in liver, kidney, lung, uterus and adnexa,1 but rare in small or large intestine.2-6 Here, we describe a case of PEComa restricted in the cecal mucosa, which displayed histological characteristics of epithelioid clear cells.     

子宫颈血管周上皮样细胞瘤临床病理观察

目的:探讨子宫颈血管周上皮样细胞瘤的临床及病理组织学特征。方法:应用光镜观察及免疫组化染色对1例子宫颈血管周上皮样细胞瘤进行临床病理分析,同时复习相关文献。结果:肿瘤主要由上皮样细胞组成,呈片状排列,细胞间分布较多薄壁小血管,呈网状或裂隙样,免疫组织化学对HMB-45、NSE表达。结论:子宫颈血管周上皮样细胞瘤是一种HMB-45阳性标记的独立真性肿瘤类型,其恶性倾向不明,预后良好。     

肾脏上皮样血管平滑肌脂肪瘤临床病理分析

目的 探讨肾上皮样血管平滑肌脂肪瘤的临床病理特点、诊断及鉴别诊断.方法 肉眼观察手术切除肾脏肿瘤标本,镜检肿瘤组织形态和免疫组化表达.结果 患者多为中年女性,临床症状不明显或以腹部包块、大出血而就诊,组织学形态表现为圆形、多边形和梭形上皮样细胞灶性分布于脂肪瘤中,上皮样瘤细胞免疫组化标记SMA、Vimentin、HMB45均表达阳性.结论 肾脏上皮样血管平滑肌脂肪瘤较少见,多为良性,依赖于光镜及免疫组化进行诊断及鉴别.     

Meningiomas in lymphangioleiomyomatosis

CONTEXT: Lymphangioleiomyomatosis (LAM), a cystic lung disease associated with progressive respiratory failure, is found predominantly in women of childbearing age and therefore has been treated with progesterone and other hormonal agents. However, meningiomas have progesterone receptors, and progesterone is believed to be a mitogen for meningioma cells in culture. Since 30% to 40% of patients with tuberous sclerosis complex (TSC) have LAM, we routinely screen patients with LAM for brain lesions found in TSC. OBJECTIVE: To determine the prevalence of meningiomas in women with LAM. DESIGN AND SETTING: Analysis of results from ongoing routine screening protocols initiated in December 1995 at the National Heart, Lung, and Blood Institute. PATIENTS: Two hundred fifty women with sporadic LAM who were referred for screening by magnetic resonance imaging (MRI) and/or computed tomography (CT) of the brain. MAIN OUTCOME MEASURES: Presence of meningiomas on MRI and/or CT scans. RESULTS: Eight women with LAM (3 with and 5 without a diagnosis of TSC) had lesions on MRI scans compatible with meningiomas. Five of the patients had been treated with progesterone. Multiple meningiomas were observed in 2 patients. CONCLUSIONS: Women with LAM appear to have a high prevalence of meningiomas. We recommend that patients with LAM be screened for meningiomas regardless of diagnosis of TSC. In view of the lack of a documented effect of progesterone on progression of lung disease in LAM and the reported mitogenic response of meningiomas to progesterone, we recommend that the drug not be given to LAM patients with an MRI result consistent with diagnosis of meningioma.     

多层螺旋CT对肾上皮样血管平滑肌脂肪瘤的诊断价值

目的探讨多层螺旋CT在诊断肾上皮样血管平滑肌脂肪瘤中的应用价值。方法回顾性分析我院2005年7月到2014年3月经术后病理证实的5例肾上皮样血管平滑肌脂肪瘤患者的CT资料,并分析其CT特点。结果 5例患者中男性2例,女性3例;1例患者病灶为两个,其余4例为单发;其中2例误诊为肾癌。6个病灶的肾皮质期表现为均匀或不均匀强化,肾实质期肿瘤强化程度不一,可表现为明显减退、轻度减退及持续强化。结论肾上皮样血管平滑肌脂肪瘤可含有脂肪成分,也可不含脂肪成分;CT表现在与其他疾病鉴别诊断方面具有一定的价值。     

Experimental Study on the Inhibitory Effects of Verapamil on the Proliferation of Meningiomas Cells

In order to investigate the effects of verapamil on the proliferation of meningiomas cells in vitro and in vivo, the cultured meningiomas cells were cultured with verapamil at different concen-trations for 24 h and the inhibitory effects of verapamil on cell proliferation were observed by MTT method. The meningiomas model was established by implanting the newly removed tumor fragments into the nude mice subcutaneously. The nude mice with tumors were divided into two groups: vera-pamil-treated group and control group. Tumor volumes were measured and after 12 weeks the tumors were taken out and examined histologically. The expression of proliferating cell nuclear antigen (PCNA) in the tumors was detected by using immunohistochemistry. It was found that verapamil could inhibit the growth of cultured meningiomas cells in a concentration-dependant manner. The in-hibitory effect could be observed in the concentration of 1 μmol/L verapamil and the most obvious effects appeared in the concentration of 100 μmol/L. Tumor volume in the verapamiltreated group was obviously smaller than that in the control group (211.40±5.50 vs 163.94±3.62, P<0.01) and the expression of PCNA was also lower (1.52±0.24 vs 2.86±0.53, P<0.05). Tumor inhibition rate was about 22.45%. It was suggested that verapamil could inhibit the proliferation and growth of men-ingiomas cells in vitro and in vivo.     

