Sugita Y, Kepes J J, Shigemori M, Kuramoto S, Reifenberger G, Kiwit J C, Wechsler W
Department of Pathology and Oncology, University of Kansas College of Health Sciences and Hospital, Kansas City 66103.
Clin Neuropathol. 1990 Nov-Dec;9(6):271-8.
Two cases of cerebral pleomorphic xanthoastrocytomas (PXA-s) with prominent vascularity and desmoplastic changes occurring in young subjects are presented. The tumors displayed the marked pleomorphism characteristic of PXA-s and had variable cellularity. The cytoplasm of many tumor cells contained an abundance of lipid droplets. Most tumor cells were positive for glial fibrillary acidic protein. The unusual feature about these tumors was the presence of very large numbers of tiny blood vessels with variable thickness of their walls. In many areas the small vessels and the neoplastic astrocytes were in close proximity to each other, with capillaries adjacent to or protruding into tumor cell cytoplasm, reminiscent of the pattern seen in highly vascularized or "angiomatous" meningiomas. In other areas extensive fibrosis was seen. We feel that the latter, as in the cases of comparably vascular meningiomas, had its origin in congelation and secondary organization of plasma proteins that have exuded through leaky walls of newly formed blood vessels. These are the first reported cases of PXA with an angiogliomatous pattern.
本文报告了两例发生于年轻患者的脑多形性黄色星形细胞瘤（PXA-s），其具有显著的血管增生和促纤维增生性改变。肿瘤呈现出PXA-s典型的显著多形性，细胞密度各异。许多肿瘤细胞的细胞质中含有大量脂滴。大多数肿瘤细胞胶质纤维酸性蛋白呈阳性。这些肿瘤的不寻常特征是存在大量壁厚度不一的微小血管。在许多区域，小血管与肿瘤性星形胶质细胞紧密相邻，毛细血管紧邻肿瘤细胞或突入肿瘤细胞胞质，这让人联想到在高度血管化或“血管瘤样”脑膜瘤中所见的模式。在其他区域可见广泛纤维化。我们认为，与血管丰富的脑膜瘤病例一样，后者起源于通过新生血管渗漏壁渗出的血浆蛋白的凝固和继发性机化。这是首次报道的具有血管性胶质瘤样模式的PXA病例。
