目的作为脑膜瘤的一种罕见亚型,脊索样脑膜瘤因不具备典型脑膜瘤的病理特征,常难以同脊索瘤及其他肿瘤区分,易造成误诊。本研究旨在通过探讨脊索样脑膜瘤临床病理特征、免疫表型及MRI特征表现,进一步提高对该亚型脑膜瘤的认识。方法收集兰州大学第二医院2010-10-01—2015-10-25经手术后病理确诊的4例脊索样脑膜瘤患者临床资料,分析临床病理特征及影像资料,结合相关文献进行对比研究。结果光镜下,4例HE染色示组织学类似脊索瘤,瘤组织排列成束状或小梁状分布于黏液样基质中,瘤细胞胞质丰富,嗜酸,并可见胞质内空泡,部分区域为典型脑膜瘤漩涡状、束状、编织状结构,2例瘤组织间可见少量淋巴细胞、浆细胞浸润。免疫表型示,瘤细胞EMA(+)、Vimentin(+)、CKp(-)、S-100(-)、GFAP(-),Ki-67阳性细胞数平均为8%。MRI示,4例均为单发病灶,3例位于顶叶,1例位于额颞叶;2例为实性类圆形,1例呈不规则团块状,1例为囊实性,实性呈结节状附壁生长;2例病灶界限不清,2例边界清晰;4例瘤周水肿明显,邻近脑组织均有不同程度受累;T1WI 4例呈等、略低信号;T2WI 3例呈等、略高信号,1例呈等、略低信号。结论诊断脊索样脑膜瘤,应结合形态学、相应的免疫组化染色及具有一定表现特征的影像学检查,以有效降低误诊率。 Purpose As a rare subtype of meningioma, chordate-like meningioma is often difficult to differentiate from chordoma and other tumors because it does not have the pathological features of typical meningiomas, which may easily lead to misdiagnosis. The aim of this study is to further improve the understanding of this subtype of meningioma by exploring the clinicopathological characteristics, immunophenotype and MRI features of chordate-like meningioma. Methods The clinical data of 4 cases of spinal meningioma confirmed by pathology after operation were collected, and the clinicopathological features and imaging data were analyzed. The related literatures were compared with each other. Results Under light microscope, four cases of HE staining showed histological similar to chordoma. The tumor tissues were arranged in a bundle or trabecular shape in the mucoid matrix. The tumor cells were rich in cytoplasm and had eosinophilicity. The cytoplasm vacuoles, Some areas of typical meningioma whorls, bundles, braided structure, 2 cases of tumor tissue showed a small amount of lymphocytes, plasma cell infiltration. The immunophenotypes showed that the average number of EMA (+), Vimentin (+), CKp (-), S-100 (-), GFAP (-) and Ki-67 positive cells was 8%. MRI showed single lesions in 4 cases, 3 in the parietal lobe, 1 in the frontotemporal lobe, 2 in the solid round, 1 in the irregular mass, 1 in the cyst, 2 cases showed unclear boundary, 2 cases had clear boundary, 4 cases had obvious peritumoral edema and adjacent brain tissues were involved in varying degrees, 4 cases showed equal and slightly lower signal on T1WI, 3 cases showed T2WI Was waited, slightly higher signal, 1 case was waited a little lower signal. Conclusion The diagnosis of chorda-like meningioma should be combined with morphological features, the corresponding immunohistochemical staining and imaging features with certain characteristics to effectively reduce the misdiagnosis rate.