本帖最后由 pathology 于 2015-12-9 14:49 编辑
本周病例(2015.11.9—2015.11.15)
1、你考虑什么诊断?
脊索瘤样脑膜瘤(Chordoid meningioma)
2、需要做什么鉴别诊断?
The differential diagnosis of CNS lesions with chordoid features includes:
● Chordoma(脊索瘤): intracranial lesions that straddle the midline and erode the clivus, EMA+, CK+, S100+ (50%)
● Chordoid meningioma(脊索瘤样脑膜瘤): EMA+, focal or negative CK, S100-, GFAP-
● Myxoid chondrosarcoma(粘液样软骨肉瘤): S100+, EMA-, CK-
● Chordoid glioma of the 3rd ventricle(三脑室脊索瘤样胶质瘤): located at third ventricle, GFAP+
● Metastatic mucinous carcinoma(转移性粘液癌): known primary, anaplasia, diffuse CK+ and EMA+
● Glioblastoma(胶质母细胞瘤): GFAP+
● Atypical teratoid/rhabdoid tumor(非典型畸胎样/横纹肌样瘤): infants, posterior fossa lesion, INI1- with positive control of blood vessels and lymphocytes
● Epithelioid hemangioendothelioma(上皮样血管内皮瘤): intracytoplasmic lumina, CD31+
● Meningioma with myxoid degeneration(脑膜瘤伴粘液变性): no epithelioid cells
● Schwannoma with myxoid degeneration(神经鞘瘤伴粘液变性): S100+, EMA-. CK–
3、本病预后如何?
本病为WHO II级,预后介于普通型脑膜瘤和间变性脑膜瘤之间。
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希望大家一如既往的支持病理每周一题, |