Li Xin-jun, Zhang Hong-ying, Lang Zhi-qiang, Wei Bing, Chen Hui-jiao, Bu Hong
Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2006 May;37(3):488-91.
To investigate the clinicopathologic and immunohistochemical features of secretory meningiomas.
Nine secretory meningiomas were examined. From each specimen, sections were cut and stained with hematoxylin-eosin, periodic acid-Schiff (PAS) stain, and periodic acid-Schiff stain with diatase(PAS-D ). Immunohistochemical markers including oestrogen receptor (ER), progesterone receptor (PR), carcinoembryonic antigen (CEA), cytokeratin (CK), epithelial membrane antigen (EMA), and MIB-1 were detected with streptavidin peroxidase (SP) immunohistochemical staining methods. One case was observed by electron microscopy (EM).
The 9 secretory meningiomas were located at sphenoid ridge, left parietal lobe or frontal lobe. Severe peritumoral edema was observed in 5 cases. Seven cases were followed up for 6 to 88 months; none of them showed evidence of recurrence. Histologically, the conspicuous feature was the eosinophilic inclusions. The finding of pericytic proliferation on examination was helpful to making a diagnosis. In all 9 cases, the tumor cells were positive for PR, but in 6 cases the inclusions were negative. ER was negative in 8 cases. CEA,CK, EMA expressed in the inclusions and the surrounding cells in 7 cases. In 1 case the positive rate for MIB-1 was 5%, but in the other 8 cases the positive rates were not more than 2%. The intercellular lumens and intracellular mucosa were observed under EM.
Secretory meningioma is a rare subtype of meningioma that shows glandular epithelium differentiation. It is a meningioma of the low-risk type in terms of incidence, recurrence and prognosis.
探讨分泌型脑膜瘤的临床病理及免疫组化特征。
对9例分泌型脑膜瘤进行检查。从每个标本上切取切片,进行苏木精-伊红染色、过碘酸-希夫(PAS)染色及过碘酸-希夫酶消化染色(PAS-D)。采用链霉亲和素过氧化物酶(SP)免疫组化染色法检测雌激素受体(ER)、孕激素受体(PR)、癌胚抗原(CEA)、细胞角蛋白(CK)、上皮膜抗原(EMA)和MIB-1等免疫组化标志物。对1例进行电子显微镜(EM)观察。
9例分泌型脑膜瘤位于蝶骨嵴、左顶叶或额叶。5例观察到严重的瘤周水肿。7例随访6至88个月;均无复发迹象。组织学上,显著特征为嗜酸性包涵体。检查发现周细胞增殖有助于诊断。9例肿瘤细胞PR均阳性,但6例包涵体阴性。8例ER阴性。7例CEA、CK、EMA在包涵体及周围细胞中表达。1例MIB-1阳性率为5%,其他8例阳性率均不超过2%。EM下观察到细胞间腔隙和细胞内黏膜。
分泌型脑膜瘤是脑膜瘤的一种罕见亚型,表现为腺上皮分化。就发病率、复发率和预后而言,它是一种低风险类型的脑膜瘤。