Shintaku Masayuki, Nagata Norikazu, Itoh Hiroshi
Department of Pathology, Osaka Red Cross Hospital, Tennoji, Osaka 543-8555, Japan.
Brain Tumor Pathol. 2009;26(1):7-10. doi: 10.1007/s10014-008-0239-3. Epub 2009 Apr 30.
In a 43-year-old man, an intramedullary spinal cord tumor spreading from the level of the T2 to T5 vertebrae was subtotally resected. The tumor predominantly consisted of a fascicular proliferation of spindle cells having bland nuclei and bipolar, long cytoplasmic processes, and a few perivascular pseudo-rosettes were found. Although there were no true ependymal rosettes, intracytoplasmic dot-like immunoreactivity for epithelial membrane antigen (EMA) was found in a few cells. In some areas, a dense and diffuse proliferation of anaplastic, short-spindled cells having hyperchromatic nuclei and scant cytoplasm was noted, and the Ki-67 labeling index was remarkably higher (18.2%) in these areas. Neither microvascular proliferation nor necrosis was observed. In the boundary region, these two areas showed gradual transition from one to the other. The patient has remained free from recurrence for 10 months postoperatively. This is the first documentation of tanycytic ependymoma in which tumor cells showed anaplastic cytological features.
在一名43岁男性患者中，对一个从T2至T5椎体水平蔓延的脊髓内肿瘤进行了次全切除。肿瘤主要由梭形细胞的束状增生构成，这些梭形细胞核呈淡染，具有双极、长的胞质突起，并且发现了一些血管周围假菊形团。虽然没有真正的室管膜菊形团，但在少数细胞中发现了针对上皮膜抗原（EMA）的胞质内点状免疫反应性。在一些区域，观察到具有核深染和胞质稀少的间变性短梭形细胞的密集和弥漫性增生，并且这些区域的Ki-67标记指数显著更高（18.2%）。未观察到微血管增生和坏死。在边界区域，这两个区域显示出从一个到另一个的逐渐过渡。该患者术后10个月未复发。这是首次记录肿瘤细胞表现出间变性细胞学特征的束状室管膜瘤。
