颅内孤立性纤维性肿瘤/血管周细胞瘤20例临床病理特征分析

doi:10.16150/j.1671-2870.2017.06.012

诊断学理论与实践 ›› 2017, Vol. 16 ›› Issue (06): 622-626.doi: 10.16150/j.1671-2870.2017.06.012

颅内孤立性纤维性肿瘤/血管周细胞瘤20例临床病理特征分析

朱培培¹, 邹珏^2,*, 陈军¹, 徐蓉蓉³, 颜红柱²

1.第二军医大学附属长征医院病理科,上海 200003;
2.上海中医药大学附属第七人民医院病理科,上海 200137;
3.无锡市第二人民医院病理科,江苏无锡 214001

收稿日期:2017-02-10 出版日期:2017-12-25 发布日期:2017-12-25
通讯作者: 颜红柱 E-mail: yanhongzhu2012@163.com
作者简介:*共同第一作者

Intracranial solitary fibrous tumor/hemangiopericytoma: a clinicopathologic study of 20 cases with review of literature

ZHU Peipei¹, ZOU Jue^{2, *}, CHEN Jun¹, XU Rongrong³, YAN Hongzhu²

1. Department of Pathology, Shanghai Changzheng Hospital, The Second Military Medical University, Shanghai, China, 200003;
2. Department of Pathology, Seventh People’s Hospital of Shanghai University of Tradional Chinese Medicine, Shanghai 200137, China;
3. Department of Pathology, Wuxi Sencond People's Hospital, Jiangsu Wuxi 214001, China

Received:2017-02-10 Online:2017-12-25 Published:2017-12-25

摘要/Abstract

摘要： 目的: 探讨颅内孤立性纤维性肿瘤/血管周细胞瘤（solitary fibrous tumor/hemangiopericytoma,SFT/HPC）的临床病理特征、诊断、鉴别诊断方法及预后。方法: 对20例颅内SFT/HPC患者的临床、组织病理学特征及免疫组织化学（免疫组化）检测结果进行观察,并复习相关文献进行探讨。结果: 20例SFT/HPC患者中,男性12例,女性8例,平均年龄为48岁,其中7例有脑膜瘤切除史6~19年。根据2016版最新WHO中枢神经系统肿瘤分级,SFT/HPC Ⅰ级病例1例,Ⅱ级病例13例,Ⅲ级病例6例。免疫组化结果显示,20例患者的病理组织均表达波形蛋白（vimentin）、bcl-2、CD34和STAT6,其中CD34在Ⅰ级肿瘤组织中呈强阳性、弥漫表达,而在Ⅱ级及Ⅲ级肿瘤组织中呈弱阳性表达、斑片状分布,所有病例均不表达上皮膜抗原（epithelial membrane antigen,EMA）、AE1/AE3、S-100、CD31和Ⅷ因子,Ki-67增殖指数为3%~30%。20例患者中,15例获得随访资料,随访时间为5个月至19年,5例患者复发,13例行术后放疗,2例术后未进行治疗,截至2017年3月,所有病例均存活。结论: 新版WHO将SFT和HPC归为一类,并作出新的组织学分级。本研究发现CD34、Ki-67免疫组化染色结果有助于SFT/HPC的组织学分级和鉴别诊断。

关键词: 颅内孤立性纤维性肿瘤/血管周细胞瘤, 免疫组织化学, 鉴别诊断

Abstract: Objective: To study the clinicopathologic features, diagnosis, differential diagnosis and prognosis of intracranial solitary fibrous tumor/hemangiopericytoma(SFT/HPC). Methods: A total of 20 cases of intracranial SFT/HPC were enrolled in this study. The clinical data, pathologic characteristics and immunophenotype were studied and relevant literatures were reviewed. Results: Of these patients, 12 cases were male and 8 were female, with an average age of 48.45 years. Seven cases received meningioma resection 6-19 years before. According to the latest 2016 WHO classification, there were 1 case of grade Ⅰ, 13 cases of grade Ⅱ and 6 cases of grade Ⅲ. Immunohisochemically, tumor cells of all specimen were positive for vimentin, bcl-2, CD34 and STAT6, and were negative for EMA, AE1/AE3, S-100, CD31 and factor Ⅷ. The cells of grade Ⅰ case were strong and diffusely positive for CD34, while the cells of grade Ⅱ and grade Ⅲ cases had weak expression and patchy distribution of CD34. Ki-67 proliferation index ranged from 3% to 30%. Fifteen of the 20 patients were followed-up for 5 months to 19 years. During this period, 5 cases had disease recurrence, and 13 received postoperative radiotherapy, while 2 case did not receive any therapy. Up to March 2017, all cases were survived. Conclusions: According to the latest releas from WHO, SFT and HPC are classified as the same type of tumor, and immunohistochemistry staining of CD34 and ki-67 may be useful to grading and differential diagnosis of SFT/HPC.

