Ritter A M, Kubal W, Luo V, Bullock M R
Department of Neurosurgery, Medical College of Virginia, Richmond, USA.
Pediatr Neurosurg. 1996 Nov;25(5):265-8. doi: 10.1159/000121137.
The unusual radiologic presentation of an optic chiasm fibrillary astrocytoma extending through and expanding the diaphragma sellae in an 8-year-old male is described. The child presented with decreased vision in the right eye. Magnetic resonance imaging demonstrated a cystic intra- and suprasellar mass, isointense on T1WI and hyperintense on T2WI, that enhanced with contrast. There was no radiographic involvement of the pituitary or hypothalamus. The optic chiasm could not be seen. The tumor mass was believed to be a craniopharyngioma and was partially removed by a transsphenoidal approach. Frozen section was not consistent with craniopharyngioma. Histochemical stains were positive for glial fibrillary acidic protein and S100 protein and nonreactive for EMA or actin. Electron microscopy showed abundant cellular processes and cytoplasmic filaments within the cells. A diagnosis of intrasellar fibrillary astrocytoma, probably arising from the optic chiasm, was made.
本文描述了一名8岁男性视交叉纤维型星形细胞瘤的罕见影像学表现，该肿瘤穿过并扩大鞍隔。患儿表现为右眼视力下降。磁共振成像显示鞍内和鞍上囊性肿块，T1加权像上等信号，T2加权像上高信号，增强扫描有强化。垂体或下丘脑无影像学受累表现。视交叉显示不清。肿瘤块被认为是颅咽管瘤，并通过经蝶窦入路部分切除。冰冻切片结果与颅咽管瘤不符。免疫组化染色显示胶质纤维酸性蛋白和S100蛋白阳性，上皮膜抗原或肌动蛋白阴性。电子显微镜检查显示细胞内有丰富的细胞突起和细胞质细丝。最终诊断为鞍内纤维型星形细胞瘤，可能起源于视交叉。
