【摘要】 目的探讨多形性黄色瘤型星形细胞瘤(PXA)的临床病理学特点及CD34在其鉴别诊断中的应用价值。方法对3例多形性黄色瘤型星形细胞瘤的临床特点、影像学表现、组织学形态及免疫组化结果进行观察,并结合文献复习讨论。结果 3例患者平均年龄23岁,2例位于顶叶,1例位于额叶。影像学上3例均位于幕上,其中1例呈囊性,囊内壁小结节明显强化;2例以结节状实性病变为主,未见强化。组织学均可见黄瘤样细胞和血管周围淋巴细胞浸润,其中2例伴梭形细胞成分,3例均未见核分裂象和血管内皮细胞增生。免疫组化示黄瘤样细胞CD68和GFAP(+),CD34弥漫(+),Syn散在(+),Ki-67增殖指数为2%～4%。结论 PXA是一种罕见的具有特殊影像学和临床病理特点的星形细胞肿瘤。CD34是PXA的一种敏感标记物,对于诊断PXA及与其他脑肿瘤相鉴别具有较高的应用价值。更多还原

【Abstract】 Objective To study the clinicopathologic features of pleomorphic xanthoastrocytoma and to assess their diagnostic value of CD34.Methods The clinicopathologic features,imaging findings and immunohistochemical phenotype were observed in three PXA cases and related literature was reviewed.Results The average age at the time of surgery of three patients was 23 years old.The lesions were located at parietal lobe for two cases,one case had lesion at frontal lobe.One case predominantly appeared as cystic lesion with small mural nodule while two cases showed as solid mass.Histologically,pleomorphic and lipidized cells and lymphocyte infiltration were seen.Mitotic figures and endothelial proliferations were not observed in all cases.There were spindle cells in two cases.Tumor cells were positive for CD68,GFAP,CD34 and Syn.Ki-67 labeling index was 2%-4%.Conclusions Pleomorphic xanthoastrocytoma of central nervous system is a rare astrocytic tumor with specific clinicopathologic and imaging features.CD34 prefers to staining for PXA.CD34 represents a valuable tool for distinguishing PXA and other brain tumors.更多还原