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脑多形性黄色星形细胞瘤8例临床、病理、MRI特征及文献复习

张应战 ,  张禹 ,  秦添 ,  王星星 ,  徐茂林 ,  冯雨婷 ,  邓雪飞

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文章导航 > 蚌埠医学院学报  > 2014,  39 > 10: (1401-1406)  
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脑多形性黄色星形细胞瘤8例临床、病理、MRI特征及文献复习

  • 1. 蚌埠医学院第二附属医院 放射科, 安徽 蚌埠 233040;

  • 2. 中国人民解放军第105医院, 影像科, 安徽 合肥 230031;

  • 3. 中国人民解放军第105医院, 病理科, 安徽 合肥 230031;

  • 4. 安徽医科大学 解剖学教研室, 安徽 合肥 230032

    • 作者简介: 张应战(1977-), 男, 主治医师.
  • 基金项目:

    国家自然科学基金青年资助项目(81200895)

  • 中图分类号: R739.41

Pleomorphic xanthoastrocytoma:the features of clinic, pathology and MRI in 8 cases and literature review

  • 1. Department of Radiology, The Second Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233040;

  • 2. Department of Medical Imaging, The 105th Hospital of PLA, Hefei Anhui 230031;

  • 3. Department of Pathology, The 105th Hospital of PLA, Hefei Anhui 230031;

  • 4. Department of Human Anatomy, Anhui Medical University, Hefei Anhui 230032, China

