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（4例报告并文献复习）

我科自1992年12月～1999年12月间,共收治中枢神经细胞瘤患者4例,现结合临床资料及文献进行总结讨论,探讨中枢神经细胞瘤的临床特征、诊断及治疗方法。     

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94例临床分析

目的 总结中枢神经细胞瘤临床特点,探讨其治疗策略.方法 回顾性分析94例中枢神经细胞瘤患者临床资料.全部行手术治疗,肿瘤全切除66例,近全切除26例,部分切除2例;分析总结中枢神经细胞瘤的临床、病理、影像特点.结果 死亡2例,随访84例,术后放疗56例,肿瘤复发4例.多数患者生存良好.结论 中枢神经细胞瘤多发于室间孔附近侧脑室系统,手术全切除是最佳治疗手段,未全切患者术后放疗可减少复发率.

Abstract：

Objective To analyze the clinical characteristics of central neurocytomas,and discuss the therapeutic strategies.Methods 94 cases of central neurocytomas were studied retrospectively.All patients underwent operation with removal of the tumor through either transcallosal or transcortical approach.Total resection was achieved in 66 patients,subtotal resection in 26 patients and partial resection in 2 patients.The clinical,radiological,histologic and immunohistochemical features of these patients were reviewed and analyzed.Methods Amongthe 94 cases of central neurocytomas,two died after surgery.Among the 84 followed- up cases,56 cases underwent postoperative radiotherapy,4 cases had recurrence.Most patients have favorable prognosis.Conclusion Central neurocytomas occur mostly in the lateral ventricle near the Monro's foramen.Total resection is the best treatment.Postoperative radiotherapy for partially removed tumors may reduce the possibility of recurrence.     

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。     

中枢神经细胞瘤一例报告

患，女，45岁。头痛，头晕2d，查体发现右侧脑室占位2d,于2002年10月入院。体格检查：体温37.1℃，脉搏82次/min，血压140/110mmHg(1mmHg=0.133kPa),既管理方式体健。神经科检查：双瞳孔等大，等圆，对光反射阳性，四肢肌力5级，无恶心、呕吐、双侧Babinski征阴性，指鼻试验阴性。实验室检查未见异常。影像学检查：（1）胞部X线片示心     

脑室外中枢神经细胞瘤1例并文献复习

目的 总结脑室外中枢神经细胞瘤诊治措施.方法 回顾性分析1例额叶中枢神经细胞瘤病例临床特点,神经影像学特点、手术治疗及预后.结果 因术前诊断复发胶质瘤,病变全切除,术后患者出现左侧肢体偏瘫.随访6个月及2年,肢体肌力部分恢复.结论 脑室外中枢神经细胞瘤罕见,影像及病理与胶质瘤及室管膜瘤相似,但治疗方案不同,特别是位于功能区部位中枢神经细胞瘤,相对保守的手术切除加放射治疗能给病人带来更良好的预后.     

中枢神经细胞瘤

一、资料与方法1.一般资料:本组2例,均为女性,年龄26-36岁,病程为4-18个月。2.临床表现:2例均表现为头痛、恶心及呕吐,伴视乳头水肿。1例双下肢肌力4级,肌张力正常,双侧巴彬斯基征阳性,另1例未发现神经系统阳性体征。     

中枢神经细胞瘤诊断及治疗

中枢神经细胞瘤（central nerve cell tumor,CNC）由Hassoun等1982年先对其进行报道并命名[1],1993年WHO中神经系统肿瘤组织学分类正式确定为独立的一类肿瘤,并归入神经元和混合神经元-胶质细胞肿瘤一类。2007年WHO中枢神经系统肿瘤分类将CNC描述为原纤维区域类似神经神经纤维网的肿瘤组织,病理级别为WHOⅡ级[2]。CNC是一种相对少见的中枢神经系统肿瘤,约占脑原发性肿瘤的0.25%~0.5%,多发于青壮年[3,4]。     

非典型性脑室外中枢神经细胞瘤一例报告及文献复习

目的 探讨提高非典型性脑室外中枢神经细胞瘤(EVN)诊疗水平的策略和方法.方法 对2010年1月南京大学医学院附属鼓楼医院神经外科收治的1例非典型性EVN的临床表现、影像学表现、病理学特征及显微外科手术预后等进行回顾性分析.结果 肿瘤位于左侧额部,与脑组织分界清楚,MRI检查T1WI相表现为等信号或稍低信号,T2WI相表现为略高信号,增强后强化不均匀,术前诊断为脑膜瘤.术中见肿瘤组织呈灰红色,质软、血供一般,快速病理倾向为高级别胶质瘤.术后免疫组化肿瘤细胞示GFAP部分(+),S100(+),NeuN(+),Syn(+),Olig2(+),CgA(+),NSE(+),EMA(-),NF(+),CD99(-),P53个别细胞(+),Ki-67约10%(+);提示增殖指数高,考虑为非典型性EVN.结论 EVN影像学表现虽具有一定的特征,但免疫组化结果对确诊很重要.显微手术是治疗最佳手段,预后可能与肿瘤的间变性和增殖指数有关.     

