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zhongshihua 离线
以下是引用笃行者 在2007-3-4 21:29:00的发言:
巨细胞性胶质母首先考虑,但也有不支持的地方:未见坏死及核分裂像、无血管内皮增生等。 室管膜下巨细胞性星形细胞瘤?病人年龄太大了。 转移性大细胞癌,也要考虑。 最后要看免疫组化结果了。 |
聞道有先後,術業有專攻
I believe this is a case of WHO grade I subependymal giant cell astrocytoma (SEGA). 我考虑本例为WHO分类的室管膜下巨细胞性星形细胞瘤I级(SEGA)。The anatomic location and histology are both very characteristic of the disease. SEGA 有特征性的解剖部位和组织学改变。Not all SEGA occur in patients with tuberous sclerosis (TS), but such clinical and family history should be looked for.不是所有的SEGA都伴有结节性硬化,但是我们应该去了解患者的临床和家族史。 The bottom line is histology - characteristic large and smaller cells with round to oval nuclei, frequent intranuclear pseudoinclusions, plump eosinophilic and often globular or polygonaal cytoplasm, associated calcospherites, and rare if any mitoses.组织学诊断的标准:见到特征性的大和小的细胞伴有圆或卵圆形的胞核,常见到核内假包涵体。细胞肥胖,浆丰、嗜酸,细胞外形呈圆球形或多角形,伴有钙球。如果有核丝分裂,也非常罕见。 Necrosis is very rarely seen, and vascular/endothelial proliferation is not present.坏死非常罕见,血管增生和血管内皮增生也不常见到。 Immunohistochemical stains will show these neoplastic cells to have both glial and neuronal (-positive) differentiation. 免疫组化显示瘤细胞向两方面分化,向胶质细胞(GFAP阳性)以及神经元(NSE-, NF-, and synaptophysin阳性)分化。