Kim D G, Chi J G, Park S H, Chang K H, Lee S H, Jung H W, Kim H J, Cho B K, Choi K S, Han D H
Department of Neurosurgery, Seoul National University College of Medicine, Korea.
J Neurosurg. 1992 May;76(5):759-65. doi: 10.3171/jns.1992.76.5.0759.
A retrospective analysis of seven patients with intraventricular neurocytoma is presented. Patient age at diagnosis ranged from 15 to 38 years (mean 24.6 years) and the male:female ratio was 6:1. Raised intracranial pressure due to hydrocephalus was the main cause of the clinical manifestations. An isodense mass with multiple intratumoral cysts and homogeneous contrast enhancement was the characteristic computerized tomography finding. The lesions commonly involved the lateral ventricle with or without extension to the third ventricle. Cerebral angiography showed homogeneous vascular staining in five patients. Magnetic resonance images revealed a mass isointense with the cerebral cortex on both T1- and T2-weighted images. Gadolinium-diethylenetriaminepenta-acetic acid-enhanced images showed homogeneous enhancement. Total removal of the tumor was possible in four patients. Pathologically, six cases were initially diagnosed as oligodendroglioma and the remaining case as ependymoma. However, immunohistochemical studies demonstrated strong positivity for neuron-specific enolase in all seven cases and for synaptophysin in five cases. On electron microscopy, three cases showed well-defined neurosecretory granules and 10-nm microtubules in their cytoplasm and cytoplasmic processes. One patient developed a recurrent tumor 18 months after surgery. The remaining six patients are free of recurrent tumors at 2 to 62 months after surgery. It is suggested that neurocytoma must be included in the differential diagnosis of intraventricular lesions, and that electron microscopic and immunohistochemical studies should be undertaken.
本文对7例脑室内神经细胞瘤患者进行了回顾性分析。诊断时患者年龄为15至38岁（平均24.6岁），男女比例为6:1。脑积水导致的颅内压升高是临床表现的主要原因。等密度肿块伴多个瘤内囊肿及均匀强化是计算机断层扫描的特征性表现。病变通常累及侧脑室，可伴有或不伴有向第三脑室的延伸。脑血管造影显示5例患者有均匀的血管染色。磁共振成像显示在T1加权和T2加权图像上肿块与脑皮质等信号。钆-二乙三胺五乙酸增强图像显示均匀强化。4例患者实现了肿瘤全切。病理上，6例最初诊断为少突胶质细胞瘤，其余1例诊断为室管膜瘤。然而，免疫组化研究显示所有7例患者神经元特异性烯醇化酶均呈强阳性，5例患者突触素呈阳性。电镜下，3例患者的细胞质及胞质突起中可见明确的神经分泌颗粒和10纳米微管。1例患者术后18个月肿瘤复发。其余6例患者术后2至62个月无肿瘤复发。提示脑室内病变的鉴别诊断必须包括神经细胞瘤，且应进行电镜和免疫组化研究。
