Slavik T, Bentley R C, Gray L, Fuchs H E, McLendon R E
Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA.
Clin Neuropathol. 1998 Jan-Feb;17(1):55-60.
Twenty-nine months after surgery, irradiation, and systemic chemotherapy for a pineal mixed germ cell tumor, an 11-year-old Caucasian male developed a 3 cm dural based nodule in the occipital lobe that proved to be a solitary fibrous tumor by immunohistochemical and ultrastructural examination. Differential diagnosis included fibrous meningioma, neurofibroma, Schwannoma, cranial fasciitis of infancy, and solitary fibrous tumor. A Masson trichrome stain revealed a prominent collagenous stroma and reticulin staining exhibited strong pericellular positivity. Immunohistochemical staining demonstrated diffuse vimentin and focal CD34 positivity of tumor cells. Ultrastructural examination revealed fibroblastic differentiation. These features are consistent with solitary fibrous tumor. Although we favor a radiation-induced origin for the neoplasm, alternative explanations for the tumor's origin include cerebrospinal fluid spread from the original germ cell tumor or a de novo neoplasm.
一名11岁的白种男性在接受松果体混合性生殖细胞肿瘤手术、放疗及全身化疗29个月后，枕叶出现一个3厘米的硬膜下结节，经免疫组化和超微结构检查证实为孤立性纤维瘤。鉴别诊断包括纤维性脑膜瘤、神经纤维瘤、神经鞘瘤、婴儿颅部筋膜炎和孤立性纤维瘤。马松三色染色显示有突出的胶原性间质，网状纤维染色显示细胞周围呈强阳性。免疫组化染色显示肿瘤细胞弥漫性波形蛋白阳性及局灶性CD34阳性。超微结构检查显示有成纤维细胞分化。这些特征符合孤立性纤维瘤。虽然我们倾向于该肿瘤起源于放疗，但肿瘤起源的其他解释包括来自原始生殖细胞肿瘤的脑脊液播散或新发肿瘤。
