Department of Pathology and Microbiology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE 68198, USA.
Department of Pathology and Immunology, Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA.
Surg Pathol Clin. 2020 Jun;13(2):249-266. doi: 10.1016/j.path.2020.02.004.
Well-circumscribed intra-axial CNS tumors encompass a wide variety of gliomas and glioneuronal tumors, usually corresponding to WHO grades I and II. Nonetheless, sometimes high-grade 'diffuse' gliomas such as gliosarcoma and giant cell glioblastoma can be relatively circumscribed but are often found to have foci of diffuse infiltration on careful examination, harboring distinct molecular alterations. These tumors are excluded from the discussion in this chapter with the current review emphasizing on lower-grade entities to include a brief description of their histology and associated molecular findings. Like elsewhere in brain biopsy evaluation, imaging is crucial and acts as a surrogate to gross examination. Given the circumscribed nature of these tumors, surgery alone is the mainstay treatment in most entities.
界限清楚的中枢神经系统内轴肿瘤包含广泛的胶质瘤和神经胶质神经元肿瘤，通常对应于世卫组织分级 I 和 II。尽管如此，有时高级别的“弥漫性”胶质瘤，如胶质肉瘤和巨细胞胶质母细胞瘤，可能相对局限，但在仔细检查时通常会发现弥漫性浸润的病灶，具有明显的分子改变。这些肿瘤不包括在本章的讨论中，目前的综述强调低级别实体，简要描述其组织学和相关分子发现。与脑活检评估的其他部位一样，影像学至关重要，可作为大体检查的替代方法。鉴于这些肿瘤的界限清楚，手术是大多数实体肿瘤的主要治疗方法。
