Department of Pathology, State Key Laboratory of Cancer Biology, Xijing Hospital, Xi'an, Shaanxi Province, China.
Neuropathology. 2010 Jun;30(3):294-8. doi: 10.1111/j.1440-1789.2009.01064.x. Epub 2009 Oct 21.
We report a case of malignant solitary fibrous tumor involving the pineal region in a 49-year-old woman. The patient presented with headache, slowly progressive weakness of the right lower extremities and upgaze palsy over the past year. Histologically, the tumor was composed of moderately hypercellular proliferated spindle cells with eosinophilic collagen bands. These cells were diffusely and strongly immunoreactive with CD34, CD99, and vimentin, but were negative with epithelial membrane antigen, S-100 protein, Bcl-2, smooth muscle actin, cytokeratin and glial fibrillary antigenic protein. MIB-1 labeling indices and mitosis rates were 7.3 +/- 1.8% and 5 per 10 high power fields, respectively. Ultrastructural examination revealed that the neoplastic cells had features of fibroblastic differentiation. Differential diagnoses included fibrous meningioma and hemangiopericytoma. The present case provides one unique example of a rare entity to the already diverse spectrum of the pineal region neoplasms encountered in neuropathology.
我们报告一例 49 岁女性发生于松果体区的恶性孤立性纤维性肿瘤。患者在过去一年中出现头痛，右侧下肢进行性无力和上视不能。组织学上，肿瘤由中等细胞密度增生的梭形细胞组成，伴嗜酸性胶原带。这些细胞弥漫且强阳性表达 CD34、CD99 和波形蛋白，但阴性表达上皮膜抗原、S-100 蛋白、Bcl-2、平滑肌肌动蛋白、细胞角蛋白和胶质纤维酸性蛋白。MIB-1 标记指数和有丝分裂率分别为 7.3 +/- 1.8%和 5/10 高倍视野。超微结构检查显示肿瘤细胞具有成纤维细胞分化的特征。鉴别诊断包括纤维性脑膜瘤和血管外皮细胞瘤。本病例为神经病理学中已多样化的松果体区肿瘤谱中罕见实体的又一独特实例。
