Kuchelmeister K, von Borcke I M, Klein H, Bergmann M, Gullotta F
Institut für Neuropathologie der Universität, Münster, Germany.
Acta Neuropathol. 1994;88(5):448-53. doi: 10.1007/BF00389497.
Two pineal parenchymal tumors are presented, arising in a 54-year-old man and a 72-year-old woman; respectively. They showed isomorphic, cellular areas of small cells, often with characteristic pineocytomatous rosettes, and of medium-sized cells, as well as less cellular regions with highly pleomorphic, often ganglioid large cells. Immunohistochemistry disclosed extensive neuronal differentiation. There was intense positivity for neurofilament protein and microtubule-associated protein 2 in the pleomorphic areas and more variable expression in the isomorphic regions. Diffuse synaptophysin positivity was seen, accentuated along the borders of pleomorphic cells and in the rosettes, as well as diffuse interstitial and/or cytoplasmic expression of neuron-specific enolase, PGP 9.5 and tau. beta-Tubulin III was detected in most cells and slight positivity was found in the rosettes. Expression of glial fibrillary acidic protein, however, was restricted to resident astrocytes and an interstitial network of processes. These neuronally differentiated pleomorphic pineocytomas underline the broad histomorphological spectrum of pineal parenchymal tumors.
本文报告了两例松果体实质肿瘤，分别发生于一名54岁男性和一名72岁女性。肿瘤呈现出同形性，有小细胞组成的细胞区域，常伴有特征性的松果体细胞瘤菊形团，还有中等大小细胞组成的区域，以及细胞较少但有高度多形性、常为神经节样大细胞的区域。免疫组化显示广泛的神经元分化。在多形性区域，神经丝蛋白和微管相关蛋白2呈强阳性，在同形区域表达则更具变异性。可见弥漫性突触素阳性，在多形性细胞边界和菊形团处更为明显，同时神经元特异性烯醇化酶、PGP 9.5和tau呈弥漫性间质和/或细胞质表达。大多数细胞检测到β-微管蛋白III，菊形团中有轻微阳性。然而，胶质纤维酸性蛋白的表达仅限于驻留星形胶质细胞和间质的细胞突网络。这些具有神经元分化的多形性松果体细胞瘤突显了松果体实质肿瘤广泛的组织形态学谱。
