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脂肪性脑膜瘤:一种罕见脑膜瘤的临床-病理表现、影像学特征及相关性。

Lipomatous Meningioma: Clinical-Pathological Findings, Imaging Characterisation and Correlations of a Rare Type of Meningioma.

机构信息

Department of Anatomy, Histology, Forensic Medicine and Orthopaedics', Sapienza University of Rome, Rome, Italy;

Department of Human Neurosciences, Division of Neurosurgery, Policlinico Umberto I University Hospital, Sapienza, University of Rome, Rome, Italy.

出版信息

In Vivo. 2021 Nov-Dec;35(6):3031-3037. doi: 10.21873/invivo.12598.

Abstract

Lipomatous meningioma (LM) is a form of metaplasia, originating from intracellular lipid bodies accumulation due to metabolic alterations. A comprehensive literature review was performed introducing further elements of evaluation. The parameters utilized were age, sex, location, clinical presentation, imaging features, treatment, and recurrences. Seizure and headache are the primary onsets of symptoms. Further LM clinical features, such as visual disturbances and visual epileptic seizures were examined. Symptoms may occur ten years prior to LM finding and it can resolve completely with the indicated surgery. LM computed tomography imaging analysis reveals hypodense regions due to the presence of fat content. On magnetic resonance imaging, the lesion displays hyperintense signal in T1-T2 with signal loss in the fat-suppression sequences. Immunohistochemically, lipidized meningioma cells are positive for Epithelial-Membrane Antigen, Vimentin, CD99, S-100 protein, and progesterone receptor. The recurrence risk rate of LM is estimated to be around 17%. Precise immune-histological findings have been correlated with imaging features to help with early diagnosis. A defined diagnosis of LM is a crucial factor in the choice of treatment.

摘要

脂肪性脑膜瘤(LM)是一种化生形式,源于代谢改变导致细胞内脂滴体积累。进行了全面的文献复习,引入了进一步的评估要素。所使用的参数包括年龄、性别、位置、临床表现、影像学特征、治疗和复发。癫痫发作和头痛是主要的症状起始。进一步检查了 LM 的其他临床特征,如视觉障碍和视觉癫痫发作。症状可能在发现 LM 前十年出现,并且通过指示性手术可以完全缓解。LM 的计算机断层扫描成像分析显示由于存在脂肪含量而呈现低信号区域。在磁共振成像上,病变在 T1-T2 上显示高信号,在脂肪抑制序列上显示信号丢失。免疫组织化学显示,脂化脑膜瘤细胞对上皮膜抗原、波形蛋白、CD99、S-100 蛋白和孕激素受体呈阳性。LM 的复发风险率估计约为 17%。精确的免疫组织学发现与影像学特征相关,有助于早期诊断。明确的 LM 诊断是治疗选择的关键因素。

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