谢谢马老师介绍的诊断标准很有用

 

 非典型性脑膜瘤

钦佩马老师治学严谨的态度

最后报告：

非典型性脑膜瘤。

因为除瘤组织坏死外，其核分裂达不到4个/10个高倍。

以下是引用zhongshihua 在2007-5-23 20:40:00的发言： 最后报告：非典型性脑膜瘤。因为除瘤组织坏死外，其核分裂达不到4个/10个高倍。

If that's all we find in this meningioma, it should have been graded as WHO grade I (benign) and not WHO grade II atypical meningioma.

 恶性脑膜瘤或间变性脑膜瘤(WHOIII级)

以下是引用shandongzhang 在2007-4-21 19:59:00的发言：  恶性脑膜瘤或间变性脑膜瘤(WHOIII级)

有坏死，核分裂象多见，支持！

There is tumor necrosis in this meningioma, but I do not see other atypical features or brain invasion. The mitotic count is very important in this case. Most neuropathologists agree that one should count the "hot" zones and not use "average" mitotic count. WHO 2000 define atypical meningioma (grade II) as one with at least 4 mitoses per 10 high power field (400x), or the presence of three or more of five features - (1) necrosis, (2) prominent nucleoli, (3) small cells with high nucleocytoplasmic ratios, (4) hypercellularity, and (5) patternless, sheet-like growth. To qualify as a "malignant" or "anaplastic" meningioma (grade III), one need to find at least 20 mitoses per 10 high power field. I cannot have an accurate count of mitoses based on these photots alone.

翻译： 在这一例脑膜瘤中有肿瘤性坏死，但是我没有看到其他的不典型结构和脑组织侵犯。在这个病例中核分裂像计数非常重要。在数核分裂像时大多数神经病理学家认为应该记数“热闹”区域而不要用平均数值。WHO定义非典型脑膜瘤（II级）需要至少在每10个高倍视野（400倍）找到4个核分裂像，或者满足下列五项特征中的三项以上：1）坏死，2）明显的核仁，3）高核浆比的小细胞，4）高细胞密度，5）片状生长的无结构区。确诊一例“恶性”或“间变型”脑膜瘤（III级），必须在10个高倍视野中至少找到20个分裂像。基于这些图片我无法作出一个精确的记数。

 同意mjma的意见，基于上述图像不够诊断间变性脑膜瘤

 也许atypical meningioma合适一些。最好按mjma教授的标准仔细观察一下再定。