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首页|期刊导航|临床与实验病理学杂志|胚胎发育不良性神经上皮肿瘤33例临床病理分析

胚胎发育不良性神经上皮肿瘤33例临床病理分析OA北大核心CSTPCD

Neuroepithelial tumors with embryogenesis dysplasia:a clinicopathological analysis of 33 cases

中文摘要英文摘要

目的 探讨胚胎发育不良性神经上皮肿瘤(dysembryoplastic neuroepithelial tumor,DNT)的临床病理特征及预后.方法 收集33例DNT患者的临床资料,采用免疫组化EnVision两步法检测Olig2、NeuN、Syn、GFAP、IDH1、CD34、BRAF V600E、H3K27M和Ki67的表达,观察其病理组织学形态及免疫组化特征进行回顾性分析,并复习相关文献.结果 33例中可随访28例,其中女性10例,男性18例;发病年龄4~57岁,平均24.97岁;临床以难治性癫痫为常见症状.DNT主要发生在幕上区域,以皮层为主.肿瘤大多界限清楚,呈分叶状、囊性或囊实性结构.镜检:DNT主要由少突胶质样细胞、漂浮在黏液基质中的神经元和增生星形胶质细胞组成,偶见钙化,未见坏死或微血管增生.免疫表型:神经元表达NeuN、Syn,少突胶质样细胞表达Olig2,增生的星形胶质细胞表达GFAP,p53多为野生型,Ki67增殖指数较低(多数<4%).结论 DNT是一种良性混合性胶质神经元肿瘤,病理诊断需结合影像学特点、镜下形态、免疫组化结果及必要的分子检测,手术完整切除后患者预后良好.

Purpose To investigate the clinical,imaging,pathological features,differential diagnosis and prognosis of em-bryonic dysplastic neuroepithelial tumor(DNT).Methods The clinical data of 33 DNT patients were collected.Immunohis-tochemical results of Olig2,NeuN,Syn,GFAP,IDH1,CD34,BRAF V600E,H3K27M and Ki67 were examined by EnVision method.Histopathological morphology and immunohistochemical features were retrospectively analyzed and relevant literature was reviewed synchronously.Results A total of 28 cases were fol-lowed up,including 10 females and 18 males.The age of onset was 4~57 years,with average 24.97 years.Refractory epilepsy was a common symptom.The lesions were mainly located in the supratentorial cortex,and most of them were well-defined,lobu-lated,cystic or cystic and solid.Microscopically,DNT was mainly composed of oligodendrocytes,neurons floating in the mucous matrix,and proliferative astrocytes.Calcification was rare,and no necrosis or microvascular hyperplasia was ob-served.Immunohistochemistry showed that neurons expressed NeuN and Syn,oligodendrocytes expressed Olig2,and prolifera-tive astrocytes expressed GFAP;p53 was mostly wild-type,and the proliferation index of Ki67 was low(mostly less than 4%).Conclusion DNT is a benign tumor with mixed glial and neu-ronal structures.Precise pathological diagnosis needs to be care-fully considered with imaging characteristics,microscopic mor-phology,immunohistochemistry and molecular test results if nec-essary.Prognosis after complete surgical resection is good.

夏轶;郑舒静;熊佶;杜尊国;胡小木;胡星;张莹

复旦大学附属华山医院病理科,上海 200040福建省漳州市医院病理科,漳州 363000复旦大学附属华山医院超声科,上海 200040

临床医学

中枢神经系统肿瘤胚胎发育不良性神经上皮肿瘤鉴别诊断预后

central nervous system tumorsembryonic dysplas-tic neuroepithelial tumorsdifferential diagnosisprognosis

《临床与实验病理学杂志》 2024 (005)

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国家自然科学基金(82072692)、复旦大学附属华山医院院内科研启动基金(HSBY2020002)

10.13315/j.cnki.cjcep.2024.05.006

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