  • CLC number: R739.41

  • 摘要: 目的: 提高对脑多形性黄色星形细胞瘤(PXA)临床、病理及MRI特征的认识.方法: 回顾性分析8例PXA的MRI表现并复习相关文献,8例脑PXA均经病理证实,均行MRI平扫、增强扫描及扩散加权成像,2例行多体素磁共振波谱(TE135ms)和灌注加权成像检查.结果: 8例PXA年龄14~56岁,25岁以下者6例.伴间变特征者2例.7例单发,1例伴间变特征者为单发肿块伴周围子灶.5例发生或累及颞叶,6例位于皮层及皮层下.MRI表现5例呈囊实性,3例呈实性,1例伴局部软脑膜受侵,1例伴出血及室管膜受侵(伴间变特征),1例伴侧脑室播散(伴间变特征).肿瘤实性区均呈明显强化的稍长T1稍长T2信号,扩散加权成像呈等或稍高信号,表观扩散系数值与正常皮层下脑白质差异无统计学意义(P>0.05).2例囊实性者囊壁强化.所有肿瘤周围均有轻到中度水肿.2例肿瘤实性区呈高灌注,胆碱峰明显升高,N-乙酰天门冬氨酸峰明显下降,多见乳酸峰.结论: PXA好发于青少年,多发生于幕上脑浅部,多位于颞叶,其病理学及遗传学特征有别于其他星形细胞瘤,肿瘤全切是预后的主要保证.PXA的常规MRI、磁共振灌注加权成像和磁共振波谱具有一定特点.
    Abstract: Objective: To analyze the MRI features of brain pleomorphic xanthoastrocytomas(PXA) in 8 cases for improving its clinical,pathological and MRI features understanding.Methods: The MRI plain scans,enhanced scans and DWI were explored in 8 cases with brain PXA diagnosed by pathology,and the MRS combined with PWI were examined in 2 cases.Results: Three patients were male and 5 patients were female,the age of all patients ranged from 14 to 56 years old(including 6 patients less than 25 years old).Interstitial change in 2 cases were found.Single lesion in 7 cases and single lesion complicated with round multiple lesions in 1 case with interstitial change were found.Five cases located or involved in temporal lobe,6 cases located in the cortex and subcortical region.Solid-cystic tumors in 5 cases and solid tumors in 3 cases(including 1 case with partial pia mater invasion,1 case with bleeding and ependymal invasion and 1 case with lateral ventricle spread) were identified by MRI.The tumor solid area showed slightly hypointense on T1-weighted images,slightly hyperintense on T2-weighted images and marked enhancement.The difference between the apparent diffusion coefficient value and subcortex alba was not statistical significance(P>0.05).The solid-cystic capsule wall enhanced in 2 cases.The light to moderate degree edema around the tumor were detected in all tumors.The significant increasing Cho peak and decreasing N-acetyl aspartic acid peak and Lip peak were found in tumor solid area with high perfusion.Conclusions: PXA occurres usually in adolescent,which locates the brain shallow position of the temporal lobe.The tumor pathologic and genetic characteristics are different from other astrocytomas,complete surgical excision is important for a good prognosis.The conventional magnetic resonance imaging,magnetic resonance perfusion weighted imaging and magnetic resonance spectroscopy of PXA have certain characteristics.
  • [1] Lim S,Kim JH,Kim SA,et al.Prognostic factors and therapeutic outcomes in 22 patients with pleomorphic xanthoastrocytoma[J].J Korean Neurosurg Soc,2013,3(5):281-287.
    [2] Yu S,He L,Zhuang X,et al.Pleomorphic xanthoastrocytoma:MR imaging nding in 19 patients[J].Acta Radiol,2011,52(2):223-228.
    [3] Goncalves VT,Reis F,Queiroz Lde S,et al.Pleomorphic xanthoastrocytoma:magnetic resonance imaging findings in a series of cases with histopathological confrmation[J].Arq Neuropsiquiatr,2013,71(1):35-39.
    [4] van Roost D,Kristof R,Zentner J,et al.Clinical,radiological,and therapeutic features of pleomorphic xanthoastrocytoma:report of three patients and review of the literature[J].J Neurol Neurosurg Psychiatry,1996,60(6):690-692.
    [5] Im SH,Chung CK,Kim SK,et al.Pleomorphic xanthoastrocytoma:a developmental glioneuronal tumor with prominent glioproliferative changes[J].J Neurooncol,2004,66(1/2):17-27.
    [6] Horiguchi S,Mitsuya K,Watanabe R,et al.Pleomorphic xanthoastrocytoma and moyamoya disease in a patient with neurofibromatosis type 1-case report-[J].Neurol Med Chir(Tokyo),2011,51(4):310-314.
    [7] Hamlat A,Le Strat A,Guegan Y,et al.Cerebellar pleomorphic xanthoastrocytoma:case report and literature review[J].Surg Neurol,2007,68(1):89-95.
    [8] Okazaki T,Kageji T,Matsuzaki K,et al.Primary anaplastic pleomorphic xanthoastrocytoma with widespread neuroaxis dissemination at diagnosis a pediatric case report and review of the literature[J].J Neurooncol,2009,94(3):431-437.
    [9] Schmidt Y,Kleinschmidt-DeMasters BK,Aisner DL,et al.Anaplastic PXA in adults:case series with clinicopathologic and molecular features[J].J Neurooncol,2013,111(1):59-69.
    [10] Ng WH,Lim T,Yeo TT.Pleomorphic xanthoastrocytoma in elderly patients may portend a poor prognosis[J].J Clin Neurosci,2008,15(4):476-478.
    [11] Marko NF,Weil RJ.The molecular biology of WHO grade Ⅱ gliomas[J].Neurosurg Focus,2013,34(2):E1.
    [12] Tsutsumi S,Abe Y,Yasumoto Y,et al.Anaplastic pleomorphic xanthoastrocytoma with a component of anaplastic astrocytoma presenting as skull base tumor followed by downward extracranial extension.Case report[J].Neurol Med Chir(Tokyo),2010,50(12):1108-1112.
    [13] Korshunov A,Golanov A.Pleomorphic xanthoastrocytomas:immunohistochemistry,grading and clinico-pathologic correlations.An analysis of 34 cases from a single institute[J].J Neuro Oncol,2001,52(1):63-72.
    [14] Chamberlain MC.Salvage therapy with BRAF inhibitors for recurrent pleomorphic xanthoastrocytoma:a retrospective case series[J].J Neurooncol,2013,114(2):237-240.
    [15] Schindler G,Capper D,Meyer J,et al.Analysis of BRAF V600E mutation in 1,320 nervous system tumors reveals high mutation frequencies in pleomorphic xanthoastrocytoma,ganglioglioma and extra-cerebellar pilocytic astrocytoma[J].Acta Neuropathol,2011,121(3):397-405.
    [16] 吕超,徐波涛,杨开军,等.多形性黄色星形细胞瘤遗传学相关研究进展[J].广东医学,2013,34(2):315-317.
    [17] Grau E,Balaguer J,Canete A,et al.Subtelomeric analysis of pediatric astrocytoma:subchromosomal instability is a distinctive feature of pleomorphic xanthoastrocytoma[J].J Neurooncol,2009,93(2):175-182.
    [18] Crespo-Rodríguez AM,Smirniotopoulos JG,Rushing EJ.MR and CT imaing of 24 pleomorphic xanthoastrecytomas and a review of the literature[J].Neuroradiology,2007,49(4):307-315.
    [19] 赵艳娥,卢光明,李南云,等.多形性黄色瘤型星形细胞瘤影像学表现与临床病理对照[J].临床放射学杂志,2008,27(6):726-730.
    [20] Yang WQ,Huang B,Liang CH.Pleomorphic xanthoastrocytoma in the lateral ventricle with extensive subarachnoid dissemination:report of a case and review of the literature[J].Chin Med J(Engl),2012,125(2):396-399.
    [21] Saikali S,Le Strat A,Heckly A,et al.Multicentric pleomorphic xanthoastrocytoma in a patient with neurofibromatosis type 1.Case report and review of the literature[J].J Neurosurg,2005,102(2):376-381.
    [22] Tien RD,Cardenas CA,Rajagopalan S.Pleomorphic xanthoastrocytoma of the brain:MR findings in six patients[J].Am J Roentgenol,1992,159(6):1287-1290.
    [23] 陈小东,刘含秋,陆健,等.多形性黄色星形细胞瘤的影像学表现[J].中国临床医学影像杂志,2012,23(8):533-537.
    [24] 康厚艺,刘才保,李晓光,等.多形性黄色瘤型星形细胞瘤5例MRI分析并文献复习[J].中国临床医学影像杂志,2013,24(5):309-313.
    [25] 张风光,程敬亮,张会霞,等.多形性黄色星形细胞瘤MRI分析[J].实用放射学杂志,2013,29(6):1016-1018.
    [26] 冯一鸣,汪晶,柯杨,等.多形性黄色瘤型星形细胞瘤13例报道并文献复习[J].华中科技大学学报:医学版,2013,42(1):74-77.
    [27] 张辉,苏晋生,李军乐,等.氢质子磁共振波谱在脑星形细胞瘤中的应用[J].中国医学影像技术,2007,23(1):37-40.
    [28] 宋建勋,何宁,刘建莉.正常人脑弥散定量研究[J].中国医学影像技术,2005,21(6):850-852.
    [29] 李茂,邓德茂,李荣富,等.扩散系数值在脑星形细胞肿瘤病理学分级中的应用[J].中华放射学杂志,2007,47(10):1057-1061.
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脑多形性黄色星形细胞瘤8例临床、病理、MRI特征及文献复习

