NERVOUSSYSTEM年月(神经模块讲义五年制中英文).ppt

Antoni A Antoni B Antoni A Clinical symptom and prognosis No symptom or tinnitus and hearing loss in some cases Malignant change is extremely rare, although local recurrence can follow incomplete resection 2.5 Neurofibroma神经纤维瘤 The neoplastic cells include schwann cells, perineural cells and fibroblasts Location:多发生在皮下，可单发也可多发 ---in the skin : cutaneous neurofibroma (the most common form) ---in peripheral nerve: solitary neurofibroma 多发性神经纤维瘤又称神经纤维瘤病 （neurofibromatosis） Neurofibroma Morphology In the skin lesions 皮肤及皮下单发性神经纤维瘤境界明显，无包膜，质实，切面灰白略透明，可见旋涡状纤维 ---present as nodules in the dermis and extending to the subcutaneous fat ---well-delineated but unencapsulated masses composed of spindle cells ---the stroma is highly collagenized and contains little myxoid material 由增生的神经鞘膜细胞和纤维母细胞构成，伴多量网状纤维和胶原纤维及疏松的粘液样基质 In peripheral nerves ---lesions are of identical histologic appearance 发生肿瘤的神经粗大，则可见神经纤维消失于肿瘤中 神经纤维瘤 Neurofibroma Prognosis The risk of malignant transformation is extremely small Cosmetic concerns are their major morbidity Tumor of Nervous SheathSchwannoma and neurofibroma CLINICAL TERM LOCATION MAJOR PATHOLOGIC CHANGE PROGNOSIS Schwan-noma The cerebell-opontine angle, other cranial nerves(rare) Well-circumscribed, encapsulated masses attached to the nerve but can be separated from it. Tumors are firm, gray masses, areas of cystic change, a yellow, xanthomatous appearance. Antoni A: elongated tumor cells are arranged in fascicles in moderate to high cellularity, antoni B: less densely cellular tissue along with microcysts and myxoid changes Tinnitus and hearing loss or no symptom. Malignant change is extremely rare Neuro-fibroma The skin (common), the peripheral nerve As nodules in the dermis and extending to the subcutaneous fat, well-delineated but unencapsulated masses. Spindle tumor cells, the stroma contains little myxoid material and is highly collagenized Benign, 10~15% Malignant