Ibayashi N, Kubo S, Sekimoto T, Takemi K, Ikeda M
No To Shinkei. 1986 Dec;38(12):1151-5.
A case of pleomorphic xanthoastrocytoma (Kepes) is reported. This patient was a 12-year-old boy with a history of convulsive seizure. Neurological examination on admission showed no abnormality. Plain CT scan revealed a well defined low density area with calcification in the right frontal lobe. A part of peripheral portion of low density area were well enhanced with contrast media. At operation, there was a cyst containing xanthochromic fluid in the right frontal lobe. A part of cyst well near the cerebral surface was reddish hard. Total removal of nodular tumor and subtotal removal of the cyst wall were performed. He has been doing well for these 3 years following craniotomy and has no deficit without CT evidence of recurrent tumor. Histologically the tumor cells displayed marked pleomorohism. However either necrosis or mitosis were not seen. Frequently these cells had vacuolated or foamy cytoplasm. There were many of the giant cells and multinucleated cells. In some area, these tumor cells were surrounded by a fine network of reticulin fibers. Electron microscopically the tumor cells were occasionally filled with glial filament and lipid granules were seen. Immunoperoxidase technique revealed GFAP in the cytoplasm of the tumor cells. This case was considered to be pleomorphic xanthoastrocytoma first proposed by Kepes.
报告一例多形性黄色星形细胞瘤（凯佩斯型）。该患者为一名12岁男孩，有惊厥发作史。入院时神经系统检查无异常。普通CT扫描显示右额叶有一个边界清晰的低密度区并伴有钙化。低密度区周边部分在注入造影剂后有明显强化。手术中，右额叶有一个含有黄色清亮液体的囊肿。靠近脑表面的部分囊肿壁呈微红的硬结状。对结节状肿瘤进行了全切，对囊肿壁进行了次全切除。开颅术后这3年他情况良好，无功能缺损，CT检查也未发现肿瘤复发迹象。组织学上，肿瘤细胞表现出明显的多形性。然而，未见坏死或有丝分裂现象。这些细胞的胞质常呈空泡状或泡沫状。有许多巨细胞和多核细胞。在某些区域，这些肿瘤细胞被纤细的网状纤维所环绕。电镜下，肿瘤细胞偶尔充满胶质细丝，可见脂质颗粒。免疫过氧化物酶技术显示肿瘤细胞胞质中有胶质纤维酸性蛋白（GFAP）。该病例被认为是凯佩斯首次提出的多形性黄色星形细胞瘤。
