Radley M G, di Sant'Agnese P A, Eskin T A, Wilbur D C
Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, New York.
Am J Clin Pathol. 1989 Sep;92(3):266-72. doi: 10.1093/ajcp/92.3.266.
Meningiomas possess features indicative of epithelial differentiation. The present study further documents this finding by a multimodality approach on serial sections from 25 meningiomas of all histologic and clinical categories. Standard light microscopic examination, immunohistochemical staining with a variety of epithelial and nonepithelial markers, and histochemical staining for mucin were performed on each case. Directed electron microscopic examination was performed on selected examples of epithelial feature-positive and -negative cases. All cases were immunoreactive for vimentin and epithelial membrane antigen. Thirty-two percent were reactive for cytokeratin and 39% for S-100. Twenty percent showed mucin positivity by histochemistry. Electron microscopic examination of cytokeratin-positive cases showed either intracellular lumina (secretory areas) or cytoplasmic tonofibrils, whereas cytokeratin-negative tumors lacked lumina and tonofibrils. Previous studies showing epithelial features in meningiomas are reviewed with emphasis on the studies using immunohistochemistry. These histochemical, immunohistochemical, and ultrastructural characteristics are of utility in the examination of tumors of suspected meningeal origin, particularly when dealing with atypical presentations or histomorphologic features.
脑膜瘤具有上皮分化的特征。本研究通过对25例各种组织学和临床类型的脑膜瘤连续切片采用多模态方法进一步证实了这一发现。对每例病例进行了标准光镜检查、用多种上皮和非上皮标志物进行免疫组化染色以及黏蛋白的组织化学染色。对上皮特征阳性和阴性病例的选定实例进行了定向电子显微镜检查。所有病例波形蛋白和上皮膜抗原免疫反应均呈阳性。32%的病例细胞角蛋白呈反应性，39%的病例S-100呈反应性。20%的病例组织化学显示黏蛋白呈阳性。对细胞角蛋白阳性病例的电子显微镜检查显示有细胞内管腔（分泌区）或细胞质张力原纤维，而细胞角蛋白阴性肿瘤则缺乏管腔和张力原纤维。回顾了先前显示脑膜瘤具有上皮特征的研究，重点是使用免疫组化的研究。这些组织化学、免疫组化和超微结构特征在检查疑似脑膜起源的肿瘤时很有用，特别是在处理非典型表现或组织形态学特征时。
