脑膜孤立性纤维性肿瘤临床病理观察

目的 探讨脑膜孤立性纤维性肿瘤的临床病理学特点、免疫组化特征及鉴别诊断.方法 对1例脑膜孤立性纤维性肿瘤并发生腰椎转移患者的手术切除标本进行组织学观察,免疫组化进行CD34、Bcl-2、CD99、vimentin、CKpan、GFAP、EMA、CD117、S-100、Ki67染色及随访,并复习相关文献.结果 转移瘤标本肉眼所见为不规则的碎骨及软组织,大小2 am×2 cm×3 cm,表面欠光滑,切面暗灰色、实性、鱼肉样.镜下检查:肿瘤由交替性分布的富于细胞和稀疏细胞区组成,梭形细胞呈束状、漩涡状或不规则状排列,部分与胶原纤维混杂,部分呈血管外皮瘤样结构.上皮样细胞有的围绕血管周围.细胞间细条索状、粗绳索样或瘢痕样胶原纤维不规则性或石棉样的胶原物质沉积.瘤细胞CD34、Bcl-2、CD99、Vimentin均为阳性,CKpan、GFAP、EMA、CD117、S-100蛋白均为阴性,Ki67增殖指数<5%.结论 脑膜孤立性纤维性肿瘤罕见,易复发和转移.需要与其他多种梭形细胞肿瘤鉴别诊断,其组织学特点和免疫组化可以帮助鉴别.其生物学行为难以预测,必须进行长期随访.

Abstract：

Objective To explore the clinicalpathological features,immunohistoehemieal characteristics and differential diagnosis of solitary fibrous tumor(SFT) of the meningeal.Methods A case suffering from SFT of the meningeal was examined with light microscopy and immunohistochemistry,including CD34,Bcl-2,CD99,Vim-entin,CKpan,GFAP,EMA,CD117,S-100 and Ki67,and related literatures were reviewed.Resuits The patient was a 32-year-old man,who was found neoplasm in IA vertebrae after removing the solitary fibrous tumors of the right temporal meningeal.Grossly,the tumor was composed of irregular bone fragments and soft tissue with dimension 2 cm×2 cm x 3 cm and dark gray.solid,fish-like on cut surface.Microscopically,the tumor was composed of bland spindle shaped cells and dense collagenous bands,with fascicular,storiform or haphazard arrangements.Focal areas showed a haemangiopericytoma like structure.Immunohistochemically,the tumor cells were positive for CD34.Bcl-2,CD99 and Vimentin,but negative for CKpan,GFAP,EMA,CD117,S-100,Ki-67 index was less than 5%.Condusious SFI"is a very rare tumor in meningeal.which often manifests local recurrence and metastasis.It should be differentiated from a variety of spindle cell tumors.Diagnosis is based on hisitologieal features supplemented with immunohistochemical findings.It's very difficult to predict the biological behavior,which requires a long-term follow-up.

Clinicopathologic analysis of solitary fibrous tumor of meningeal

Objective To explore the clinicalpathological features,immunohistoehemieal characteristics and differential diagnosis of solitary fibrous tumor(SFT) of the meningeal.Methods A case suffering from SFT of the meningeal was examined with light microscopy and immunohistochemistry,including CD34,Bcl-2,CD99,Vim-entin,CKpan,GFAP,EMA,CD117,S-100 and Ki67,and related literatures were reviewed.Resuits The patient was a 32-year-old man,who was found neoplasm in IA vertebrae after removing the solitary fibrous tumors of the right temporal meningeal.Grossly,the tumor was composed of irregular bone fragments and soft tissue with dimension 2 cm×2 cm x 3 cm and dark gray.solid,fish-like on cut surface.Microscopically,the tumor was composed of bland spindle shaped cells and dense collagenous bands,with fascicular,storiform or haphazard arrangements.Focal areas showed a haemangiopericytoma like structure.Immunohistochemically,the tumor cells were positive for CD34.Bcl-2,CD99 and Vimentin,but negative for CKpan,GFAP,EMA,CD117,S-100,Ki-67 index was less than 5%.Condusious SFI"is a very rare tumor in meningeal.which often manifests local recurrence and metastasis.It should be differentiated from a variety of spindle cell tumors.Diagnosis is based on hisitologieal features supplemented with immunohistochemical findings.It's very difficult to predict the biological behavior,which requires a long-term follow-up.