Neurological Surgery 脳神経外科46巻8号

2018年08月発行

症例

骨髄転移を来したIDH変異・1p/19q共欠失乏突起膠腫の1例

著者： 喜古一成¹ 陶山謙一郎¹ 山本邦厚¹ 持田英俊¹ 大屋滋¹ 唐澤秀治¹ 渡辺三郎¹ 鈴木良夫²

所属機関： ¹総合病院国保旭中央病院脳神経外科 ²総合病院国保旭中央病院臨床病理科

ページ範囲：P.699 - P.706

Ⅰ．はじめに
　2016年のWHO脳腫瘍分類第4版改訂版では，従来の形式学的分類のみでなく，分子情報を合わせた診断名が用いられることとなった．とりわけ神経膠腫については，分子遺伝学的知見を重視するという方向性がHaarlemコンセンサスガイドライン（2014年）¹⁶⁾において打ち出された．乏突起膠細胞系腫瘍はその考え方が最も色濃く反映された腫瘍型の1つとなり，乏突起膠細胞系腫瘍の診断にはIDH変異の有無と1p/19q共欠失の有無についての検討が必要となった．
　乏突起膠腫は成人に発生するびまん性，浸潤性に進展する腫瘍で，近傍の軟膜直下にもしばしば浸潤が及ぶとされるが，頭蓋外転移の報告は極めて少ない．今回われわれは，術後約半年で多発骨髄転移を来した症例を経験したので，文献的考察を加えて報告する．

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