第三脑室脊索样胶质瘤1例临床及病理分析

摘要

Objective To investigate the clinical , imaging and pathological features of the third ventricle chor glioma.Methods This paper investigated and reviewed the clinic pathology feature of a case of chordoid glioma of the third ventricle by light-microscopy , electron microscopy , and immunohistochemistry study , and reviewed the literatures .Results Glioma of the third ventricle chordoid imaging mainly as placeholders shadow on the third ventricle and saddle , homogeneous enhancement, edge clarity.Histologically, the tumor showed diffuse evenly distributed , clustered, cord-like epithelial cells buried in the vacuoles myxoid matrix , the interval between tumor cells and the surrounding endoplasmic characteristic with plasma cell infiltration .Tumor cells lacking pleomorphic mitotic and necrotic .GFAP immunohistochemistry shows diffuse strongly positive .Complete removal is the main treatment , prognosis between benign and malignant .Conclusion Chordoid glioma of the third ventricle is a unique clinical , histopathological , immunological phenotype characterized by electron micros-copy and rare central nervous system tumors , easily misdiagnosed .Pathological diagnosis is mainly based on the growth of tumor -specific parts chordoid organizational structure and GFAP immunohistochemistry diffuse strongly positive .%目的：探讨第三脑室脊索样胶质瘤的临床、影像及病理学特点。方法回顾1例第三脑室脊索样胶质瘤患者的诊断和治疗过程，并结合文献进行分析。结果第三脑室脊索样胶质瘤影像学上主要表现为三脑室及鞍上占位影，均匀强化，边缘清晰。组织学上肿瘤呈均匀弥漫分布，簇状、条索状上皮样细胞埋在空泡状黏液样基质中，肿瘤间隔及周边间质内出现特征性淋巴细胞、浆细胞浸润。瘤细胞缺乏多形性、核分裂及坏死。免疫组化染色示GFAP弥漫性强阳性。手术全切是目前主要治疗措施，预后介于良、恶性之间。结论第三脑室脊索样胶质瘤是一种具有独特临床、组织病理学、免疫表型和电镜特点的罕见中枢神经系统肿瘤，容易误诊。病理确诊主要是根据肿瘤特定的生长部位、脊索样组织结构和免疫组化GFAP弥漫强阳性。