Department of Neurosurgery, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan.
Brain Tumor Pathol. 2010 Oct;27(2):127-31. doi: 10.1007/s10014-010-0274-8. Epub 2010 Nov 3.
We report a rare case of epileptogenic glioma composed of glial progenitor cells that differentiated into an astrocytic and oligodendrocytic tumor. This 4-year-old girl presented with a 1-year history of complex partial seizure. MR scan showed a mass in the left temporal lobe with a cyst and a contrast-enhanced component. Subtotal resection of the tumor was achieved. Histological examination revealed that the tumor exhibited low cellularity composed of astrocytic and oligodendrocytic components, as well as low mitotic activity (MIB-1 = 1%). Immunohistochemical examination revealed GFAP positivity within the astrocytic cells, olig2 positivity within the oligodendrocytic cells, and S100 positivity in both cell types. MAP2 and CD34 were negative, and neurofilament was only positive in preexisting neurons. The pathological diagnosis was epileptogenic glioma (grade I) composed of glial progenitor cells. The postoperative course has been uneventful with good seizure control for 3 years.
我们报告一例罕见的由神经胶质祖细胞分化为星形细胞瘤和少突胶质细胞瘤的致痫性神经胶质瘤。该 4 岁女孩因复杂部分性癫痫发作病史 1 年就诊。MR 扫描显示左颞叶有一个带有囊肿和对比增强成分的肿块。肿瘤行次全切除术。组织学检查显示肿瘤细胞密度低，由星形细胞瘤和少突胶质细胞瘤组成，有丝分裂活性低（MIB-1 = 1%）。免疫组化检查显示星形细胞瘤内 GFAP 阳性，少突胶质细胞瘤内 olig2 阳性，两种细胞类型内 S100 阳性。MAP2 和 CD34 阴性，神经丝仅在原有神经元中阳性。病理诊断为致痫性神经胶质瘤（I 级），由神经胶质祖细胞组成。术后 3 年无并发症，癫痫得到良好控制。
