髄膜性腫瘍の病理  [in Japanese] Pathology of Meningeal Tumors  [in Japanese]

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Abstract

髄膜からは多種多様の病変が生じる.髄膜腫は脳神経外科領域において最もよく遭遇する髄膜性腫瘍である.過去数十年にわたり髄膜腫に対する組織学的分類が検討されてきたが, 2000年に改訂されたWHO分類では新しい診断指針が示された.ほとんどの髄膜腫は良性であり, WHO分類のgrade (G) Iに相当する.その一部には悪性の髄膜腫があり, それらをG IIあるいはGIIIとし, 良性の髄膜腫と区別している.明細胞髄膜腫, 脊索腫様髄膜腫, 異型性髄膜腫はGIIで, 術後再発する可能性が高い.乳頭状髄膜腫, ラブドイド髄膜腫, 退形成性髄膜腫はGIIIで, 脳への浸潤や転移も認められ, 全摘したと考えられても再発する危険性がきわめて高い.髄膜性腫瘍の術後には摘出標本の詳細な分類とKi-67標識率の検討が必須である.

The meninges (dura mater, arachnoid, pia mater) are the site of numerous pathological lesions including inflammation and neoplasm. Meningiomas are the most frequently observed lesions and the most common of primary meningeal tumors. Over the years, meningiomas have been histologically classified and some entities have been added to the cadre of meningioma variants, while others have been designated as other types and tumors. The 2,000 revision of the WHO system provided diagnostic guidelines. Most meningiomas are biologically benign and correspond to WHO grade I. However, certain meningiomas have an increased tendency to recur or follow an aggressive clinical behavior and are assigned to WHO grade II and III. Atypical meningioma, clear cell meningioma and chordoid meningioma, corresponding to WHO grade II, have a substantially increased incidence of recurrence. Rhabdoid meningioma, papillary meningioma and anaplastic meningioma, corresponding to WHO grade III, have an even higher incidence of recurrence and may be associated with systemic metastasis or brain invasion.

Journal

  • Japanese Journal of Neurosurgery

    Japanese Journal of Neurosurgery 14(12), 761-771, 2005

    The Japanese Congress of Neurological Surgeons

References:  57

Cited by:  2

Codes

  • NII Article ID (NAID)
    110004050253
  • NII NACSIS-CAT ID (NCID)
    AN10380506
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    0917-950X
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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