Hirano Hirofumi, Yunoue Shunji, Kaji Masatomo, Tsuchiya Masahiro, Arita Kazunori
Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.
Brain Tumor Pathol. 2008;25(1):25-31. doi: 10.1007/s10014-007-0224-2. Epub 2008 Apr 16.
A 17-year-old male patient underwent surgery five times (four consecutive intracranial tumor removal surgeries and a final spinal tumor removal surgery). After the third surgery, this case was reported as a low-grade astroblastoma that is characterized by perivascular pseudorosettes consisting of elongated tumor cells arranged around the blood vessels. However, the fourth and fifth surgical specimens demonstrated very interesting histological changes in the astroblastoma. Through the course of relapses, the constituent cells of the astroblastic perivascular rosettes became smaller and rounder, and a multilayered cell arrangement was observed. The nucleus-to-cytoplasm ratio increased, and the compact intervascular cells ultimately lost glial fibrillary acidic protein (GFAP) expression. These undifferentiated cells showed high MIB-1 indices and an increased olig2 index. On the other hand, the cells in all the surgical specimens were positive for certain neuronal markers such as NSE, TUJ1, and nestin. Some astroblastomas may be more immature than the usual astrocytes; however, it is necessary to study more cases to confirm this.
一名17岁男性患者接受了五次手术(连续四次颅内肿瘤切除术和最后一次脊柱肿瘤切除术)。第三次手术后,该病例被报告为低级别成星形细胞瘤,其特征为血管周围假菊形团,由围绕血管排列的细长肿瘤细胞组成。然而,第四和第五次手术标本显示成星形细胞瘤出现了非常有趣的组织学变化。在复发过程中,成星形细胞血管周围菊形团的组成细胞变得更小、更圆,并且观察到细胞呈多层排列。核质比增加,紧密的血管间细胞最终失去胶质纤维酸性蛋白(GFAP)表达。这些未分化细胞显示出高MIB-1指数和增加的olig2指数。另一方面,所有手术标本中的细胞对某些神经元标志物如NSE、TUJ1和巢蛋白呈阳性。一些成星形细胞瘤可能比普通星形胶质细胞更不成熟;然而,有必要研究更多病例以证实这一点。