脉络丛肿瘤临床特点分析

目的总结脉络丛肿瘤（CPT）的临床特点和诊治经验。方法本组31例CPT中，28例为脉络丛乳头状瘤，3例为脉络丛癌．全部行显微手术治疗。结果肿瘤全切24例，次全切除6例，大部分切除1例，无手术死亡病例。术后9例患者复查CT示脑积水改善不明显。结论脑积水是CPT的突出表现，与肿瘤大小及性质不一致，手术缓解率不高。虽然脉络丛肿瘤大多为慢性起病．但仍有少数表现为急症。     

异位脉络丛癌(附1例报告及文献复习)

目的介绍脉络丛乳头状癌的病理和免疫组化特征。方法对一例脉络丛乳头状癌患者的临床表现、组织形态学和免疫组化染色进行分析,并结合文献对本病的诊断、鉴别要点进行了探讨。结果脉络丛乳头状癌的组织学形态特点:由柱状上皮围绕毛细血管、纤维组织所形成的乳头样结构。瘤细胞有异型,可见核分裂相。免疫组化示细胞角蛋白(CK)阳性,胶质纤维酸性蛋白(GFAP)、S-100及波形蛋白(Vimentin)灶性阳性,上皮膜抗原(EMA)、突触素(Syn)、神经元特异性烯醇化酶(NSE)、神经微丝(NF)及均为阴性。Ki67:>20%。PAS染色阴性。结论脉络丛乳头状癌的诊断主要依靠其组织学形态和免疫组化标记;常需与室管膜瘤、转移癌及乳头瘤型脑膜瘤鉴别。     

脉络丛肿瘤的研究进展

脉络丛肿瘤是中枢神经系统的上皮源性肿瘤,但免疫组化表型上可同时表达CK和Vi-mentin,部分还可表达GFAP,表明其并非一般所称的上皮。不典型脉络丛肿瘤在形态上及生物学行为上均有别于恶性的脉络丛癌。本文还介绍了电镜,DNA流式细胞术等新技术在脉络丛肿瘤研究中的应用结果。     

脉络丛乳头状癌一例

患者　男 ,6 1岁。于 6个月前出现阵发性头胀痛 ,发作时间及间隔无规律 ,发作时无剧痛 ,也无恶心及呕吐。一周前开始头部胀痛 ,在发作时曾因左下肢无力 ,摔倒过三次 ,但症状均能自行缓解。体检 :神志清醒 ,语言流利 ,颅神经正常 ,左侧Ｂａｂｉｎｓｋｉ征阳性。ＣＴ示左侧顶枕叶颅骨内板下方略高密度灶 ,ＣＴ值 4 0Ｈｕ ,病灶中央有小片状低密度影 ,周围可见水肿带围绕。侧脑室后角变形移位 ,但中线居中。增强后病灶有明显强化 ,与病灶中央出现坏死区。术前诊断为左顶枕叶占位性病变 ,以胶质瘤的可能性大。于 1月 8日在全麻下行左顶枕开颅 ,…     

儿童脉络丛乳头状癌1例并文献复习

目的 探讨儿童脉络丛乳头状癌的临床、影像学表现及诊疗经验。方法 回顾性分析1例儿童脉络丛乳头状癌患者的临床资料,并结合相关文献进行复习。结果 患儿男,因“突发抽搐3 d”,门诊拟“左侧脑室肿瘤”收治入院。入院后完善相关检查,择期行侧脑室三角区入路肿瘤切除术,肿瘤全切。术后病理诊断为脉络丛乳头状癌。文献复习结果显示儿童脉络丛乳头状癌为比较罕见的中枢神经系统肿瘤,诊断存在一定难度。结论 临床表现、影像学特点及病理学特征是诊断该病的主要依据;手术为首选治疗手段,放疗有一定疗效。     

脉络丛乳头状癌3例临床分析

<正>脉络丛乳头状瘤是临床少见的起源于脉络丛上皮细胞的肿瘤,占颅内肿瘤的0.3%～0.7%。任何年龄均可发生,以10 岁以下儿童多见。男性稍多于女性。成人好发部位为第四脑室,小儿则以侧脑室和第三脑室多见,位于侧脑室者以左侧多见。恶性者为脉络丛乳头状癌,临床尤为罕见。复习我院1995～2003年病人资料,有临床表现并经病理证实为脉络丛乳头状癌者仅有3例,报告分析如下: 1.病例资料病例1,患者男性,30岁,住院号A-230405.主因阵发性颈部疼痛、呕吐1年,间断性黑朦20天入院。头颅CT扫描:左     

不典型脉络丛乳头状瘤1例：临床及病理研究

目的探讨不典型脉络丛乳头状瘤的临床特点、病理诊断及鉴别诊断。方法分析1例4岁男性不典型脉络丛乳头状瘤病人的临床资料，光镜下观察病理形态特征并行免疫组化研究。结果CT显示右侧颞叶脑实质占位。MRI显示右侧侧脑室囊实性占位。病理形态多样，部分区域分化差，细胞密度增加、核分裂3-5个／10HPF，呈片状方式生长。免疫组化结果：角蛋白（CK）、波形蛋白（Vimentin）阳性，上皮膜抗原（EMA）弱阳性；S-100、胶质纤维酸性蛋白（GFAP）等均为阴性。Ki-67阳性率局部〉5％。结论病人年龄、肿瘤准确定位等临床资料对病理诊断较为重要；严格掌握肿瘤的诊断标准并辅以合理的免疫组化检查，对诊断与鉴别诊断极为重要。     

