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以下是引用石头在2008-5-24 12:27:00的发言：  横纹肌样脑膜瘤

 

 横纹肌样脑膜瘤

有经典脑膜瘤区域，有横纹肌样细胞区域，是否就可以诊断横纹肌样脑膜瘤？对于横纹肌样细胞的比例有无要求？对于细胞异型性和核分裂像有无规定？

提几个问题供大家讨论

  Figures 1 and 2 look like a benign meningioma. 图1-2好象良性脑膜瘤。The history of "destruction of overlying skull bone" is also consistent with meningioma. 颅骨破坏区也是脑膜瘤。Figures 3,4 and 6 contain polygonal cells that do not look like that seen in usual benign meningiomas, but the admixed small lymphocytes are similar to that seen in Figures 1 and 2. 图3、4和图6由多角形性细胞组成不象常见的良性脑膜瘤，但是混有淋巴细胞又类似图1、2。They are not consistent with rhabdoid meningioma, either.这些形态改变也不是横纹肌样脑膜瘤。.I believe they could still be part of the same benign meningioma. 我考虑还是良性脑膜瘤的一部分。Though necrosis is seen in Figure 5, I do not see other atypical features. 虽然图5有坏死，未见有其它非典型性改变特点。The only thing left to do is mitotic count to be sure this is not an atypical meningioma. 应该好好数一下分裂相，以确保其不是非典型性脑膜瘤。

 考虑间变性脑膜瘤

 Figures 1 and 2 look like a benign meningioma. The history of "destruction of overlying skull bone" is also consistent with meningioma. Figures 3,4 and 6 contain polygonal cells that do not look like that seen in usual benign meningiomas, but the admixed small lymphocytes are similar to that seen in Figures 1 and 2. They are not consistent with rhabdoid meningioma, either..I believe they could still be part of the same benign meningioma. Though necrosis is seen in Figure 5, I do not see other atypical features. The only thing left to do is mitotic count to be sure this is not an atypical meningioma.

 有坏死，细胞明显异型，若再有高核分裂指数要考虑间变性脑膜瘤

 形态考虑横纹肌样脑膜瘤，胶质瘤作为鉴别诊断。做些免疫组化看看表达情况如何。

以下是引用liguoxia71在2008-5-17 15:09:00的发言：  图5上方粉染物是坏死吗？如是，支持恶性脑膜瘤。不知 非典型畸胎瘤样肿瘤/横纹肌样瘤 可否有象图1、2的梭形细胞？请教了！

it is necrosis.横纹肌样脑膜瘤