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脳腫瘍

脳腫瘍は,脳実質由来のものだけでなく,頭蓋骨及び頭蓋骨内より発生したすべての腫瘍群をいう. 2007年に改訂された中枢神経系腫瘍のWHO分類(Louis DN, et al(eds): WHO classification of tumours of the central nervous system. 4th edn, IARC, WHO press, Lyon, 2007)を示す(表1).この表から分かるように、脳腫瘍には非常に多くの種類がある.このうち,比較的頻度の高い腫瘍について概説する.なおPituitary adenoma(下垂体腺腫)は,この中枢神経系腫瘍のWHO分類には含まれないが,臨床上,脳腫瘍の一つとして扱われ,本腫瘍についても記載する.

記事のある病名一覧

表1 中枢神経系腫瘍のWHO分類

TUMOURS OF NEUROEPITHELIAL TISSUE

Astrocytic tumours
Oligodendroglial tumours
Oligoastrocytic tumours
  • Oligoastrocytoma
  • Anaplastic oligoastrocytoma
Ependymal tumours
  • Subependymoma
  • Myxopapillary ependymoma
  • Ependymoma(上衣腫)
    • Cellular
    • Papillary
    • Clear cell
    • Tanycytic
  • Anaplastic ependymoma
Choroid plexus tumours
  • Choroid plexus papilloma
  • Atypical choroid plexus papilloma
  • Chroid plexus carcinoma
Other neuroepithelial tumours
  • Astroblastoma
  • Chordoid glioma of the third ventricle
  • Angiocentric glioma
Neuronal and mixed neuronal-glial tumours
  • Dysplastic gangliocytoma of cerebellum (Lhermitte-Duclos)
  • Desmoplastic infantile astrocytoma/ganglioglioma
  • Dysembryoplastic neuroepithelial tumour
  • Gangliocytoma
  • Ganglioglioma
  • Anaplastic ganglioglioma
  • Central neurocytoma
  • Extraventricular neurocytoma
  • Cerebellar liponeurocytoma
  • Papillary glioneuronal tumour
  • Rosette-forming glioneuronal tumour of the fourth ventricle
  • Paraganglioma
Tumours of the pineal region
  • Pineocytoma
  • Pineal parenchymal tumour of intermediate differentiation
  • Pineoblastoma
  • Papillary tumour of the pineal region
Embryonal tumours
  • Medulloblastoma(髄芽腫)
    • Desmoplastic/nodular medulloblastoma
    • Medulloblastoma with extensive nodularity
    • Anaplastic medulloblastoma
    • Large cell mdulloblastoma
  • CNS primitive neuroectodermal tumour
    • CNS neuroblastoma
    • CNS ganglioneuroblastoma
    • Medulloepithelioma
    • Ependymoblastoma
  • Atypical teratoid/rhabdoid tumour

TUMOURS OF CRANIAL AND PARASPINAL NERVES

  • Schwannoma(神経鞘腫)
    • Cellular
    • Plexiform
    • Melanotic
  • Neurofibroma
    • Plexiform
  • Perineurioma
    • Perineurioma, NOS
    • Malignant perineurioma
  • Malignant peripheral nerve sheath tumour (MPNST)
    • Epithelioid MPNST
    • MPNST with mesenchymal differentiation
    • Melanotic MPNST
    • MPNST with glandular differentiation

TUMOURS OF THE MENINGES

Tumours of meningothelial cells
  • Meningioma(髄膜腫)
    • Meningothelial
    • Fibrous (fibroblastic)
    • Transitional (mixed)
    • Psammomatous
    • Angiomatous
    • Microcystic
    • Secretary
    • Lymphoplasmacyte-rich
    • Metaplastic
    • Chordoid
    • Clear cell
    • Atypical
    • Papillary
    • Rhabdoid
    • Anaplastic (malignant)
Mesenchymal tumours
  • Lipoma
  • Angiolipoma
  • Hibernoma
  • Liposarcoma
  • Solitary fibrous tumour
  • Fibrosarcoma
  • Malignant fibrous histiocytoma
  • Leiomyoma
  • Leiomyosarcoma
  • Rhabdomyoma
  • Rhabdomyosarcoma
  • Chondroma
  • Chondrosarcoma
  • Osteoma
  • Osteosarcoma
  • Osteochondroma
  • Haemangioma
  • Epithelioid haemangioendothelioma
Haemangiopericytoma
  • Anaplastic haemangiopericytoma
  • Angiosarcoma
  • Kaposi sarcoma
  • Ewing sarcoma-PNET
Primary melanocytic lesions
  • Diffuse melanocytosis
  • Melanocytoma
  • Malignant melanoma
  • Meningeal melanomatosis
Other neoplasms related to the meninges

LYMPHOMAS AND HAEMATOPOIETIC NEOPLASMS

GERM CELL TUMOURS

  • Germinoma(胚細胞腫)
  • Embryonal carcinoma
  • Yolk sac tumour
  • Choriocarcinoma
  • Teratoma
    • Mature
    • Immature
    • Teratoma with malignant transformation
  • Mixed germ cell tumour

TUMOURS OF THE SELLAR REGION

METASTATIC TUMOURS(転移性腫瘍)