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Neurological Surgery No Shinkei Geka Volume 27, Issue 6 （June 1999）

Neurological Surgery 脳神経外科 27巻6号（1999年6月発行）

Japanese English

研究

Dysembryoplastic Neuroepithelial Tumor（DNT）の病理像—難治性てんかん手術5例における検討 Pathological Features of Dysembryoplastic Neuroepithelial Tumor (DNT) : study of five surgical cases with intractable epilepsies 浅野英司 ¹ , 鈴木博義 ² , 社本博 ³ , 大槻泰介 ⁴ , 吉本高志 ⁴ Eishi ASANO ¹ , Hiroyoshi SUZUKI ² , Hiroshi SHAMOTO ³ , Taisuke OTSUKI ⁴ , Takashi YOSHIMOTO ⁴ ¹東北大学脳神経外科 ²国立仙台病院臨床検査科 ³広南病院脳神経外科 ⁴国立精神神経センター脳神経外科 ¹Department of Neurosurgery, Tohoku-University School of Medicine ²Department of Pathology and Laboratory Medicine, Sendai National Hospital ³Department of Neurosurgery, Konan Hospital ⁴Department of Neurosurgery, National Center of Neurology and Psychiatry キーワード： dysembryoplastic neuroepithelial tumor , epilepsy surgery , immunohistochemistry Keyword: dysembryoplastic neuroepithelial tumor , epilepsy surgery , immunohistochemistry pp.541-547

発行日 1999年6月10日 Published Date 1999/6/10

DOI https://doi.org/10.11477/mf.1436901736

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Abstract 文献概要
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I．はじめに

　Dysembryoplastic Neuroepithelial Tumor（DNT）は，1988年にDaumas-Duportが新しい臨床病理学的見地から定義した胎生期発達異常を基盤とする良性脳腫瘍である^4）．

　臨床的には，若年発症の難治てんかん患者の大脳皮質に好発し，手術により良好な発作予後が期待できるとされている．DNTは放射線化学療法を不要とするため，他のグリオーマとの鑑別は必須と考えられている^4,11）．

The dysembryoplastic neuroepithelial tumor (DNT), characterized by its favorable prognosis, must beprecisely differentiated from other gliomas to prevent overtreatment by radio/chemotherapy. We studied,here, pathological features of five surgical cases of DNT with intractable epilepsies.

There were two males and three females with a median age of 20.4 years (range 12-41). We evaluatedlesional topography, gross appearances and microscopic findings including immunohistochemical data.

One tumor was located in the temporal lobe, another two in the parietal lobe, another in the occipitallobe, and the other one in the occipito-parietal junction. The lesions were predominantly intracortical in allcases. Macroscopically, two tumors were grayish-soft, another two were yellowish-elastic, and the otherone was resected as soft-mucinous fragments. Microscopically, the main glial components were oligoden-drocyte-like cells (OLCs) in all cases, except for one case in which atypical glial cells were also prominent.Histopathological characteristics of the DNTs included the specific glioneuronal elements (the mixture ofOLCs and neurons) in four cases, alveolar pattern (all cases), microcystic degeneration (all cases), multi-nodular architecture (four cases), and adjacent cortical dysplasia (all cases). Immunohistochemically,Ki-67 labelling indices ranged from 0 to 0.8%. OLCs were positive for glial fibrillary acidic protein in two cases, for S-100 protein in all cases, for synaptophysin in two cases, and for class III β tubulin in all cases. Pathological features of our cases were characterized by its heterogeneous histological appearances anddivergent cellular differentiation.