Shibahara Ichiyo, Kanamori Masayuki, Kumabe Toshihiro, Endo Hidenori, Sonoda Yukihiko, Ogawa Yoshikazu, Watanabe Mika, Tominaga Teiji
Department of Neurosurgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
Brain Tumor Pathol. 2009;26(1):1-5. doi: 10.1007/s10014-008-0243-7. Epub 2009 Apr 30.
The incidence of hemorrhagic onset in pilocytic astrocytoma and pilomyxoid astrocytoma, and the clinical and histological characteristics, were compared to other types of neuroepithelial tumors or nonhemorrhagic pilocytic astrocytoma by retrospective review of 445 consecutive neuroepithelial tumors treated at our institute. Hemorrhagic onset was observed in 4 of 35 (11.4%) patients with pilocytic astrocytoma and pilomyxoid astrocytoma, with higher incidence than in glioblastoma (3.9%), anaplastic oligodendroglioma (7.7%), and anaplastic ependymoma (7.1%). The hemorrhagic onset occurred in 2 patients with sporadic pilocytic astrocytoma, 1 with pilocytic astrocytoma associated with neurofibromatosis type 1, and 1 with pilomyxoid astrocytoma. There was no correlation between hemorrhagic onset and clinical features, including age, sex, tumor location, proliferative activity, or microvascular proliferation. Hemorrhagic onset of pilocytic astrocytoma and pilomyxoid astrocytoma is not as uncommon as was previously thought, so pilocytic astrocytoma or pilomyxoid astrocytoma should be considered in the differential diagnosis of patients with brain tumors manifesting as hemorrhagic onset.
通过对我院连续治疗的445例神经上皮肿瘤进行回顾性研究，比较了毛细胞型星形细胞瘤和毛黏液样星形细胞瘤出血性发病的发生率及其临床和组织学特征，并与其他类型的神经上皮肿瘤或非出血性毛细胞型星形细胞瘤进行了对比。在35例毛细胞型星形细胞瘤和毛黏液样星形细胞瘤患者中，有4例（11.4%）出现出血性发病，其发生率高于胶质母细胞瘤（3.9%）、间变性少突胶质细胞瘤（7.7%）和间变性室管膜瘤（7.1%）。出血性发病的患者中，2例为散发性毛细胞型星形细胞瘤，1例为与1型神经纤维瘤病相关的毛细胞型星形细胞瘤，1例为毛黏液样星形细胞瘤。出血性发病与包括年龄、性别、肿瘤位置、增殖活性或微血管增殖在内的临床特征之间无相关性。毛细胞型星形细胞瘤和毛黏液样星形细胞瘤的出血性发病并不像之前认为的那样罕见，因此在对表现为出血性发病的脑肿瘤患者进行鉴别诊断时，应考虑毛细胞型星形细胞瘤或毛黏液样星形细胞瘤。
