圖1 光學(xué)顯微鏡觀察顯示,腫瘤細(xì)胞緊密排列呈Antoni A型 HE染色 ×100 圖2 光學(xué)顯微鏡觀察顯示,馬賽克樣細(xì)胞胞核表達(dá)INI1 免疫組織化學(xué)染色(EnVision二步法) ×400Figure 1 Optical microscopy findings showed tumor cells were composed of compact Antoni A. HE staining ×100 Figure 2 Optical microscopy findings showed nuclei of mosaic cells were positive for INI1. Immunohistochemical staining(EnVision) ×400
叢狀神經(jīng)鞘瘤定義為叢狀或多結(jié)節(jié)性生長的神經(jīng)鞘瘤變異型,可以呈現(xiàn)普通型神經(jīng)鞘瘤或細(xì)胞性神經(jīng)鞘瘤形態(tài)。組織學(xué)形態(tài)觀察,腫瘤組織由緊密、拉長的腫瘤性施萬細(xì)胞組成,排列方式上致密的Antoni A型多于疏松的Antoni B型(圖1),上皮樣細(xì)胞形態(tài)罕見,偶見核分裂象,可見血管透明變性。免疫組織化學(xué)染色,腫瘤細(xì)胞胞質(zhì)和胞核一致性表達(dá)S?100蛋白(S?100),胞核表達(dá)SOX10;“馬賽克”樣細(xì)胞胞核SMARCB1(INI1)陽性(圖2)可見于93%的家族性神經(jīng)鞘瘤、55%散發(fā)性神經(jīng)鞘瘤和83%NF2基因相關(guān)腫瘤,僅5%為孤立性散發(fā)性神經(jīng)鞘瘤。