摘要
目的探讨上皮样胶质母细胞瘤(Ep-GBM)的影像表现及病理特征。方法回顾性分析5例经术后病理证实上皮样胶质母细胞瘤,并结合文献报道讨论该病的临床、影像表现及病理特征。结果5例Ep-GBM,其中男1例,女4例,3例(3/5)病灶位于脑皮层下白质,1例(1/5)病灶位于脑白质深部、1例(1/5)病灶位于侧脑室三角区,均为单发。CT显示病灶稍低、低密度,且瘤体与水肿分界不清。MRI显示3例(3/5)囊实性病灶,实性及囊壁明显强化,且囊壁光整无壁结节;1例(1/5)实性肿块呈“花环状”明显强化;1例(1/5)实性肿块呈不均匀明显强化。3例(3/5)瘤周水肿较明显,2例(2/5)瘤周轻度水肿。病理表现:镜下观由上皮样肿瘤细胞区域、部分横纹肌细胞区域及局灶的典型胶质母细胞瘤区域构成。分子病理免疫组织化学:vimentin(+),S-100(+),GFAP(+),ATRX(+),P53突变型10%~20%,Ki-67表达10%~35%,IDH1无突变,BRAF V600E突变。结论Ep-GBM具有一定的影像特征,结合患者的发病年龄、部位,可提高术前Ep-GBM诊断率。
Objective To explore the imaging and pathological features of epithelioid glioblastoma(epithelioid glioblastoma,Ep-GBM).Methods 5 cases of epithelioid glioblastoma confirmed by postoperative pathology were analyzed retrospectively,and the clinical,imaging,and pathological features of the disease were discussed.Results Among the 5 cases of Ep-GBM,one male and four females,3 cases(3/5)were located in the subcortical white matter,1 case(1/5)was located in the deep part of the white matter,1 case(1/5)was located in the triangle of the lateral ventricle,and all the lesions were single.CT scan showed that the focus was slightly low and low density,and the boundary between tumor and edema was unclear.MRI showed cystic and solid lesions in 3 cases(3/5),obvious enhancement of solid part and cyst wall,and smooth cyst wall without mural nodules,1 case(1/5)showed"garland"enhancement,and 1 case(1/5)showed inhomogeneous enhancement.Peritumoral edema was obvious in 3 cases(3/5)and mild edema in 2 cases(2/5).Pathological findings:Microscopically,it comprises epithelioid tumor cell region,partial striated muscle cell region,and typical glioblastoma region.Molecular pathological immunohistochemistry:Vimentin(+),S-100(+),GFAP(+),ATRX(+),P5310%~20%,Ki-6710%~35%,IDH1 has no mutation,BRAF V600E mutation Conclusion Ep-GBM has certain imaging features.Combined with the age and location of the patients,the diagnosis rate of Ep-GBM before operation can be improved.
作者
陈翠云
郭芳芳
付芳芳
李晓栋
朱绍成
王梅云
CHEN Cui-yun;GUO Fang-fang;FU Fang-fang;LI Xiao-dong;ZHU Shao-cheng;WANG Mei-yun(Department of Medical Imaging,Henan Provincial People’s Hospital&People’s Hospital of Zhengzhou University,Zhengzhou 450003,Henan Province,China;Department of Pathology,Henan Provincial People’s Hospital University,Zhengzhou 450003,Henan Province,China)
出处
《中国CT和MRI杂志》
2021年第12期1-3,52,共4页
Chinese Journal of CT and MRI
基金
中国国家自然科学基金(81720108021)。
