Brain surface spindle cell glioma in a patient with medically intractable partial epilepsy: A variant of monomorphous angiocentric glioma?
Brain surface spindle cell glioma in a patient with medically intractable partial epilepsy: A variant of monomorphous angiocentric glioma?
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DOI：
10.1111/j.1440-1789.2007.00849.x
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发表时间：
2008-10-01
期刊：
影响因子：
2.3
通讯作者：
Baba, Hiroshi
中科院分区：
文献类型：
--
作者：
Sugita, Yasuo;Ono, Tomonori;Baba, Hiroshi
我们报道了一名患有难治性部分性癫痫的 6 岁日本男孩的脑表面血管中心性胶质瘤病例。 MRI 显示右侧枕顶叶皮质的液体衰减反转恢复和 T2 加权成像有些不明确的高信号病变。手术时，浅黄色肿瘤位于浅层皮质。在组织学上，肿瘤主要由细长的星形胶质细胞组成，在血管周围形成环状。肿瘤细胞围绕血管周围主要在低细胞性区域，而在细胞较多的区域观察到与血管周围假玫瑰花结的径向排列。这些血管周围的假玫瑰花结与室管膜瘤的假玫瑰花结非常相似。肿瘤细胞与 GFAP 表现出不同的细胞质免疫反应性。这些发现更可能是单形血管中心神经胶质瘤，这是由 Wang 等人首先描述的。 2005年。然而，在我们的病例中，肿瘤具有多形性外观的小病灶和相对较高的MIB-1标记指数（8%）。因此，本病例可能是单形性血管中心胶质瘤的非典型形式。然而，文献中尚未报道与我们的病例类似的新发间变性单形性血管中心胶质瘤。单形性血管中心神经胶质瘤的行为是否是良性生物学特征的一个例子，或者是否更类似于低度恶性肿瘤，仍有待确定。
We report a case of brain surface angiocentric glioma in a 6-year-old Japanese boy with medically intractable partial epilepsy. MRI showed somewhat ill-defined high-signal lesions on fluid-attenuated inversion recovery and T2-weighted imagings of the right occipitoparietal cortex. At surgery, a yellowish tumor was localized in the superficial cortex. Histologically, the tumor was predominantly composed of elongated astrocytic cells forming rings around blood vessels. Tumor cells circumferential to vessels predominanted in low cellurarity areas, whereas radial alignment with perivascular pseudorosettes was observed in more cellular regions. These perivascular pseudorosettes closely resembled those of ependymoma. The tumor cells showed variable cytoplasmic immunoreactivity with GFAP. These findings were more likely monomorphous angiocentric glioma, which was first described by Wang et al. in 2005. However, in our case the tumor had a small foci of polymorphous appearance and a comparatively high MIB-1 labeling index (8%). Therefore, the present case may be an atypical form of monomorphous angiocentric glioma. However, no de novo anaplastic monomorphous angiocentric glioma similar to our case has yet been reported in the literature. It remains to be determined whether the behavior of monomorphous angiocentric glioma is an example of benign biological characteristics or whether it more closely resembles a low-grade malignant tumor.