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目的探讨难治性癫相关脑肿瘤及瘤样病变的临床病理特征。方法对因难治性癫接受致病灶切除术并经病理诊断为脑肿瘤及瘤样病变的患者临床资料进行回顾性研究。结果患者42例,平均发病年龄11.1岁,平均病程10.5年,头颅核磁共振检查多见异常信号表现(95.2%,40/42),多位于颞叶(76.2%,32/42)。组织学分类最多为节细胞胶质瘤(40.5%,17/42),肿瘤常伴有局灶性皮质发育不良(61.9%,26/42)。免疫组化:21例CD34(+)、23例nestin(+)。结论难治性癫相关脑肿瘤及瘤样病变诊断应强调临床、影像和病理学特点的综合判断,nestin免疫组化染色对诊断与鉴别诊断有一定的应用价值。
Objective To investigate the clinicopathological features of brain tumors and tumor-like lesions in refractory epilepsy. Methods The clinical data of patients with refractory epilepsy who received focal resection of the fistula and who were pathologically diagnosed as brain tumors and tumor-like lesions were retrospectively reviewed. Results There were 42 patients with an average age of 11.1 years and a mean duration of 10.5 years. Most of them showed abnormal signals (95.2%, 40/42) in the MRI of the skull and were mostly located in the temporal lobe (76.2%, 32/42). The most histologic classification was gangliosarcoma (40.5%, 17/42). The tumors were often associated with focal cortical dysplasia (61.9%, 26/42). Immunohistochemistry: 21 cases of CD34 (+), 23 cases of nestin (+). Conclusion The diagnosis of intractable epilepsy-associated brain tumors and tumor-like lesions should emphasize the comprehensive judgment of clinical, imaging and pathological features. The immunohistochemical staining of nestin may be of value in diagnosis and differential diagnosis.