Capizzano A A, Kirby P, Moritani T
Division of Neuroradiology, Department of Radiology, University of Iowa Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA, 52242, USA,
Clin Neuroradiol. 2015 Jun;25(2):127-35. doi: 10.1007/s00062-014-0287-5. Epub 2014 Jan 29.
The purpose of this study was to assess imaging and pathologic characteristics of limbic tumors. Our hypothesis was that temporal lobe limbic tumors have distinctive features from extralimbic tumors.
This retrospective radiologic-pathologic correlation study of primary temporal lobe tumors (excluding glioblastoma) distinguished limbic from extralimbic tumors based on preoperative magnetic resonance imaging. Limbic tumors were categorized according to Yaşargil's classification into (1) mediobasal temporal (mbT), (2) insular-temporo-opercular (I-TO), and (3) fronto-orbital-insular-temporopolar (FO-I-TP).
A total of 50 cases with a mean age at diagnosis of 38 ± 19.9 years (14 women, 36 men) were included. Pathologic diagnoses were as follows: 20 anaplastic astrocytomas, 11 gangliogliomas, 8 astrocytomas (World Health Organization grade II), 3 pilocytic astrocytomas, 2 dysembryoplastic neuroepithelial tumors, 2 oligodendrogliomas (grade II), 2 anaplastic oligodendrogliomas, 1 low-grade glioneuronal tumor, and 1 atypical extraventricular neurocytoma. In all, 36 tumors were limbic and displayed consistent growth patterns (16 mbT, 11 I-TO, 8 FO-I-TP, and 1 pantemporal) and 14 were extralimbic. There were no differences between limbic and extralimbic tumors with regard to age, sex, pathologic diagnosis, and presentation with seizures. mbT tumors had more frequent neuronal differentiation (50 %) than I-TO (0 %) and FO-I-TP (25 %) tumors (chi-square = 7.8, df = 2, p = 0.02). Neuronal differentiation correlated with lower grade (r = 0.52, p < 0.01) and younger age (r = 0.52, p < 0.01).
Limbic tumors displayed consistent growth routes. mbT limbic tumors had more frequent neuronal differentiation, which may result from proximity to the neurogenic subgranular zone of the hippocampus. Neuronal differentiation was maximal in mbT and lowest in I-TO and FO-I-TP tumors and correlated with lower tumor grade and younger age at diagnosis.
本研究旨在评估边缘叶肿瘤的影像学和病理学特征。我们的假设是颞叶边缘叶肿瘤具有与边缘叶外肿瘤不同的特征。
这项对原发性颞叶肿瘤（不包括胶质母细胞瘤）的回顾性放射学 - 病理学相关性研究，根据术前磁共振成像区分边缘叶肿瘤和边缘叶外肿瘤。边缘叶肿瘤根据亚萨吉尔分类法分为：（1）颞叶中基部（mbT），（2）岛叶 - 颞叶 - 脑岛盖部（I - TO），以及（3）额 - 眶 - 岛 - 颞极部（FO - I - TP）。
共纳入50例患者，诊断时平均年龄为38±19.9岁（女性14例，男性36例）。病理诊断如下：20例间变性星形细胞瘤，11例神经节胶质瘤，8例星形细胞瘤（世界卫生组织二级），3例毛细胞型星形细胞瘤，2例胚胎发育不良性神经上皮肿瘤，2例少突胶质细胞瘤（二级），2例间变性少突胶质细胞瘤，1例低级别神经胶质神经元肿瘤，以及1例非典型脑室外神经细胞瘤。总体而言，36例肿瘤为边缘叶肿瘤，呈现一致的生长模式（16例mbT，11例I - TO，8例FO - I - TP，1例全颞叶型），14例为边缘叶外肿瘤。边缘叶肿瘤和边缘叶外肿瘤在年龄、性别、病理诊断以及癫痫发作表现方面无差异。mbT肿瘤的神经元分化频率（50%）高于I - TO（0%）和FO - I - TP（25%）肿瘤（卡方检验=7.8，自由度=2，p = 0.02）。神经元分化与较低级别（r = 0.52, p < 0.01）和较年轻年龄（r = 0.52, p < 0.01）相关。
边缘叶肿瘤呈现一致的生长路径。mbT边缘叶肿瘤的神经元分化更频繁，这可能是由于其靠近海马体的神经源性颗粒下区。神经元分化在mbT肿瘤中最高，在I - TO和FO - I - TP肿瘤中最低，并且与较低的肿瘤级别和诊断时较年轻的年龄相关。
