Malignant meningioma or rhabdoid meningioma may have similar histopathology, but the immunohistochemical staining pattern shown is not consistent with any antibody commonly used for meningioma. The neoplastic cells do form Homer-Wright rosettes, which are again consistent with medulloblastoma of the large cell/anaplastic type. I would love to be corrected of my interpretation.

恶性脑膜瘤或横纹肌样脑膜瘤也可能出现相似的组织病理学改变,但该例显示的免疫组化染色模式不同于任何一种常用于脑膜瘤诊断的抗体.肿瘤细胞形成Homer-Wright 菊形团,这也与间变性/大细胞性髓母细胞瘤相吻合.

A cerebellar tumor like this, occurring in a 21 year old, generates a list of differential diagnosis that includes medulloblastoma (anaplastic or large cell variant), atyical rhabdoid/teratoid tumor (AT/RT), and less likely, choroid plexus carcinoma and metastasis. Distinction between these possibilities depends on clinical history, MRI finding and immunohistochemistry. Histologic features of anaplastic medulloblastoma overlap with that of AT/RT. AT/RT often contains mesenchymal areas of spindle cells, whic are not seen here. The last photo appears to be synaptophysin immunostain, which is strongly positive in neoplastic cells. If so, anaplastic/large cell medulloblastoma would be favored. This said, I would like to see more photos before making a final diagnosis.

发生于21岁男性小脑类似这样的病变,需要跟多种肿瘤鉴别,包括髓母细胞瘤(间变或大细胞亚型),不典型畸胎瘤样/横纹肌样瘤,脉络丛癌以及转移性肿瘤等.需要结合临床病史、MRI表现以及免疫组化结果来进行鉴别.在组织学上,间变性髓母细胞瘤与AT/RT有所重叠,后者常常含有梭形细胞间叶成分,本例看不到这种现象.最后一张图看上去应该是SYN免疫染色,肿瘤细胞强阳性,如果确实如此的话,倾向于考虑间变性或大细胞性髓母细胞瘤.当然,在确诊前我希望看到更多的图片.