Kepes J J
Can J Neurol Sci. 1987 May;14(2):109-21. doi: 10.1017/s0317167100026214.
The relationship between the morphology of astrocytomas and their prognosis is complex, with the localization of the tumour, the predominant cell type and the degree of anaplasia all playing an important part in determining the patient's future. Since many astrocytomas have a diversity of patterns, small needle biopsies taken from just one or a few areas may fail to elucidate the principal features of a given tumour. In addition to the astrocytoma subtypes listed in the WHO's International Histological Classification of brain tumours, new entities have been observed in the last few years. These include lipidized forms, such as the relatively benign pleomorphic xanthoastrocytoma and the highly malignant lipidized glioblastoma. Neoplastic astrocytes are capable of forming basal laminae and of phagocytosis, and often contain alpha-1-antitrypsin, features that may lead to confusing them with histiocytes. They may be arranged in a whorled pattern imitating meningiomas, their myxoid intercellular stroma may assume the morphology of cartilage and closely packed tumour cells in "epithelioid" astrocytomas come close to imitate metastatic carcinoma. Some astrocytomas contain cells indistinguishable from those of granular cell tumours of other tissues. The presence of reactive lymphocytes in astrocytomas and reactive astrocytes in malignant lymphomas can be the source of confusion between those two kinds of neoplasms.
星形细胞瘤的形态与其预后之间的关系很复杂，肿瘤的定位、主要细胞类型和间变程度在决定患者的未来方面都起着重要作用。由于许多星形细胞瘤具有多种模式，仅从一个或几个区域进行的小针活检可能无法阐明特定肿瘤的主要特征。除了世界卫生组织脑肿瘤国际组织学分类中列出的星形细胞瘤亚型外，在过去几年中还观察到了新的实体。这些包括脂质化形式，如相对良性的多形性黄色星形细胞瘤和高度恶性的脂质化胶质母细胞瘤。肿瘤性星形胶质细胞能够形成基底膜并具有吞噬作用，并且通常含有α-1-抗胰蛋白酶，这些特征可能导致将它们与组织细胞混淆。它们可能呈涡状排列，模仿脑膜瘤，其黏液样细胞间质可能呈现软骨形态，而“上皮样”星形细胞瘤中紧密排列的肿瘤细胞则接近模仿转移癌。一些星形细胞瘤含有与其他组织的颗粒细胞瘤无法区分的细胞。星形细胞瘤中反应性淋巴细胞的存在以及恶性淋巴瘤中反应性星形胶质细胞的存在可能是这两种肿瘤之间混淆的来源。
