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- 脑肿瘤？脓肿?这些增生的是血管母细胞吗？请会诊
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男，42岁。反复头痛1月余。手术见颅内包块相临右颞筋膜增厚。切除包块及增厚筋膜。
软组织9×6×2.5cm，淡褐色，不规则，碎。
显微镜检查病灶内淋巴细胞浸润为主,伴酸性细胞浸润,部分区域血管增生,炎细胞浸润累及” 右颞筋膜”。拟诊断脑慢性脓肿。但切片免疫组织化学染色见密集ki-67阳性区。以下为免疫组织化学及ki-67阳性区的H.E。
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×参考诊断
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The surrounding area of the brain abscess usually show large amount of fibroblastic reaction, granulation reaction with increased vascular structure, and gliosis, which may give an increased Ki-67 stain, this is a trick sign, don't misdiagnosed as tumor, Brain abscess has classic MRI presentation and pathology diagnosis can be confirmed by reticulin or trichrome stain to show the fibrosis (normal brain has no fibrosis, neither for brain tumor, unless this tumor is gliosarcoma), hopefully, this may help your dx. If you can submit a culture that will help your final dx.
| 以下是引用fyshan在2008-10-1 10:24:00的发言： The surrounding area of the brain abscess usually show large amount of fibroblastic reaction, granulation reaction with increased vascular structure, and gliosis, which may give an increased Ki-67 stain, this is a trick sign, don't misdiagnosed as tumor, Brain abscess has classic MRI presentation and pathology diagnosis can be confirmed by reticulin or trichrome stain to show the fibrosis (normal brain has no fibrosis, neither for brain tumor, unless this tumor is gliosarcoma), hopefully, this may help your dx. If you can submit a culture that will help your final dx. |
非常感谢．补充各图片名称：
图１，切片的cd２０，图２，lca，图３syn．图４s－１００．图５，６，７，８ki－６７．图９ki－６７阳性区的cd２０．图１０ki－６７阳性区的vin．图１１－１４ki－６７阳性区的ＨＥ．
