室管膜下瘤9例临床分析

目的探讨室管膜下瘤的临床、影像学和病理特点。方法对9例室管膜下瘤患者的临床资料进行回顾性分析,对手术切除的肿瘤组织标本进行病理及免疫组化检查。结果本组患者的男女比例为2∶1,平均年龄54岁;术后随访10~109个月,均无转移和复发。MRI检查示,肿瘤位于侧脑室内8例、右颞叶1例,T1WI呈等信号6例、低信号及高信号各1例,T2WI高信号6例、等信号2例;增强扫描轻度增强、无明显强化各4例。病理检查示,瘤组织胶质纤维丰富,瘤细胞成簇状分布其间;除1例右颞叶肿瘤无微囊结构外,其余均有微囊形成。免疫组化检查:瘤细胞胶质纤维酸性蛋白(GFAP)、S-100、波形蛋白(Vimentin)阳性表达,突触素(SYN)、上皮膜抗原(EMA)、神经元特异性核心抗原(Neu-N)为阴性;Ki-67标记指数4%1例,1%~3%8例。结论室管膜下瘤多发于老年男性,进展缓慢,预后较好。其大多发生在侧脑室内,发生在脑实质的少见。认识其临床、影像学和病理特点有利于诊断及治疗。

Clinical analysis of 9 paitients with subependymoma

Objective To study clinical, imaging and pathologic features of subependymoma. Methods The clinical data of 9 patients with subependymoma were analyzed retrospectively.Surgical removal of the tumor tissue specimens were performed using pathologic and immunohisto-chemical examination.Results Male and female of this group was with a ratio of 2:1 with mean age 54 years. Postoperative follow-up of 10-109 months, there were no metastasis and recurrence.MRI demon-strated the tumors located in the lateral ventricle of 8 cases and the right temporal lobe in 1 case. There were 6 cases showed iso-signal,1 case showed low-signal and 1 case showed high-signal on T1 WI.There were 6 cases showed high-signal and 2 cases showed iso-signal on T2 WI.Enhancement scan demonstrated 4 cases got slight enhancement and 4 cases were without enhancement respectively.Pathologic examination showed that the tumors were highly fibrillar and clusters of nuclei embedded in it.Most cases showed microcystic formation except 1 case in the right temporal lobe.Immunohistochemical examination was positive for GFAP,S-100 and Vimentin and negative for SYN,EMA and Neu-N.Ki-67 labelling indices showed 1 case was 4%and 8 cases were 1%-3%. Conclusions Subependy-moma occurs most freqently in old male.It carries a slowly progress and good prognosis.It occurs mostly in the lateral intraventricular, whereas rarely in the brain parenchyma.Correct understanding the clinical, imaging and pathological are beneficial to the diagnosis and treatment.