Pilocytic Astrocytoma of the Right Orbital Optic Nerve: A Case Report and Review of the Literature

眼球內神經毛囊狀星狀細胞瘤：一病例報告及文獻回顧

楊雅堂(Yia-Tang Yiang) ； 張保欽(Bao-Chiien Chang) ； 韓鴻志(Horng-Jyh Harn) ； 陳震宇(Cheng-Yu Chen) ； 周秉義(Ping-I Chou) ； 趙榮勤(Jung-Chin Chauo) ； 李偉華(Wei-Hwa Lee)

《Journal of Medical Sciences》 20卷1期 (1999/08) Pp. 39-45

摘要

視神經毛囊狀星狀細胞瘤是一種少見的低度惡性腦瘤。本文報告一個22歲男性視神經毛囊狀星狀細胞瘤病患，其主耍臨床症狀是逐漸降低視力合併凸眼。經頭部斷層檢查及核磁共振檢查顯示其右側視神經有一紡綞狀腫塊並呈現局部鈣化點，顯微鏡下呈羅申陶耳氏（Rosenthal）纖維、嗜伊紅性透明樣小球、及一些微囊狀區域類似寡樹突腫瘤細胞，同時可發現有局部透明化血管壁及鈣化點，免疫化學染色顯示腫瘤細胞對神經膠原纖維酸性蛋白（GFAP）呈陽性反應。綜合病人之臨床症候、放射線學表徵、以及病理檢查發現，我們診斷為視神經毛囊狀星狀細胞瘤。因為視神經毛囊狀星狀細胞瘤是一低度惡性腦瘤，手術癒後良好，故必須做一精確的診斷並給予適當的治療，因此提出報告並做臨床病理及放射影像學的討論。

關鍵字

毛囊狀星狀細胞瘤 ； 視神經 ； 神經膠細胞瘤 ； 核磁共振檢查

並列摘要

A case of pilocytic astrocytoma of the right orbital optic nerve in a 22-year-old boy presenting with progressively decreased visual acuity and exophthalmos is reported. Both computerized tomographic scans and magnetic resonance imaging reveal an extracranial intraorbital fusiform mass with foci of calcification. include Rosenthal fibers, eosinophilic hyaline globules, and microcystic zones with areas of oligodendroglioma-like cells are noteced. Focal hyalinized wall of blood vessels and calcification features are also found. Immunohistochemical study shows positive stain for glial fibrillary acidic protein. Thus the diagnosis was confirmed as a pilocytic astrocytoma of optic nerve. It is a grade-1 astrocytoma with excellent prognosis after surgical removal. Tumor excision procedure in this case is necessary for an accurate diagnosis and adequate therapy. The clinico-pathological and radiological features are discussed.

並列關鍵字

pilocytic astrocytoma ； optic nerve ； glioma ； MR imaging