Mørk S J, Rubinstein L J, Kepes J J, Perentes E, Uphoff D F
Department of Pathology, University of Virginia School of Medicine, Charlottesville 22908.
J Neuropathol Exp Neurol. 1988 Mar;47(2):101-18. doi: 10.1097/00005072-198803000-00003.
Six cases are reported (four gliosarcomas and two glioblastomas) in which the epithelial-like areas of glial anaplasia showed focal squamous cell differentiation, characterized by the development of epithelial whorls, keratin pearls and immunopositivity for cytokeratin. The expression of glial fibrillary acidic protein and the development of squamous metaplasia usually were mutually exclusive. Autopsy findings in two patients and clinical work-up in five failed to disclose a primary extraneural malignancy. It is suggested that squamous differentiation may represent an extreme form of epithelial metaplasia in a malignant glioma. This possibility should be kept in mind in the diagnostic evaluation of such cases, especially in view of the current emphasis on the immunomorphologic demonstration of intermediate filament tumor markers.
报告了6例病例（4例胶质肉瘤和2例胶质母细胞瘤），其中胶质间变的上皮样区域显示局灶性鳞状细胞分化，其特征为上皮性涡旋、角化珠形成以及细胞角蛋白免疫阳性。胶质纤维酸性蛋白的表达与鳞状化生的发生通常相互排斥。2例患者的尸检结果及5例患者的临床检查均未发现原发性神经外恶性肿瘤。提示鳞状分化可能代表恶性胶质瘤上皮化生的一种极端形式。在对此类病例进行诊断评估时应牢记这一可能性，尤其是考虑到当前对中间丝肿瘤标志物免疫形态学显示的重视。
