颅内原发性精原细胞瘤患者临床病理特征分析及预后
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摘要
目的探讨颅内原发性精原细胞瘤患者的临床病理特征及预后情况。方法选取2013年5月至2018年1月间湛江市南部战区海军第一医院收治的40例颅内原发性精原细胞瘤患者,分析患者颅内原发性精原细胞瘤的病理特征和预后。结果患者原发性精原细胞瘤发生于松果体区13例,发生于鞍上区8例。患者视力下降及视野缺损14例,垂体功能减退9例,颅高压症状11例,双下肢乏力3例,体重下降3例。镜下观察颅内原发性精原细胞瘤瘤细胞与健康者正常精小管内精原细胞较为类似,虽无明显差异,但可见瘤细胞偏大。镜下观察发现其境界较为清楚,瘤细胞胞浆透明,瘤细胞核较大,可见核分裂像,但核分裂不多见,核位于中央。镜下观察19例患者瘤细胞内有1个嗜酸性核仁,21例患者瘤细胞内有2个嗜酸性核仁,淋巴细胞及浆细胞等大量浸润,间质为纤细的纤维组织。21例患者采取肿瘤全切术,其余行部分切除术。术中取材作病理活检,1例术后6个月再次复发,病理诊断与之前一样,病变位置为三脑室。其余患者均无复发。结论颅内原发性精原细胞瘤镜下观察与健康者正常精小管内精原细胞较为类似,主要发生于蝶鞍区及松果体区。经精准化治疗,预后均较良好。
Objective To investigate the clinicopathological characteristics and prognosis in 40 patients with primary seminoma in brain. Methods Forty patients with intracranial primary seminoma who were admitted to The First Hospital of the Southern Theater of Zhanjiang City from May 2013 to January2018 were enrolled in this study. The pathological features of primary intracytoplasmic seminoma and prognosis were analyzed retrospectively. Results Of the 40 patients,13 patients had primary seminoma in conarium,8 had primary seminoma in suprasellar region 14 patients had visual acuity and visual field defects,9 had pituitary dysfunction,11 had cranial hypertension symptoms,3 had lower limb weakness,and3 had weight loss. Intracranial primary seminoma cells in patients with primary seminoma in brain was similar to normal spermatogonial cells in healthy individuals by microscopic observation. Although there is no significant difference,it can be seen that the tumor cells are too large. Microscopic observation revealed that the boundary was clear,the cytoplasm of the tumor cells was transparent,the nucleus of the tumor cells was large,and the mitotic image was seen,but the nuclear division was rare,and the nucleus was located in the center. Microscopic observation revealed that there were 1 eosinophilic nucleoli in 19 intracranial primary seminoma cells,and 2 eosinophils in lymphocytes in 21 intracranial primary seminoma,a large amount of infiltration of plasma cells. The interstitial tissue was fine fibrous tissue. A total of 21 of the 40 patients in this study underwent total tumor resection and the remaining partial resection. Intraoperative biopsy was used as a pathological biopsy. The relapse only occurred in 1 patient at 6 months after the surgery. The pathological diagnosis was the same as before,and the lesion location was the third ventricle. There were no recurrence in the remaining cases. Conclusion The intracranial primary spermatogonia is similar to the spermatogonia in the normal small tubules in healthy people and is mainly in the sella region and the pineal region. Under normal circumstances,the prognosis in patients with primary intracytoplasmic seminoma is relatively good after accurate treatment.
Objective To investigate the clinicopathological characteristics and prognosis in 40 patients with primary seminoma in brain. Methods Forty patients with intracranial primary seminoma who were admitted to The First Hospital of the Southern Theater of Zhanjiang City from May 2013 to January2018 were enrolled in this study. The pathological features of primary intracytoplasmic seminoma and prognosis were analyzed retrospectively. Results Of the 40 patients,13 patients had primary seminoma in conarium,8 had primary seminoma in suprasellar region 14 patients had visual acuity and visual field defects,9 had pituitary dysfunction,11 had cranial hypertension symptoms,3 had lower limb weakness,and3 had weight loss. Intracranial primary seminoma cells in patients with primary seminoma in brain was similar to normal spermatogonial cells in healthy individuals by microscopic observation. Although there is no significant difference,it can be seen that the tumor cells are too large. Microscopic observation revealed that the boundary was clear,the cytoplasm of the tumor cells was transparent,the nucleus of the tumor cells was large,and the mitotic image was seen,but the nuclear division was rare,and the nucleus was located in the center. Microscopic observation revealed that there were 1 eosinophilic nucleoli in 19 intracranial primary seminoma cells,and 2 eosinophils in lymphocytes in 21 intracranial primary seminoma,a large amount of infiltration of plasma cells. The interstitial tissue was fine fibrous tissue. A total of 21 of the 40 patients in this study underwent total tumor resection and the remaining partial resection. Intraoperative biopsy was used as a pathological biopsy. The relapse only occurred in 1 patient at 6 months after the surgery. The pathological diagnosis was the same as before,and the lesion location was the third ventricle. There were no recurrence in the remaining cases. Conclusion The intracranial primary spermatogonia is similar to the spermatogonia in the normal small tubules in healthy people and is mainly in the sella region and the pineal region. Under normal circumstances,the prognosis in patients with primary intracytoplasmic seminoma is relatively good after accurate treatment.