    作者简介: 张应战(1977-), 男, 主治医师.
  • 1. 蚌埠医学院第二附属医院 放射科, 安徽 蚌埠 233040;
  • 2. 中国人民解放军第105医院, 影像科, 安徽 合肥 230031;
  • 3. 中国人民解放军第105医院, 病理科, 安徽 合肥 230031;
  • 4. 安徽医科大学 解剖学教研室, 安徽 合肥 230032
  • 收稿日期: 2014-06-05
基金项目:  国家自然科学基金青年资助项目(81200895)

摘要: 目的: 提高对脑多形性黄色星形细胞瘤(PXA)临床、病理及MRI特征的认识.方法: 回顾性分析8例PXA的MRI表现并复习相关文献,8例脑PXA均经病理证实,均行MRI平扫、增强扫描及扩散加权成像,2例行多体素磁共振波谱(TE135ms)和灌注加权成像检查.结果: 8例PXA年龄14~56岁,25岁以下者6例.伴间变特征者2例.7例单发,1例伴间变特征者为单发肿块伴周围子灶.5例发生或累及颞叶,6例位于皮层及皮层下.MRI表现5例呈囊实性,3例呈实性,1例伴局部软脑膜受侵,1例伴出血及室管膜受侵(伴间变特征),1例伴侧脑室播散(伴间变特征).肿瘤实性区均呈明显强化的稍长T1稍长T2信号,扩散加权成像呈等或稍高信号,表观扩散系数值与正常皮层下脑白质差异无统计学意义(P>0.05).2例囊实性者囊壁强化.所有肿瘤周围均有轻到中度水肿.2例肿瘤实性区呈高灌注,胆碱峰明显升高,N-乙酰天门冬氨酸峰明显下降,多见乳酸峰.结论: PXA好发于青少年,多发生于幕上脑浅部,多位于颞叶,其病理学及遗传学特征有别于其他星形细胞瘤,肿瘤全切是预后的主要保证.PXA的常规MRI、磁共振灌注加权成像和磁共振波谱具有一定特点.

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