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目的探讨多形性黄色瘤型星形细胞瘤(PXA)及巨细胞胶质母细胞瘤(GCG)的临床病理特点、诊断及鉴别诊断。方法对4例PXA及6例GCG进行临床病理学观察,免疫组化分析。结果PXA患者组织学特征:肿瘤由巨怪瘤细胞、梭形细胞和泡沫样瘤细胞组成,有丰富的网状纤维及淋巴细胞浸润,坏死和核分裂像少见。免疫组织化学染色GFAP、Vim、S-100阳性,呈弥漫性表达,CD34阳性率75%。GCG患者组织学特征:瘤细胞多形性,以巨怪形瘤巨细胞为主,核分裂像和出血坏死多见,网状纤维沿血管周围分布,有淋巴细胞浸润。瘤细胞弥漫性表达Vim、S-100,GFAP灶性阳性,CD34阳性率17%。结论PXA及GCG临床及病理组织形态非常相似,两者鉴别诊断的要点在于有无泡沫样瘤巨细胞、核分裂像、坏死以及CD34、GFAP的表达不同。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of pleomorphic xanthooblastoma (PXA) and giant cell glioblastoma (GCG). Methods Four cases of PXA and six cases of GCG were observed by clinicopathology and immunohistochemistry. Results The histological features of PXA patients: The tumor consisted of giant tumor cells, spindle cells and foamy tumor cells, which were rich in reticular fibers and lymphocytes infiltration. Necrosis and mitosis were rare. Immunohistochemical staining GFAP, Vim, S-100-positive, diffuse expression, CD34-positive rate of 75%. Histological features of GCG patients: tumor cell pleomorphism, giant giant tumor giant cells, mitotic and hemorrhagic necrosis more common, reticular fibers along the perivascular distribution, with lymphocyte infiltration. Diffuse diffuse expression of tumor cells Vim, S-100, GFAP focal positive, CD34 positive rate of 17%. Conclusion The clinical and pathological features of PXA and GCG are very similar. The key point of differential diagnosis between the two is the presence or absence of giant cells, mitosis, necrosis, and the expression of CD34 and GFAP.