引文
[1]张龙举,刘晓丽,蒲盛蓝,等.纵隔原发性精原细胞瘤二例并国内三十年临床病例资料文献复习[J].中国全科医学,2017,20:3047-3050.
[2]陈燕坪,朱伟峰,陈丽芳,等.睾丸弥漫性大B细胞淋巴瘤中OCT4蛋白的表达及其临床病理特征[J].中华病理学杂志,2017,46:383-387.
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[6]李健,谢凯,龚洪翰,等.性腺外原发性精原细胞瘤CT与MRI表现[J].实用放射学杂志,2016,32:562-565.
[7]Tampakis A,Tampaki EC,Damaskos C,et al.Orchitis reveals an extragonadal primary mediastinal thymic seminoma:a coincidence or not?[J].World J Surg Oncol,2017,15:85.
[8]王珊珊,李海波,苏敏,等.一例45,X/46,X,Yqh-混合型生殖腺发育不全患者的临床特征及遗传学分析[J].中华医学遗传学杂志,2016,33:216-220.
[9]Russell CM,Sharma P,Agarwal G,et al.Is percent seminoma associated with intraoperative morbidity during post-chemotherapy RPLND?[J].Can J Urol,2016,23:8127-8134.
[10]牛晨,郭丽萍,令潇,等.罕见纵隔原发性精原细胞瘤的CT表现及临床特点[J].现代肿瘤医学,2016,24:3937-3940.
[11]蒋建发,薛薇,邓燕,等.不同类型雄激素不敏感综合征性腺肿瘤临床分析[J].实用妇产科杂志,2016,32:110-112.
[12]沈勤,饶秋,余波,等.免疫组化染色及FISH检测12号染色体短臂捕获对Ⅱ型睾丸生殖细胞肿瘤的诊断意义[J].中华男科学杂志,2016,22:692-697.
[13]Sladkevicius P,Opolskiene G,Valentin L.Prospective temporal validation of mathematical models to calculate risk of endometrial malignancy in patients with postmenopausal bleeding[J].Ultrasound Obstet Gynecol,2017,49:649-656.
[14]Al Ani AH,Al Ani HA.Testicular seminoma metastasis to duodenum.Misdiagnosed as primary duodenal tumor[J].Int JSurg Case Rep,2016,25:149-152.
[2]陈燕坪,朱伟峰,陈丽芳,等.睾丸弥漫性大B细胞淋巴瘤中OCT4蛋白的表达及其临床病理特征[J].中华病理学杂志,2017,46:383-387.
[3]彭丹丹,邓东,周欣可,等.原发性性腺外精原细胞瘤CT和MRI诊断[J].实用放射学杂志,2016,32:749-752.
[4]顾玲玲,张兰芳,沈文荣,等.纵隔原发精原细胞瘤的临床及影像学特征[J].临床肿瘤学杂志,2017,22:1121-1126.
[5]施全,陈文静,廖秋林,等.儿童及青少年生殖细胞肿瘤的临床病理特征与文献复习[J].中国妇幼保健,2016,31:5381-5385.
[6]李健,谢凯,龚洪翰,等.性腺外原发性精原细胞瘤CT与MRI表现[J].实用放射学杂志,2016,32:562-565.
[7]Tampakis A,Tampaki EC,Damaskos C,et al.Orchitis reveals an extragonadal primary mediastinal thymic seminoma:a coincidence or not?[J].World J Surg Oncol,2017,15:85.
[8]王珊珊,李海波,苏敏,等.一例45,X/46,X,Yqh-混合型生殖腺发育不全患者的临床特征及遗传学分析[J].中华医学遗传学杂志,2016,33:216-220.
[9]Russell CM,Sharma P,Agarwal G,et al.Is percent seminoma associated with intraoperative morbidity during post-chemotherapy RPLND?[J].Can J Urol,2016,23:8127-8134.
[10]牛晨,郭丽萍,令潇,等.罕见纵隔原发性精原细胞瘤的CT表现及临床特点[J].现代肿瘤医学,2016,24:3937-3940.
[11]蒋建发,薛薇,邓燕,等.不同类型雄激素不敏感综合征性腺肿瘤临床分析[J].实用妇产科杂志,2016,32:110-112.
[12]沈勤,饶秋,余波,等.免疫组化染色及FISH检测12号染色体短臂捕获对Ⅱ型睾丸生殖细胞肿瘤的诊断意义[J].中华男科学杂志,2016,22:692-697.
[13]Sladkevicius P,Opolskiene G,Valentin L.Prospective temporal validation of mathematical models to calculate risk of endometrial malignancy in patients with postmenopausal bleeding[J].Ultrasound Obstet Gynecol,2017,49:649-656.
[14]Al Ani AH,Al Ani HA.Testicular seminoma metastasis to duodenum.Misdiagnosed as primary duodenal tumor[J].Int JSurg Case Rep,2016,25:149-152.