复发性神经鞘瘤和神经纤维瘤形态学特征的回顾性队列研究

D. Murzaeva, Y. Zabrodskaya, A. A. Dolgushin, L. N. Dobrogorskaya, A. Orlov
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引用次数: 0

摘要

良性周围神经鞘肿瘤(BPNST)在全切除术后复发的发生率为2.6-11.0%。复发性BPNST的组织学特征的意义尚未得到充分研究。比较复发性和非复发性BPNST(神经鞘瘤和神经纤维瘤)的病理形态学特征。材料和方法。我们对101例BPNST患者进行了回顾性评估,其中13例(12.9%)BPNST复发,其发育不良程度不超过i级。研究纳入有组织学档案的患者:研究组(n = 7)包括有一次或多次BPNST复发的患者,对照组(n = 5)包括术后5年及以上无复发的患者。研究了主要临床特征,并进行了组织学检查。两组在基线特征(肿瘤类型(神经鞘瘤、神经纤维瘤)、性别分布、年龄、定位、临床症状)方面无差异。神经纤维瘤患者复发率为8 / 3,而神经鞘瘤患者复发率为6 / 5。在所有复发性神经鞘瘤病例和1例神经纤维瘤中,组织学模式以单相为主,有节律性结构,如Verocay小体,带线纹和核色增多,而对照组则以混合型结构为代表,各种组织学模式均匀交替(p < 0.05)。复发组间质及血管周围内皮细胞增生及淋巴细胞浸润较多(p < 0.05)。两组间变的病理形态学征象为:细胞核多态、细胞核染色增多、内皮细胞增生、有丝分裂;两组间变的轻微征象为:肿瘤束状形态的凝固、多化和凋亡小体的出现频率相同。复发时,被膜丢失,变薄,间歇性,有时侵犯周围组织。在复发性BPNST中,肿瘤的初始征象为发育不全,如内皮细胞增生、高细胞化倾向和具有显著Verocay小体的组织学模式。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Retrospective cohort study of morphological features of recurrent schwannomas and neurofibromas
Recurrences of benign peripheral nerves sheaths tumours (BPNST) after total resection were described in 2.6–11.0% of patients. The significance of the histological features of recurrent BPNST is still insufficiently studied.Aim. To compare the pathomorphological features of recurrent and non-recurrent BPNST (schwannomas and neurofibromas).Materials and methods. A retrospective assessment was made of 101 patients with BPNST with a degree of anaplasia corresponding not more than Grade I. Recurrence of BPNST developed in 13 (12.9%) cases. The study included patients with histological archive: the study group (n = 7) included patients with one or more relapses of BPNST, the control group included patients (n = 5) without relapses after surgery for 5 or more years. The main clinical characteristics were studied and histological examination was performed.Results. There were no differences between the groups in baseline characteristics (the type of tumour (schwannoma, neurofibroma), distribution by sex, age, localization, clinical symptoms). The relapse rate among patients with neurofibromas was 8 in 3 patients vs. 6 in 5 patients with schwannomas. In all cases of recurrent schwannomas and in one of neurofibroma, the histological pattern was predominantly monophasic with rhythmic structures like Verocay bodies with underlined pattern and nuclear hyperchromasia, in contrast to the control group, represented by tumours with a mixed type of structure with uniform alternation of various histological patterns (p < 0,05). Endothelial proliferation and lymphocytic infiltration in the stroma and perivascular area were more common in the relapse group (p < 0.05). Pathomorphological signs of anaplasia: cell-nuclear polymorphism, nuclear hyperchromasia, endothelial proliferation, mitosis, as well as minor signs of anaplasia: solidization, muirization of the fascicular pattern of a tumour and apoptotic bodies were found with the same frequency in both groups. With relapse, the capsule was lost, thinned, intermittent, and sometimes invaded the surrounding tissues.Conclusion. Tumours with the initial signs of anaplasia, such as endothelial proliferation, tendency to hypercellularity, and histological pattern with prominent Verocay bodies dominate among recurrent BPNST.
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