Yung W K, Tepper S J, Young D F
Ann Neurol. 1983 Nov;14(5):581-5. doi: 10.1002/ana.410140514.
Extraneural metastases from malignant glioma and glioblastoma are believed to be rare. The most common sites of metastases are lung, lymph nodes, bone, and liver. We recently encountered two patients with glioblastoma multiforme who presented with pain and thrombocytopenia caused by diffuse metastasis to bone marrow. A premortem diagnosis was established in the first patient with the aid of peroxidase-antiperoxidase staining of the bone marrow biopsy specimen for glial fibrillary acidic protein, a glial-specific marker. In the second patient glial fibrillary acidic protein staining confirmed the glial nature of the primary brain tumor as well as the metastatic tumor in bone marrow. The first patient also had metastatic nodules on the pleural surface and on the fifth rib. All three metastatic foci had similar cellular morphology, suggesting selection of a population of tumor cells with extraneural metastatic potential.
恶性胶质瘤和胶质母细胞瘤的神经外转移被认为很罕见。转移的最常见部位是肺、淋巴结、骨和肝。我们最近遇到了两名多形性胶质母细胞瘤患者，他们因骨髓弥漫性转移而出现疼痛和血小板减少。在第一名患者中，借助对骨髓活检标本进行胶质纤维酸性蛋白（一种胶质特异性标志物）的过氧化物酶-抗过氧化物酶染色，在生前做出了诊断。在第二名患者中，胶质纤维酸性蛋白染色证实了原发性脑肿瘤以及骨髓转移瘤的胶质性质。第一名患者的胸膜表面和第五肋骨上也有转移结节。所有三个转移灶具有相似的细胞形态，提示选择了具有神经外转移潜能的肿瘤细胞群体。