多发性间变型脉络丛乳头状瘤手术治疗及文献复习

脉络丛乳头状瘤是生长缓慢的良性肿瘤，起源于脑室的脉络丛上皮细胞，儿童多见，男性多于女性，常伴有脑积水，发病率较低，国外文献报告约占颅内肿瘤总数的0．4％～0．6％。间变型脉络丛乳头状瘤（Anaplastic Choroid plexus papilloma，ACPP）也称脉络丛乳头状癌（Choroid plexus carcinoma，CPC），相当少见。而幕上、幕下多发性间变型脉络丛乳头状瘤更少见。本文报道2例女性成人幕上、幕下多发性间变型脉络丛乳头状瘤临床治疗过程。     

酷似巨大囊肿的脉络丛乳头状瘤一例

患者,女性,8岁,因反复抽搐5年,加重6个月于1995年9月13日入院。90年病人无诱因出现四肢抽搐,口角歪斜,口吐白沫,意识不清约1分钟,当时未诊治。以后反复出现上述症状,曾在外院抗癫痫治疗效果不佳。6月前病人抽搐频繁,左侧肢体无力,不能行走,行头颅MRI检查:右顶枕部占位性病变,T_1、T_2均为均匀一致的水样信号,T_1低信号,T_2高信号,与同侧侧脑室相连,边缘清楚,无水肿及占位效应。诊断右顶枕部巨大囊肿。9月23日在全麻下拟行囊肿切除加带蒂大网膜颅内移植术。术中发现脑表面未见明确异常,切开脑皮层0.2cm及囊壁进入囊内,囊腔10cm×8cm×5cm大小,与侧脑室后角相通,囊内为清亮脑脊     

立体定向辅助下侧脑室脉络丛乳头状癌切除1例报告

1病历资料女性,40岁。入院前当天突发癫大发作1次,持续约5min,自行缓解,发作后头痛、头晕,急诊行头CT扫描,示左侧脑室及其三角区团状等、高混杂密度影,大小约1.0 cm ×1.5cm,边界模糊,脑室形态尚可,中线结构居中。体格检查:生命体征平稳,嗜睡,语言功能正常,双瞳孔正常,双眼向右侧凝视,无眼震,生理反射正常,病理反射未引出,肢体活动自如。手术方法:先在局麻下安装Leksell-G型定向仪框架,行MRIT1序列轴位相扫描,层厚0.5cm,将颅内肿瘤的中心点定为可见靶点,计算出三维坐标。病人改为全麻,平卧位,头高15°,手术入路采取顶枕入路,安装定向仪,…     

Choroid plexus tumors in childhood

Choroid plexus tumors are rare and account for only 2.3% (8/352) of primary childhood intracranial neoplasms in our series. Most of our patients were under 2 years of age. The tumors had a predilection for the lateral ventricle. Calcification was found in half of these tumors, and ossification was seen in 1 case. Histological features of malignancy including invasion, loss of differentiation, and severe nuclear pleomorphism pointed to a poor prognosis. Such features were found in 2 cases. Neither a large number of mitoses nor necrosis was a constant feature in cases of malignancy. Transthyretin, a marker for choroid plexus tumors, was positive in all cases. However, negative S-100 or positive carcinoembryonic antigen was not necessarily associated with a more aggressive histological pattern. All the papillomas could be totally resected without recurrence, and all the patients with carcinoma died within a few months.     

Choroid plexus adenoma: case report and review of the literature

Case report An 8-month-old infant with macrocephaly was found to have hydrocephalus and a cystic third ventricular tumour; biopsy of the tumour showed a choroid plexus adenoma. The tumour was attached to the ependymal lining and was strongly adherent to the walls and floor of the anterior third ventricle.Treatment After biopsy, it was felt that a radical resection would carry a high risk of injury to the floor of the third ventricle and cause new neurological deficits. Therefore, an external ventricular drain was inserted and bilateral ventriculo-peritoneal shunts were inserted 1 week post-operatively. In view of the benign nature of the tumour, no adjuvant radiotherapy or chemotherapy was given.Outcome There was no further tumour growth or clinical deterioration over a 6-year follow-up period.     

