Coons S, Johnson P C, Dickman C A, Rekate H
Division of Neuropathology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ 85013.
J Neuropathol Exp Neurol. 1989 Jul;48(4):483-93. doi: 10.1097/00005072-198907000-00008.
Choroid plexus carcinomas in siblings aged 11 months and 10 years were examined by light microscopy and immunocytochemistry. One case was studied by electron microscopy. Choroid plexus carcinoma is rare, with approximately 24 reported cases in children. Predicting the behavior of choroid plexus tumors from the histology can be difficult. Neither mitoses nor necrosis were seen in one case, but evaluation of proliferation using Ki-67 monoclonal antibody showed 9% of the cells to be in proliferative phases of the cell cycle, a high value for a glial-derived neoplasm. Ki-67 activity may be a more sensitive measure of proliferation in malignant choroid plexus tumors than the presence of mitoses and necrosis, and additional studies may establish its role in distinguishing between choroid plexus carcinoma and papilloma when histologic classification is equivocal. Both tumors were immunoreactive for keratin, which confirmed previous studies. Both were nonreactive for glial fibrillary acidic protein, S-100, and carcinoembryonic antigen (CEA), unlike a previous study which reported that choroid plexus carcinoma, compared to papilloma, was uniquely S-100-negative and CEA-positive. Choroid plexus carcinoma in siblings has not been reported. Chance occurrence in siblings is extremely unlikely; thus a genetic basis for the neoplasms is likely, although environmental influences cannot be excluded.
对一名11个月大的婴儿和一名10岁儿童患脉络丛癌的病例进行了光镜和免疫细胞化学检查。其中1例进行了电镜检查。脉络丛癌较为罕见，儿童中报道的病例约有24例。从组织学上预测脉络丛肿瘤的行为可能具有一定难度。在1例中未发现有丝分裂和坏死，但使用Ki-67单克隆抗体评估增殖情况显示，9%的细胞处于细胞周期的增殖期，这对于神经胶质来源的肿瘤来说是一个较高的值。对于恶性脉络丛肿瘤，Ki-67活性可能是比有丝分裂和坏死的存在更敏感的增殖指标，当组织学分类不明确时，更多研究可能会明确其在区分脉络丛癌和乳头状瘤方面的作用。两种肿瘤对角蛋白均呈免疫反应性，这证实了既往研究结果。两者对胶质纤维酸性蛋白、S-100和癌胚抗原（CEA）均无反应，这与之前一项研究不同，该研究报道脉络丛癌与乳头状瘤相比，独特地表现为S-100阴性和CEA阳性。此前尚未报道过兄弟姐妹均患脉络丛癌的病例。兄弟姐妹同时发病的可能性极小；因此，虽然不能排除环境影响，但这些肿瘤很可能存在遗传基础。
