脑膜上皮增生:11例临床病理、免疫组织化学和遗传学研究。

PubMed ID
发表日期 2005年Apr月

原始出处 脑病理学(瑞士苏黎世)
Brain pathology (Zurich, Switzerland)
作者 Perry  Arie  Lusis  Eriks A  Gutmann  David H 

文献标题 脑膜上皮增生:11例临床病理、免疫组织化学和遗传学研究。
Meningothelial hyperplasia: a detailed clinicopathologic, immunohistochemical and genetic study of 11 cases.

文献摘要

脑膜上皮增生是一种特征性较差的疾病,常与高龄、慢性肾功能衰竭、外伤、出血和肿瘤形成有关。为了阐明这种病变的性质,我们将11例由10层或10层以上细胞构成的巢穴与正常蛛网膜帽细胞和脑膜瘤进行了比较。免疫组化和FISH检测NF2(merlin)、蛋白4.1B、EMA、孕酮受体(PR)、EGFR、survivin、VEGF、PDGF-BB、PDGFRβ、E-cadherin和组织蛋白酶D的状态。所有病例至少有一个假定的易感因素,包括出血(7)、慢性肾病(5)、老年(5)、外伤(1)和邻近的视神经毛细胞星形细胞瘤(1)。有典型的不连续生长模式,没有侵犯周围正常组织。未发现基因缺失,2例可见散在的多倍体细胞。免疫组化结果与正常cap细胞相似,只有一个例外;而正常细胞PR均为阴性,64%的增生细胞核呈阳性,其频率与良性脑膜瘤相似。我们的数据提示脑膜上皮增生是一种反应性过程,通常根据临床病理和遗传特征与脑膜瘤相鉴别。在某些情况下可能是癌前病变,不过还需要进一步的研究来验证这一假设。


Meningothelial hyperplasia is a poorly characterized entity, often associated with advanced age, chronic renal failure, trauma, hemorrhage, and neoplasia. In order to elucidate the nature of this lesion, 11 cases defined by the presence of nests of 10 or more cell layers thick, were compared with normal arachnoidal cap cells and meningiomas. Immunohistochemistry and FISH were performed to determine NF2 (merlin), protein 4.1B, EMA, progesterone receptor (PR), EGFR, survivin, VEGF, PDGF-BB, PDGFR-beta, E-cadherin, and cathepsin D status. All cases had at least one putative predisposing factor, including hemorrhage (7), chronic renal disease (5), old age (5), trauma (1), and an adjacent optic nerve pilocytic astrocytoma (1). There was typically a discontinuous growth pattern, with no invasion of surrounding normal tissue. No gene deletions were found, though scattered polyploid cells were seen in 2 cases. The immunoprofile was similar to normal cap cells with one exception; whereas normal cells were uniformly negative for PR, nuclear positivity was seen in 64% of hyperplasias, a frequency similar to that of benign meningiomas. Our data suggest that meningothelial hyperplasia is a reactive process that is usually distinguishable from meningioma based on clinicopathologic and genetic features. It may be preneoplastic in some, though further studies are needed to test this hypothesis.


获取全文 10.1111/j.1750-3639.2005.tb00505.x