中枢神经细胞瘤影像学及病理特征观察

目的观察中枢神经细胞瘤（centralneurocytoma，CNC）的影像学表现、临床病理特征与免疫组化特点，探讨其治疗方法及预后。方法回顾性分析15例CNC患者的临床表现，CT、MRI扫描观察其影像学特征，HE及免疫组化染色观察其病理及免疫表型特点，患者随访评估预后。结果肿瘤大多位于侧脑室邻近Monro孔，CT扫描呈等或稍高不均匀密度影；MRI检查T1WI上呈等或低信号，T2WI呈高信号，肿瘤内部可见“蜂窝”状或“丝瓜瓢”样改变。增强扫描呈不均匀斑片状、条状强化。病理所见CNC由圆形或卵圆形细胞组成，有核周空晕，瘤细胞呈蜂窝状结构。免疫组化示肿瘤组织Syn均阳性，CgA均阴性。CNC首选手术切除。15例随访病例中，全切、全切＋放疗组未见复发。结论CNC好发于侧脑室邻近Monro孔处。MRI特征性改变为“丝瓜瓢”状或匍行性流空信号影。Syn阳性表达是可靠的诊断标志。CNC总体预后良好。

A clinicopathological and neuroradiological study of central neurocytoma

Objective To investigate the imaging clinicopathological and immunohistochemical features of central neurocytoma （CNC） and study method of treatment and prognosis of CNC. Methods The clinical presentation of 15 CNC patients were analysed retrospectively. Imaging features were explored by CT and MRI scans. The pathological and immunophenotypic characteristics were ob- served by HE and immunohistochemical staining. Treatment effects and prognosis were followed up in the patients. Results CNC were located in lateral ventricle near the Monro foramen and exhibited to be isodense or hyperdense on CT scan. On T1 - weighted MRI ima- ges, CNC were isointense or hypointense. On T2 - weighted images, they were hyperintense. Honeycomb or towel gourd ladle changes can be seen in the tumor. Patched and stripped enhaneemens were found after gadolinium administration. CNC were constituted of round or oval monomorphie cells with perinuclear halos. Intraeellular branching capillaries formed the characteristic honeycomb struc- ture of CNC. Positive expression of Syn and negative CgA were found in all tumor tissures by immunohistoehemical staining method. Surgical resection was the primary therapy of CNC. In the 15 patients followed - up, no recurrence were seen in the total resection and total resection with radiotherapy groups. Conclusions CNC is located mainly in lateral ventricle near the Monro foramen. Positive ex- pression of Syn can be viewed as the reliable diagnostic eriteron. Towel gourd ladle or serpiginus flow voids are characteristic MRI changes of CNC. The tumor should be removed totally and CNC has a benign prognosis in general.