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[目的]探讨中分化松果体实质肿瘤(PPT)的临床病理特征,提高对中分化PPT的认识。[方法]对3例中分化PPT进行光镜、免疫组化标记检查,复习3例患者的临床资料及相关文献并随访。[结果]3例均为成年患者,男性2例,女性1例,主要症状为头晕、头痛、呕吐、行走不稳等。肿瘤位于松果体区,直径1.6～3.0cm。光镜下瘤细胞密度中等,呈弥漫状、巢片状分布,分化程度中等,或具有松果体细胞瘤和松果体母细胞瘤混合的区域,可见Homer-Wright菊形团、松果体细胞瘤菊形团。免疫表型示所有瘤细胞表达Syn和NF,少数细胞表达CgA,GFAP、S-100、CK、EMA均阴性,Ki-67可见高表达和低表达区域。[结论]中分化PPT是一种罕见的中枢神经系统肿瘤,诊断主要依靠临床特点、组织病理特征及免疫表型。
[Objective] To explore the clinicopathological features of moderately differentiated pineal parenchymal tumor (PPT) and to improve the understanding of differentiated PPT. [Method] The 3 cases of differentiated PPT were examined by light microscope and immunohistochemistry. The clinical data and related literature of 3 cases were reviewed and followed up. [Results] Three cases were all adult patients. There were 2 males and 1 females. The main symptoms were dizziness, headache, vomiting, unstable walking and so on. Tumor located in the pineal area, diameter 1.6 ~ 3.0cm. Under the light microscope, the tumor cells were medium density, diffuse, spreading in the form of a lamella, moderately differentiated, or mixed with pinealoblastoma and pinealoblastoma, showing that Homer-Wright chrysanthemum, pineal Cell tumor chrysanthemum. Immunophenotype showed that Syn and NF were expressed in all tumor cells, CgA was expressed in a few cells, negative for GFAP, S-100, CK and EMA, and Ki-67 showed high expression and low expression. [Conclusion] Differentiated PPT is a rare central nervous system tumor. The diagnosis mainly depends on clinical features, histopathological features and immunophenotype.