INTRACRANIAL GERM-CELL TUMORS - PATHOBIOLOGICAL AND IMMUNOHISTOCHEMICAL ASPECTS OF 70 CASES
INTRACRANIAL GERM-CELL TUMORS - PATHOBIOLOGICAL AND IMMUNOHISTOCHEMICAL ASPECTS OF 70 CASES
复制标题
DOI：
10.1097/00005072-198501000-00003
复制
发表时间：
1985-01-01
影响因子：
3.2
通讯作者：
LEECH, RW
中科院分区：
文献类型：
--
作者：
BJORNSSON, J;SCHEITHAUER, BW;LEECH, RW
报告70例经手术病理证实的颅内生殖细胞肿瘤，其中生殖细胞瘤43例，未成熟畸胎瘤16例，成熟畸胎瘤7例，胚胎癌2例，绒毛膜癌1例，卵黄囊瘤1例。生殖细胞瘤患者平均年龄19岁，未成熟畸胎瘤患者平均年龄11岁，成熟畸胎瘤患者平均年龄17岁。症状持续时间平均为19mo。生殖细胞瘤，3个月。未成熟畸胎瘤，11个月。对于成熟的畸胎瘤。66个肿瘤位于中线；58%的生殖细胞瘤发生在松果体前部，而29%的未成熟性畸胎瘤和14%的成熟性畸胎瘤位于前部。生殖细胞瘤的组织学表现与常见的睾丸精原细胞瘤难以区分。未成熟畸胎瘤包括3个胚层的组织，具有胎儿组织的形态特征。14例未成熟畸胎瘤中，7例伴有其他恶性生殖细胞成分，其中2例为畸胎癌，2例为生殖细胞瘤和未成熟畸胎瘤，2例为未成熟畸胎瘤中广泛分化的横纹肌肉母细胞瘤，1例为生殖细胞瘤和胚胎癌。7例成熟畸胎瘤由完全分化的上皮组织和间充质组织组成。23例人绒毛膜促性腺激素(HCG)、甲胎蛋白(AFP)和癌胚抗原(CEA)的免疫过氧化物酶染色结果与生殖器生殖细胞病变基本相同。生殖细胞瘤患者的存活时间最长。在中枢神经系统生殖细胞肿瘤的分类中，WHO对睾丸生殖细胞肿瘤的分类优于其现有的分类或颅内生殖细胞肿瘤。
Cases (70) of histologically verified intracranial germ cell tumor were reviewed: 43 germinomas, 16 immature teratomas, 7 mature teratomas, 2 embryonal carcinomas, 1 choriocarcinoma, and 1 yolk sac tumor. The male-to-female ratio was 2.6:1. The average age was 19 yr in patients with germinoma, 11 yr in patients with immature teratoma, and 17 yr in patients with mature teratoma. Duration of symptoms averaged 19 mo. for germinoma, 3 mo. for immature teratoma, and 11 mo. for mature teratoma. Sixty-six lesions were located in the midline; 58% of the germinomas arose anterior to the pineal gland, whereas 29% of the immature and 14% of the mature teratomas were located anteriorly. The histological appearance of the germinomas was indistinguishable from that of the usual testicular seminoma. The immature teratomas contained tissue from all 3 germ layers and exhibited morphologic features of fetal tissue. Of 14 immature teratomas, 7 contained, in addition, foci of other malignant germ cell elements; thus, there were 2 teratocarcinomas, 2 lesions with germinoma and immature teratoma, 2 lesions with extensive rhabdomyoblastic differentiation in an immature teratoma, and 1 lesion with both germinoma and embryonal carcinoma in addition to immature teratoma. The 7 mature teratomas consisted of fully differentiated epithelial and mesenchymal tissues. In 23 cases, immunoperoxidase stains for human chorionic gonadotropin (HCG), .alpha.-fetoprotein (AFP), and carcino-embryonic antigen (CEA) revealed patterns which, with minor exceptions, were essentially identical to those found in genital germ cell lesions. Survival was longest for patients with germinomas. In classifying germ cell tumors of the CNS, WHO classification of testicular germ cell tumors is preferable to its present classification or intracranial germ cell tumors.