Cummings T J, Burchette J L, McLendon R E
Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA.
Acta Neuropathol. 2001 Oct;102(4):349-54. doi: 10.1007/s004010100389.
Intracranial solitary fibrous tumors (SFTs) are typically dural-based, CD34-positive neoplasms of uncertain histogenesis. We examined ten cases of meninges obtained at autopsy from patients with no history of neurological illness, head trauma, or neurosurgical intervention, and ten cases of typical meningiomas with attached dural margins not involved by tumor. All cases were immunostained with CD34. CD34 reactivity was noted in the long, thin delicate processes of dural fibroblasts preferentially located in the meningeal portion of the dura rather than the periosteal portion. No CD34 reactivity was identified in the arachnoid or pia mater, except in some endothelial cells. One supratentorial dural-based fibrous nodule and one SFT within the confines of the fourth ventricle showed strong and diffuse reactivity to CD34, bcl-2, and vimentin, and were negative for epithelial membrane antigen (EMA), S-100 protein, glial fibrillary acidic protein, smooth muscle actin, and desmin. We also describe a meningothelial meningioma within which a well circumscribed SFT-like nodule was embedded. The SFT-like nodule was strongly CD34 positive and EMA negative, and the meningioma was strongly EMA positive and CD34 negative. Fibroblasts of the dural border cell layer are attached to the underlying arachnoid, and their inclusion with arachnoidal stromal elements and pial-based tela choroidea during formation of choroid plexus interstitium may account for intraventricular SFTs. Our results suggest that SFTs and dural-based fibrous nodules derive from CD34-positive dural-based fibroblasts, and that CD34 reactivity in meningiomas may result from inclusion of dural fibroblasts within the neoplasm.
颅内孤立性纤维瘤(SFTs)通常是起源于硬脑膜、CD34阳性、组织发生不明的肿瘤。我们检查了10例尸检获得的脑膜标本,这些患者无神经疾病、头部外伤或神经外科干预史,以及10例伴有未被肿瘤累及的硬脑膜边缘的典型脑膜瘤。所有病例均进行了CD34免疫染色。在硬脑膜成纤维细胞细长、纤细的突起中观察到CD34反应性,这些突起优先位于硬脑膜的脑膜部分而非骨膜部分。除了一些内皮细胞外,在蛛网膜或软脑膜中未发现CD34反应性。一个幕上硬脑膜纤维结节和一个位于第四脑室内的SFT对CD34、bcl-2和波形蛋白呈强弥漫性反应,而上皮膜抗原(EMA)、S-100蛋白、胶质纤维酸性蛋白、平滑肌肌动蛋白和结蛋白均为阴性。我们还描述了一例脑膜内皮型脑膜瘤,其中嵌入了一个边界清楚的SFT样结节。SFT样结节CD34强阳性、EMA阴性,而脑膜瘤EMA强阳性、CD34阴性。硬脑膜边界细胞层的成纤维细胞附着于下方的蛛网膜,在脉络丛间质形成过程中,它们与蛛网膜基质成分和软脑膜脉络膜组织一起参与,这可能解释了脑室内SFT的发生。我们的结果表明,SFT和硬脑膜纤维结节起源于CD34阳性的硬脑膜成纤维细胞,脑膜瘤中的CD34反应性可能是由于肿瘤内包含硬脑膜成纤维细胞所致。