Barbosa M D, Balsitis M, Jaspan T, Lowe J
Department of Neurosurgery, University of Nottingham Medical School, England.
Neurosurgery. 1990 Jun;26(6):1045-54.
Three patients with a recently described tumor of neuronal origin, intraventricular neurocytoma, are presented. These tumors occur as intraventricular lesions in young patients, and the prognosis after surgical treatment is favorable. The initial pathological diagnosis of intraventricular neurocytoma may be difficult because of the striking resemblance of these tumors to oligodendroglioma and, to a lesser extent, ependymoma on light microscopic examination. Despite the use of wide-ranging panels of monoclonal antibodies, previous authors have not found any characteristic immunohistochemical staining patterns, but in our three patients, the use of synaptophysin, glial fibrillary acidic protein, and Leu-7 demonstrated staining patterns that may be useful in the diagnosis of this tumor. The monoclonal antibody Ki-67 was used to stain one tumor and showed a low cell proliferation rate. We have reviewed the clinical, radiological, and pathological features of these 3 patients and 17 previously described patients in an attempt to determine the important diagnostic features of intraventricular neurocytoma. Intraventricular neurocytoma should be considered in any young patient with symptoms of raised intracranial pressure and radiological evidence of an intraventricular lesion. Pathological diagnosis requires the use of electron microscopy to show features of neuronal differentiation; however, immunohistochemical demonstration of a neuronal phenotype is also a useful adjunct to diagnosis. Failure to use specialized techniques for pathological diagnosis will lead to misdiagnosis of these lesions as oligodendrogliomas, as was the initial diagnosis in 2 of our patients before review.
本文介绍了3例患有最近描述的神经元起源肿瘤——脑室内神经细胞瘤的患者。这些肿瘤在年轻患者中表现为脑室内病变，手术治疗后的预后良好。由于在光学显微镜检查下，这些肿瘤与少突胶质细胞瘤极为相似，在较小程度上与室管膜瘤也相似，因此脑室内神经细胞瘤的初步病理诊断可能存在困难。尽管使用了大量的单克隆抗体组合，之前的作者并未发现任何特征性的免疫组化染色模式，但在我们的3例患者中，使用突触素、胶质纤维酸性蛋白和Leu-7显示出的染色模式可能有助于该肿瘤的诊断。使用单克隆抗体Ki-67对其中1例肿瘤进行染色，结果显示细胞增殖率较低。我们回顾了这3例患者以及之前描述的17例患者的临床、放射学和病理特征，试图确定脑室内神经细胞瘤的重要诊断特征。任何出现颅内压升高症状且有脑室内病变放射学证据的年轻患者都应考虑脑室内神经细胞瘤的可能。病理诊断需要使用电子显微镜来显示神经元分化的特征；然而，免疫组化显示神经元表型也是诊断的有用辅助手段。未能使用专门的病理诊断技术将导致这些病变被误诊为少突胶质细胞瘤，就像我们的2例患者在回顾之前的初始诊断那样。
