Kim Dong Sug, Park So Yoon, Lee Sang Pyung
Department of Pathology, Yeungnam University College of Medicine, Daegu, Korea.
J Korean Med Sci. 2004 Oct;19(5):772-6. doi: 10.3346/jkms.2004.19.5.772.
Astroblastoma is one of the very unusual type of tumors, whose histogenesis has not been clarified. It occurs mainly among children or young adults. Astroblastoma is grossly well-demarcated, and shows histologically characteristic perivascular pseudorosettes with frequent vascular hyalinization. Perivascular pseudorosettes in astroblastoma have short and thick cytoplasmic processes and blunt-ended foot plates. A 15-yr-old girl presented with headache and diplopia for one and a half year. A well-demarcated mass, 9.7 cm in diameter, was found in the right frontal lobe in brain MRI, and it was a well-enhanced inhomogenous mass. Cystic changes of various sizes were observed inside the tumor mass as well as in the posterior part of the mass, but no peritumoral edema was found. Histologically, this mass belongs to a typical astroblastoma, and no sign of anaplastic astrocytoma, gemistocytic astrocytoma or glioblastoma was found in any part of the tumor. Immunohistochemically, the tumor cells showed diffuse strong positivity for glial fibrillary acidic protein, S-100 protein, vimentin and neuron specific enolase, and focal positivity for epithelial membrane antigen and CAM 5.2, while showing negativity for synaptophysin, neurofilament protein, pan-cytokeratin and high molecular weight keratin.
成星形细胞瘤是一种非常罕见的肿瘤类型,其组织发生尚未明确。它主要发生于儿童或年轻成年人。成星形细胞瘤大体上界限清楚,组织学上显示具有频繁血管玻璃样变的特征性血管周围假菊形团。成星形细胞瘤中的血管周围假菊形团具有短而粗的胞质突起和钝端脚板。一名15岁女孩因头痛和复视就诊,症状持续了一年半。脑部MRI检查发现右侧额叶有一个界限清楚的肿块,直径9.7厘米,是一个强化不均匀的肿块。在肿瘤块内部以及肿块后部观察到各种大小的囊性改变,但未发现瘤周水肿。组织学上,该肿块属于典型的成星形细胞瘤,在肿瘤的任何部位均未发现间变性星形细胞瘤、肥胖细胞型星形细胞瘤或胶质母细胞瘤的迹象。免疫组化显示,肿瘤细胞对胶质纤维酸性蛋白、S-100蛋白、波形蛋白和神经元特异性烯醇化酶呈弥漫性强阳性,对上皮膜抗原和CAM 5.2呈局灶性阳性,而对突触素、神经丝蛋白、全细胞角蛋白和高分子量角蛋白呈阴性。