Usefulness of synaptophysin immunohistochemistry in an adult case of choroid plexus carcinoma

Abstract

Choroid plexus carcinoma in an adult case is a very rare tumor and difficult to differentiate from metastatic tumors. The authors report a case of a 49-year-old female with choroid plexus carcinoma who previously had multiple carcinomas. In this case, synaptophysin immunohistochemistry proved to be extremely helpful for the histological diagnosis. [Neurol Res 2000; 22: 478-480]     

Choroid plexus histidine transport

System-N transport plays an important role in l-glutamine uptake into isolated rat choroid plexus but its role in the transport of another System-N substrate, l-histidine, has yet to be determined. Similarly, the possible effects on System-N mediated l-histidine transport of changes in pH and extracellular l-glutamine, such as occur in cerebral ischemia and hepatic encephalopathy, have yet to be examined. In the absence of competing amino acids, l-[³H]histidine uptake in isolated rat choroid plexus was mediated by both Na⁺-independent and Na⁺-dependent transport. The former was inhibited by 2-amino-2-norbornane carboxlic acid, indicating System-L transport, while the latter appears System-N mediated as it was inhibited by three System-N substrates but not substrates for System-A and -ASC. The Na⁺-dependent uptake had a K_m of 0.2 mM and a V_max of 1.4 nmol/mg/min. It accounted for 30% of l-histidine uptake in the presence of physiological concentrations of amino acids. Reductions in pH markedly inhibited Na⁺-dependent but not Na⁺-independent transport indicating that, as in liver but not neurons, System-N mediated transport at the choroid plexus is pH sensitive. Increases in l-glutamine concentration in the pathophysiological range reduced l-histidine uptake via both System-L and -N.     

Choroid plexus papillomas in infancy and childhood

The present study deals with 15 cases of choroid plexus papilloma, out of approximately 500 cases of brain tumors observed in children up to 16 years old. Several features are considered, including clinical symptoms and signs—mostly related to increased intracranial pressure—radiological diagnosis, pathology and surgical treatment, and results. Surgery may be radical in most cases, with the exception of histologically malignant papillomas. The management results are usually satisfactory. An adequate choice of surgical approach is mandatory and surgical technique should be meticulous, also in order to avoid the risk of intraoperative tumoral seeding.Presented in part at the 11th Meeting of the European Society for Paediatric Neurosurgery, Naples 1988     

Choroid plexus papillomas in childhood

Chroid plexus papillomas account for only 0.4-0.6% of intracranial tumours at all ages and less than 5% in childhood. Two paediatric cases are reported to demonstrate the variability in clinical presentation, location and neurological outcome of this benign tumour. One case has been followed for 13 years.     

Choroid plexus papilloma containing bone

Summary The presence of bone in choroid plexus papillomas is a rare event. The authors report a case of choroid plexus papilloma of the IVth ventricle containing bone in a 18-year-old man, and review two previously reported cases, as well as the mechanisms proposed for the presence of bone and cartilage in neuroepithelial neoplasms.     

Choroid plexus papillomas of the III ventricle in childhood

Ten infants and children with choroid plexus papilloma of the III ventricle are presented. Hydrocephalus of various degrees was present in all patients, and seven patients had bilateral ventriculoperitoneal shunts prior to craniotomy. All patients were investigated with computed tomography and angiography. Tumor was resected through the transfrontal-transventricular approach in nine and through a transcallosal approach in one. One patient died intraoperatively due to an uncontrollable hemorrhage from a subependymal vein at its point of entry into the homolateral internal cerebral vein, and another died shortly after surgery due to hypothalamic trauma. The remaining eight patients are alive without recurrence over a minimum follow-up period of 3 years; three have mental retardation and seizure disorder. Despite this tumor's deep location and vascularity and occurrence in infancy, choroid plexus papillomas of the III ventricle can be successfully resected. Appropriate care for hydrocephalus and intra- and postoperative management are important.     

Clinicopathologic correlations in epithelial choroid plexus neoplasms: a study of 52 cases

Summary Sixty-seven tumor specimens of epithelial choroid plexus neoplasms obtained by 60 biopsies and 7 autopsies from 52 patients were investigated. Diagnoses of the first operations were choroid plexus papilloma (PP; 32 cases), choroid plexus papilloma with histological atypies (atypical PP; 6 cases), and choroid plexus carcinoma (PC; 14 cases). Carcinoembryonic antigen was expressed by 2 of the 3 biopsies autoptically recognized as metastatic carcinomas and by 2 autopsy cases of PC, while it was absent in all biopsies of true choroid plexus tumors. Tumor cells positive for transthyretin (TTR, prealbumin), S-100 protein (S100), and glial fibrillary acidic protein (GFAP) were detected in 39, 46 and 13, respectively, of the 49 cases of true choroid plexus tumors. Fourth ventricle tumors expressed more S100 (number of positive tumor cells) than lateral ventricle tumors, PP more S100 and TTR than atypical PP/PC. Tumors from patients 20 years of age and older expressed more GFAP and TTR than tumors from younger patients. Of the 30 patients with complete follow-up 19 were alive 2 to 11 years after surgery, including 7 recurrencies. Eleven died from the tumor 4 months to 7 years after surgery. The following histopathologic features (in order of decreasing significance) were correlated with poor prognosis (recurrency or fatal outcome): less than 50% of the tumor cells heavily positive for S100, presence of mitoses, absence of TTR-positive cells, brain invasion by cell nests, absence of marked stromal edema, and presence of necrotic areas. Our results indicate that some histologic features correlate significantly with poor prognosis and that immunohistochemical results correlate with tumor localization, age, and malignancy.