Key words: Solitary fibrous tumor/hemangiopericytoma, Immunohistochemistry, Differential diagnosis

中图分类号:

R739.41

朱培培, 邹珏, 陈军, 徐蓉蓉, 颜红柱. 颅内孤立性纤维性肿瘤/血管周细胞瘤20例临床病理特征分析[J]. 诊断学理论与实践, 2017, 16(06): 622-626.

ZHU Peipei, ZOU Jue, CHEN Jun, XU Rongrong, YAN Hongzhu. Intracranial solitary fibrous tumor/hemangiopericytoma: a clinicopathologic study of 20 cases with review of literature[J]. Journal of Diagnostics Concepts & Practice, 2017, 16(06): 622-626.

参考文献

[1] Ecker RD, Marsh WR, Pollock BE, et al.Hemangiopericytoma in the central nervous system: treatment, pathological features, and long-term follow up in 38 patients[J]. J Neurosurg,2003,98(6):1182-1187.
[2] Maruya J, Seki Y, Morita K, et al.Meningeal hemangiopericytoma manifesting as massive intracranial hemorrhage--two case reports[J]. Neurol Med Chir (Tokyo),2006,46(2):92-97.
[3] Stout AP, Murray MR.Hemangiopericytoma: A vascular tumor featuring zimmermann's pericytes[J]. Ann Surg,1942,116(1):26-33.
[4] Fletcher CD. The evolving classification of soft tissue tumours: an update based on the new WHO classification[J]. Histopathology.2006 Jan;48(1):3-12.
[5] Begg CF, Garret R.Hemangiopericytoma occurring in the meninges: case report[J]. Cancer,1954,7(3):602-606.
[6] Fletcher CDM, Unni KK, Mertens F, et al.World Health Organization Classification of Tumours[M]. 3rd. Lyon:IARC Press,2002.
[7] Gold JS, Antonescu CR, Hajdu C, et al.Clinicopathologic correlates of solitary fibrous tumors[J]. Cancer,2002,94(4):1057-1068.
[8] Scheithauer BW, Fuller GN, VandenBerg SR. The 2007 WHO classification of tumors of the nervous system: controversies in surgical neuropathology[J]. Brain Pathol,2008,18(3):307-316.
[9] Louis DN, Ohgaki H, Wiestler OD, et al.WHO classification of tumours of the Central Nervous System[M]. WHO Press: World Health Organiza,2007:97-109.
[10] Mena H, Ribas JL, Pezeshkpour GH, et al.Hemangiopericytoma of the central nervous system: a review of 94 cases[J]. Hum Pathol,1991,22(1):84-91.
[11] Ghia AJ, Allen PK, Mahajan A, et al.Intracranial hemangiopericytoma and the role of radiation therapy: a population based analysis[J]. Neurosurgery,2013,72(2):203-209.
[12] Ghia AJ, Chang EL, Allen PK, et al.Intracranial hemangiopericytoma: patterns of failure and the role of radiation therapy[J]. Neurosurgery,2013,73(4):624-630.
[13] Bouvier C, Métellus P, de Paula AM, et al. Solitary fibrous tumors and hemangiopericytomas of the meninges: overlapping pathological features and common prognostic factors suggest the same spectrum of tumors[J]. Brain Pathol,2012,22(4):511-521.
[14] Yalcin CE, Tihan T.Solitary Fibrous Tumor/Hemangiopericytoma Dichotomy Revisited: A Restless Family of Neoplasms in the CNS[J]. Adv Anat Pathol,2016,23(2):104-111.
[15] Chang IW, Lin JW, Wu YT.The status of MGMT protein expression is a prognostic factor for meningeal hemangiopericytoma: a clinicopathologic and immunohistoche-mical study of 12 cases at a single institution[J]. J Neurooncol,2011,105(3):563-572.

颅内孤立性纤维性肿瘤/血管周细胞瘤20例临床病理特征分析

Intracranial solitary fibrous tumor/hemangiopericytoma: a clinicopathologic study of 20 cases with review of literature

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