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筛状神经上皮肿瘤(CRINET):一种具有INI1缺失且预后相对良好的非横纹肌样室管膜肿瘤。

Cribriform neuroepithelial tumor (CRINET): a nonrhabdoid ventricular tumor with INI1 loss and relatively favorable prognosis.

作者信息

Hasselblatt Martin, Oyen Florian, Gesk Stefan, Kordes Uwe, Wrede Brigitte, Bergmann Markus, Schmid Hansjörg, Frühwald Michael C, Schneppenheim Reinhard, Siebert Reiner, Paulus Werner

机构信息

Institute of Neuropathology, University Hospital Münster, Münster, Germany.

出版信息

J Neuropathol Exp Neurol. 2009 Dec;68(12):1249-55. doi: 10.1097/NEN.0b013e3181c06a51.

Abstract

Atypical teratoid/rhabdoid tumors are malignant embryonal tumors characterized by the presence of rhabdoid cells, genetic alterations affecting the SMARCB1 gene (hSNF5/INI1), and a poor prognosis. Whether INI1 plays a role in the pathogenesis of other central nervous system tumors is uncertain. We report on cases of 2 young children with unusual intracranial nonrhabdoid neuroectodermal tumors within and around the third or fourth ventricle that are characterized by cribriform strands and trabeculae and well-defined epithelial membrane antigen-immunopositive surfaces and show INI1 protein loss. Histological and immunohistochemical features did not correspond to established tumor types, including atypical teratoid/rhabdoid tumors, medulloepithelioma, choroid plexus carcinoma, and ependymoma. Fluorescence in situ hybridization analyses failed to identify chromosomal alterations affecting the SMARCB1 locus, but sequencing revealed a homozygous 4-bp duplication in exon 4 (492duplCCTT) in one of the tumors. Both children responded well to conventional adjuvant therapy protocols and are alive and in complete remission longer than 5 years postoperatively. We suggest that cribriform neuroepithelial tumor (CRINET) is a nonrhabdoid ventricular tumor that shows loss of tumoral INI1 protein and has a relatively favorable prognosis.

摘要

非典型畸胎样/横纹肌样瘤是一种恶性胚胎性肿瘤,其特征为存在横纹肌样细胞、影响SMARCB1基因(hSNF5/INI1)的基因改变以及预后不良。INI1是否在其他中枢神经系统肿瘤的发病机制中起作用尚不确定。我们报告了2例幼儿病例,他们患有位于第三或第四脑室内及周围的不寻常颅内非横纹肌样神经外胚层肿瘤,其特征为筛状条索和小梁以及界限清晰的上皮膜抗原免疫阳性表面,且显示INI1蛋白缺失。组织学和免疫组化特征与已确定的肿瘤类型不符,包括非典型畸胎样/横纹肌样瘤、髓上皮瘤、脉络丛癌和室管膜瘤。荧光原位杂交分析未能识别出影响SMARCB1基因座的染色体改变,但测序显示其中一个肿瘤的外显子4存在纯合的4碱基对重复(492duplCCTT)。两名患儿对传统辅助治疗方案反应良好,术后存活且完全缓解超过5年。我们认为筛状神经上皮肿瘤(CRINET)是一种非横纹肌样室管膜肿瘤,显示肿瘤性INI1蛋白缺失且预后相对良好。

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