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[年轻型多形性低度恶性神经上皮肿瘤的临床病理特征]

[Clinicopathological features of polymorphous low-grade neuroepithelial tumor of the young].

作者信息

Ge R, Fang H F, Chang Y Q, Li Z, Liu C F

机构信息

Ningbo Diagnostic Pathology Center, Ningbo 315021, China.

Department of Pathology, Shibei Hospital of Jing'an District, Shanghai 200435, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2020 Nov 8;49(11):1131-1135. doi: 10.3760/cma.j.cn112151-20200213-00086.

Abstract

To investigate the clinicopathological features, diagnosis and prognosis of polymorphous low-grade neuroepithelial tumor of the young (PLNTY). Two cases of PLNTY diagnosed during January 2016 to December 2019 were collected from Ningbo Diagnostic Pathology Center, Zhejiang, China. The clinical features, histopathological characteristics, immunohistochemical and molecular genetic findings were analyzed and the relevant literature was reviewed. The two patients were both female, at the ages of 14 and 25 years, respectively. Both patients presented with seizure attacks. The imaging study showed a mixed signal in the cerebral cortex, located in the occipital and temporal lobes, respectively. Microscopically, the tumors were characterized by the invariable presence of oligodendroglioma-like appearance, often with calcification. Immunohistochemically, the tumors were diffusely and intensely CD34 positive with ramified, CD34-expressing neural elements in regional cortex. The tumors were positive for GFAP, Olig2 and ATRX, and negative for IDH1, Neu N, nestin and EMA. The Ki-67 labeling index was less than 2%. The case number 2 harbored the BRAF V600E mutation, while the case number 1 was negative for both the BRAF V600E mutation and 1p/19q codeletion. Both patients recovered very well and were free of seizures after the following-up of 2 and 24 months, respectively. PLNTY is an uncommon neuroepithelial tumor. Histopathologic and immunohistochemical examinations are necessary for establishing the diagnosis and for excluding oligodendroglioma. PLNTY should be considered as a benign tumor corresponding to WHO Grade I. The prognosis is overall good after complete tumor-resection.

摘要

探讨青年多形性低度神经上皮肿瘤(PLNTY)的临床病理特征、诊断及预后。收集2016年1月至2019年12月期间在浙江省宁波市诊断病理中心确诊的2例PLNTY病例。分析其临床特征、组织病理学特征、免疫组化及分子遗传学结果,并复习相关文献。2例患者均为女性,年龄分别为14岁和25岁。2例患者均表现为癫痫发作。影像学检查显示大脑皮质有混合信号,分别位于枕叶和颞叶。显微镜下,肿瘤的特征是始终存在少突胶质细胞瘤样外观,常伴有钙化。免疫组化显示,肿瘤弥漫性且强烈CD34阳性,在局部皮质有分支状、表达CD34的神经成分。肿瘤GFAP、Olig2和ATRX阳性,IDH1、Neu N、巢蛋白和EMA阴性。Ki-67标记指数小于2%。病例2存在BRAF V600E突变,而病例1的BRAF V600E突变和1p/19q共缺失均为阴性。分别随访2个月和24个月后,2例患者恢复良好,均无癫痫发作。PLNTY是一种罕见的神经上皮肿瘤。组织病理学和免疫组化检查对于确诊及排除少突胶质细胞瘤是必要的。PLNTY应被视为WHO I级的良性肿瘤。肿瘤完全切除后总体预后良好。

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