Payano Maria, Kondo Yoshiyuki, Kashima Kenji, Daa Tsutoma, Yatsuka Tomoji, Kida Hirotaka, Nakayama Iwao, Yokoyama Shigeo
Department of Pathology, Oita University Faculty of Medicine, Oita, Japan.
APMIS. 2004 Feb;112(2):141-7. doi: 10.1111/j.1600-0463.2004.apm1120209.x.
Clear cell meningioma is a rare disorder. We report two cases of nondura-based clear cell meningioma of the cauda equina, one in a 24-year-old male and the other in a 19-year-old female. Both patients had complained of numbness and spontaneous pain in the lower back and limbs for several months. Magnetic resonance imaging and computed tomography scanning revealed an intradural tumor in the cauda equina in each case. At surgery, a neurilemoma was suspected, because each of the tumors had displaced nerve roots and had attached to one of the nerve roots without any adherence to the dura. Light microscopy revealed that both tumors were well-demarcated with a thin capsule and consisted mainly of clear, glycogen-rich, polygonal cells with vague whorl formations, and of copious deposits of hyalinized blocky collagen in the stroma and perivascular areas. The neoplastic cells were immunopositive for vimentin and epithelial membrane antigen, but immunonegative for S-100 protein and chromogranin A. Positive nuclei for MIB-1 were very few in both cases, and PCNA-labeling indices were 12.1% and 24.7%, respectively. No local recurrence has been seen for 61 months and for 52 months, respectively.
透明细胞型脑膜瘤是一种罕见的疾病。我们报告两例马尾非硬脑膜起源的透明细胞型脑膜瘤，一例为24岁男性，另一例为19岁女性。两名患者均主诉下背部及四肢麻木和自发疼痛数月。磁共振成像和计算机断层扫描显示两例均为马尾硬膜内肿瘤。手术时，怀疑为神经鞘瘤，因为每个肿瘤均使神经根移位并附着于一根神经根，未与硬脑膜粘连。光镜检查显示，两个肿瘤边界清楚，有薄包膜，主要由透明、富含糖原的多边形细胞组成，有模糊的漩涡状结构，间质和血管周围区域有大量玻璃样变的块状胶原沉积。肿瘤细胞波形蛋白和上皮膜抗原免疫阳性，但S-100蛋白和嗜铬粒蛋白A免疫阴性。两例MIB-1阳性核均很少，增殖细胞核抗原标记指数分别为12.1%和24.7%。分别随访61个月和52个月均未见局部复发。
