·臨床醫(yī)學圖像·
RELA融合基因陽性室管膜瘤
圖1 光學顯微鏡觀察顯示,腫瘤細胞密度較高,可見假“菊形團”樣結構,亦可見分支狀血管HE染色×100圖2光學顯微鏡觀察顯示,腫瘤細胞胞質彌漫性表達L1CAM,胞膜灶性表達L1CAM免疫組織化學染色(EnVision二步法)×200Figure 1Optical microscopy findings showed primary ependymoma with hypercellularity,perivascular pseudorosettes and fine branching vasculature.HE staining×100Figure 2Optical microscopy findings showed the tumor cells were diffusely positive for L1CAM in cytoplasm and focally positive for L1CAM in membrane.Immunohistochemical staining(EnVision)×200
2016年,世界衛(wèi)生組織(WHO)中樞神經系統(tǒng)腫瘤分類將RELA融合基因陽性室管膜瘤定義為一種以RELA融合基因為特征的幕上室管膜瘤,占兒童幕上室管膜瘤的70%,而在成人中比例較低。發(fā)生于顱后窩和脊髓的室管膜瘤無RELA融合基因。組織學形態(tài)無特異性,腫瘤呈現(xiàn)標準幕上室管膜瘤結構和細胞學特征,形成假“菊形團”樣結構;可見特異性分支狀毛細血管排列(圖1)或細胞透明樣變性。免疫組織化學染色,腫瘤細胞胞質表達膠質纖維酸性蛋白(GFAP)和上皮膜抗原(EMA)、彌漫性表達細胞黏附分子L1(L1CAM),胞膜灶性表達L1CAM(圖2),且與RELA融合基因相關性良好。
(天津市環(huán)湖醫(yī)院病理科閻曉玲供稿)
Ependymoma,RELA fusion?positive
YAN Xiao?ling
Department of Pathology,Tianjin Huanhu Hospital,Tianjin 300350,China(Email:ll934065@126.com)
10.3969/j.issn.1672?6731.2017.04.014