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的诊断和治疗经验。方法回顾性分析1995年8月～2003年7月我院收治的12例中枢神经细胞瘤，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12例，其中9例完全切除．3例大部分切除，手术后常规进行放射治疗，随访6～24个月，效果良好。结论显微手术切除肿瘤辅助放疗是中枢神经细胞瘤的一种有效治疗策略。     

中枢神经细胞瘤的诊断和治疗

目的深入认识中枢神经细胞瘤,以期提高本病的诊疗水平。方法回顾性总结我科22例中枢神经细胞瘤的临床表现、影像学检查、诊断及治疗效果。结果所有22例均手术治疗,术后11例全切除病例中4例联合放射治疗,8例次全切除病例中3例联合放射治疗、1例化疗,3例部分切除病例中1例联合放射治疗、1例化疗。死亡7例,失访6例,其余9例随访2个月至35年,均未见肿瘤复发或再长。结论脑室内中枢神经细胞瘤手术风险较大,死亡率较高;运用显微神经外科及术中导航技术切除肿瘤可有效降低致残率和死亡率;联合术后放疗可减少本病复发;化疗的疗效有待评价。     

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.     

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.     

Central neurocytoma: an immunohistochemical, ultrastructural and cell culture study

To clarify the histogenesis and differentiation potential of central neurocytoma, a pathological investigation of seven tumors from three patients was conducted using immunohistochemistry and ultrastructural analysis in addition to systematic in vitro studies. Six tumors were studied immunohistochemically and five were examined ultrastructurally. All cases that were immunostained were positive for synaptophysin in nuclear-free neuropil islands. In five tumors, a few tumor cells, in addition to reactive astrocytes, were positive for glial fibrillary acidic protein (GFAP). Vimentin staining was also positive in a few tumor cells of five specimens. Neurofilament staining was always negative. All cases for which ultrastructure was examined showed various synaptic abnormalities. Cultured cells were subdivided into three distinct tumor cell types: neuronal cells which stained for neurofilament proteins with neurosecretory granules; small flat undifferentiated cells with a high nuclear-cytoplasmic ratio and scant cytoplasmic organelles; and small round or multipolar astrocytic cells with 10-nm intermediate filaments which stained for GFAP. Our tissue culture studies disclosed that cultured neurocytoma cells form a cellular mosaic similar to subependymal plate layers that are composed of mitotically active cells, neurons and glia. Received: 21 October 1996 / Revised, accepted: 26 February 1997     

脑室中枢神经细胞瘤显微手术入路方式的选择及疗效分析

目的探讨脑室中枢神经细胞瘤显微手术入路的选择及其临床疗效。 方法选取广州三九脑科医院神经外一科自2011年12月至2019年10月采用显微手术治疗的33例脑室中枢神级细胞瘤患者,对患者的手术入路选择、手术要点、不同手术入路的手术相关情况及术后评分等临床资料进行回顾性分析。 结果20例患者采取额中回-侧脑室前角入路,10例患者采取三角区造瘘-脑室手术入路,3例患者采取行前纵裂-胼胝体入路。肿瘤完全切除26例,次全切除7例。术后再行脑室-腹腔分流2例,行放射治疗和化学治疗7例。随访6个月~8年,未发现复发病例。3种手术入路患者的手术时间和出血量相比,差异有统计学意义（P<0.05）;纵裂-胼胝体入路的手术时间、出血量均高于额中回入路、三角区入路,差异有统计学意义（P<0.05）。术后3个月,3种手术入路患者卡氏评分比较,差异无统计学意义（P>0.05）。 结论根据脑室中枢神经细胞瘤的病灶特点,选择合适的手术入路有助于手术全切脑室中枢神经细胞瘤,术后配合放射治疗和化学治疗可改善患者的预后。     

中枢神经细胞瘤的诊断和治疗

目的探讨中枢神经细胞瘤的临床特点、诊断及治疗方法。方法回顾性分析12例中枢神经细胞瘤患者的临床资料,所有患者均行手术治疗。结果12例中枢神经细胞瘤患者,肿瘤全切除9例,次全切除2例,大部分切除1例。所有患者术后随访3个月至lO年,l例术后1年复查示脑积水,行脑室一腹腔分流术;按GOS评分,12例均恢复良好。结论中枢神经细胞瘤显微手术切除术后辅以放疗可获得良好的治疗效果。