基礎(chǔ)醫(yī)學(xué)北大病理學(xué)課件 腦部腫瘤

Primaryintracranialtumor:

Glioma膠質(zhì)瘤（40%）Meningioma腦膜瘤（15%）Acousticneurinoma聽神經(jīng)瘤（8%）Metastatictumors:lung,breast

§6Tumors分類發(fā)病率children:glioma,medulloblastoma

髓母細(xì)胞瘤醫(yī)學(xué)課件園Primaryintracranialtumor:§61Size,location>natureLocaleffectGeneraleffect特點(diǎn)影響B(tài)iologic~histologicmalignancyInvasionMetastasistumor醫(yī)學(xué)課件園Size,location>nature特點(diǎn)影響2Differentiation分化ClinicalprogressionGeneticchangesI.Astrocytoma星形細(xì)胞瘤AstrocytomaAnaplasticastrocytoma間變性-Glioblastomamultiforme多形性膠質(zhì)母細(xì)胞瘤醫(yī)學(xué)課件園I.AstrocytomaAstrocytoma醫(yī)學(xué)課件3atypia,mitoticrate,capillary,endothelialcells,necrosis,hemorrhageAstrocytomaAnaplasticastrocytomaGlioblastomamultiformepoorlydefinedgray-whitesolidmultiform多形性:cyst,necrosis,hemorrhageAstrocytona病變醫(yī)學(xué)課件園atypia,mitoticrate,Astrocyto4P53

mutation/lossofchr.17pLossofchr.22qRb

mutation/lossofchr.13qP16deletion/lossofchr.3pLossofchr.19qLossofch.10EGFRgeneamplificationGeneticchangesinastrocytomaNormalastrocyteAstrocytomaAnaplasticastrocytomaGlioblaxtomamultiforme醫(yī)學(xué)課件園P53mutation/lossofchr.175astrocytoma醫(yī)學(xué)課件園astrocytoma醫(yī)學(xué)課件園6醫(yī)學(xué)課件園醫(yī)學(xué)課件園7Astrocytoma醫(yī)學(xué)課件園Astrocytoma醫(yī)學(xué)課件園www.yxkjy.co8Glioblatonamultiforme醫(yī)學(xué)課件園Glioblatonamultiforme醫(yī)學(xué)課件園ww9Giantcellsinglioblastomamultiforme醫(yī)學(xué)課件園Giantcellsinglioblastomamu10Giantcellsinglioblastomamultiforme醫(yī)學(xué)課件園Giantcellsinglioblastomamu11Giantcellsinglioblastomamultiforme,IHGFAP醫(yī)學(xué)課件園Giantcellsinglioblastomamu12Pseudopalisading(glioblastomamultiforme)醫(yī)學(xué)課件園Pseudopalisading(glioblastoma13Endothelialcellproliferationglioblastomamultiforme醫(yī)學(xué)課件園Endothelialcellproliferation14<20yCerebellumPrimitiveundifferentiatedcellsmalltumorcells,scantycytoplasmrosette菊形團(tuán)SeedingthroughCSFHighlymalignantII.Medulloblastoma

髓母細(xì)胞瘤醫(yī)學(xué)課件園<20yII.Medulloblastoma醫(yī)學(xué)課件15Medulloblastoma醫(yī)學(xué)課件園Medulloblastoma醫(yī)學(xué)課件園www.yxkj16醫(yī)學(xué)課件園醫(yī)學(xué)課件園17Seedingofmedulloblastoma醫(yī)學(xué)課件園Seedingofmedulloblastoma醫(yī)學(xué)課件18

From:arachnoidcell蛛網(wǎng)膜細(xì)胞

部位:~arachnoidgranulationdura硬腦膜

大體：solid,gritty砂粒樣

光鏡：whorl-likepatternpsammoma砂粒體Malignant:rareIII.Meningioma腦膜瘤醫(yī)學(xué)課件園III.Meningioma腦膜瘤醫(yī)學(xué)課件園www19meningioma醫(yī)學(xué)課件園meningioma醫(yī)學(xué)課件園20Hereisanotherbenignmeningiomabeneaththedura.Theseneoplasmsareslowgrowing,butmayreachalargesizebeforesymptomsleadtodetection.醫(yī)學(xué)課件園Hereisanotherbenignmeningi21Meningiomaofsphenoidwing醫(yī)學(xué)課件園Meningiomaofsphenoidwing醫(yī)學(xué)課22醫(yī)學(xué)課件園醫(yī)學(xué)課件園23醫(yī)學(xué)課件園醫(yī)學(xué)課件園24醫(yī)學(xué)課件園醫(yī)學(xué)課件園25From:Schwanncell大體:encapsulated,solitary~nerves,spinalroots光鏡:Spindletumorcells,

排列成束狀，網(wǎng)狀BenignIV.Neurilemmoma神經(jīng)鞘瘤Schwannoma醫(yī)學(xué)課件園From:SchwanncellIV.Neuril26Acousticschwannoma醫(yī)學(xué)課件園Acousticschwannoma醫(yī)學(xué)課件園www.y27Schwannomaofaspinalroot醫(yī)學(xué)課件園Schwannomaofaspinalroot醫(yī)學(xué)28Acousticschwannoma醫(yī)學(xué)課件園Acousticschwannoma醫(yī)學(xué)課件園www.y29Gemistocytixastrocytoma醫(yī)學(xué)課件園Gemistocytixastrocytoma醫(yī)學(xué)課件園30Gemistocytixastrocytoma醫(yī)學(xué)課件園Gemistocytixastrocytoma醫(yī)學(xué)課件園31Schwannoma醫(yī)學(xué)課件園