Lipper M H, Eberhard D A, Phillips C D, Vezina L G, Cail W S
Department of Radiology, University of Virginia Health Sciences Center, Charlottesville 22908.
AJNR Am J Neuroradiol. 1993 Nov-Dec;14(6):1397-404.
To analyze and discuss CT and MR features of pleomorphic xanthoastrocytoma (PXA) and present salient histopathologic features of this distinctive astroglial tumor.
CT, MR, and histopathologic studies on seven patients with the histologic diagnosis of PXA were reviewed retrospectively.
All patients were in their first 3 decades of life when first diagnosed and demonstrated peripherally situated supratentorial tumors of varying size involving the superficial cortex and leptomeninges. Five of six cases examined with CT showed areas of mixed attenuation with four demonstrating well-demarcated enhancement. MR demonstrated low or mixed signal intensity on T1-weighted and high or mixed signal intensity on T2-weighted sequences. All five who received gadopentetate dimeglumine showed well-defined enhancement. Three showed cyst formation. Typical histologic features included marked cellular pleomorphism with giant cells, bizarre nuclei, variable cytoplasmic lipidization and positive immunoreactivity for glial fibrillary acidic protein. Necrosis and endothelial-pericytic cell proliferation were absent.
PXA has a highly suggestive neuroradiologic and distinctive histopathologic appearance.
分析和讨论多形性黄色星形细胞瘤（PXA）的CT和MR特征，并呈现这种独特星形胶质细胞瘤的显著组织病理学特征。
回顾性分析7例经组织学诊断为PXA患者的CT、MR及组织病理学研究。
所有患者首次诊断时均处于生命的前3个十年，表现为幕上不同大小的外周肿瘤，累及浅表皮质和软脑膜。6例接受CT检查的患者中，5例显示混合密度区域，4例显示边界清晰的强化。MR在T1加权序列上显示低信号或混合信号强度，在T2加权序列上显示高信号或混合信号强度。接受钆喷酸葡胺检查的5例患者均显示边界清晰的强化。3例显示囊肿形成。典型的组织学特征包括明显的细胞多形性，伴有巨细胞、怪异核、可变的细胞质脂质化以及对胶质纤维酸性蛋白的阳性免疫反应。无坏死和内皮-周细胞增殖。
PXA具有高度提示性的神经放射学表现和独特的组织病理学外观。