脑膜瘤组织中组织蛋白酶异常表达及其诊断价值研究

目的:探讨组织蛋白酶B(cathepsinsB,CatB)及其抑制因子在区别良、恶性脑膜瘤方面的价值。方法:以免疫组织化学分析法,检测76例脑膜瘤的肿瘤组织标本CatB及其抑制剂StefinA和CystatinC的表达水平。结果:恶性脑膜瘤组及非典型性脑膜瘤组的CatB免疫组织化学积分(4~6)率分别显著高于良性脑膜瘤组(χ2=6.24,P<0·05;χ2=6.28,P<0.05);脑膜瘤不同部位组织,发现邻近矢状窦脑膜瘤组与皮层凸面脑膜瘤组的CatB免疫组织化学积分(4~6)率均分别显著高于颅底脑膜瘤组(χ2=4.43,P<0.05;χ2=8.70,P<0.01)。结论:CatB表达水平,在恶性脑膜瘤中显著高于良性脑膜瘤和非典型性脑膜瘤,有望成为区别良、恶性脑膜瘤的重要指标。     

Histopathological classification and location of consecutively operated meningiomas at a single institution in China from 2001 to 2010

Background  Meningioma is one of the most common primary tumors of the central nervous system, but there are not many detailed studies on the sex, age, subtypes and locations of large series. This study was a retrospective analysis of the characteristics of meningioma cases consecutively operated on at a single institution in China from 2001 to 2010.

Methods  This study investigated the demographic background of 7084 meningioma cases, and the subtypes and locations of the tumors. Sex and age distributions were analyzed, and the pathological subtypes were classified according to the World Health Organization (WHO) classification. The location of the meningiomas was also categorized.

Results  The female:male ratio of the 7084 cases was 2.34:1. The mean age was 51.4 years (range, 11 months–86 years). The mean age of cases of WHO grade I meningioma was significantly older than that of grade II or III meningiomas (P <0.001, Fisher’s Least Significant Digit test). There was a significantly higher female:male ratio in WHO grade I meningiomas than in grade II or grade III meningiomas (2.57, 1.03 and 0.76, respectively; P <0.001, χ² test). Meningothelial (n=2061) and fibrous meningiomas (n=3556) were the most common subtypes, comprising 79.3% of all meningiomas. All meningioma cases were classified into 23 locations in this study, with the cerebral convexity the most common site (38.33%, n=2722). Cases with uncommon locations such as extra-cranial and sylvian fissure meningiomas were also present in this series.

Conclusions  Female predominance was found for benign meningiomas, while malignant subtypes showed male predominance. The mean age of patients with WHO grade I meningiomas was older than that of patients with higher-grade tumors. Meningothelial and fibrous meningiomas were the most common subtypes. The cerebral convexity was the most common meningioma location.

     

上皮样肉瘤6例临床病理分析

目的:探讨上皮样肉瘤的临床病理特征和鉴别诊断。方法:分析6例上皮样肉瘤的临床病理特征并进行文献复习。结果:6例均为手术切除标本,镜下均呈特征性结节性生长,肿瘤细胞有两种形态:一类为大的多角形或卵圆形细胞,胞质丰富,嗜伊红,类似上皮样细胞;另一类为梭形细胞,丰满似纤维母细胞样,两种细胞逐渐移行。免疫表型:6例瘤细胞vimentin、pan-CK、EMA(+),2例CD34(+),1例S-100(+)。结论:上皮样肉瘤是一种少见的独特的病变,典型病例诊断不难。对取材较少或镜下表现不典型,尤其是结节中心坏死较小甚至无坏死时,易与滑膜肉瘤、上皮样血管内皮瘤、上皮样恶性神经鞘瘤等混淆,需综合临床资料、镜下特征和免疫组化等特点进行鉴别。     

人脑内血管的一些超微结构观察

应用电镜观察了人类成体相对正常和二月胎儿的脑内血管,发现前者进入脑内的血管有微动脉、中间微动脉及毛细血管;后者脑内仅见毛细血管。脑内毛细血管衬以单层无孔连续性内皮,内皮细胞向管腔面和基膜面发出突起,在细胞间连接处有突向管腔的边缘褶。脑肿瘤患者及胎脑血管中内皮细胞向管腔的突起长而分枝,呈皱襞状。并对毛细血管内皮细胞的细微结构进行了观察描述。