眼眶神经鞘瘤8例临床病理分析

目的：探讨眼眶神经鞘瘤的临床病理特征，诊断及鉴别诊断要点。方法对2010年1月-2012年12月间8例神经鞘瘤进行临床病理学观察及免疫组化染色。结果8例神经鞘瘤，男5例，女3例，年龄21～63岁，平均35岁。右眼5例，左眼3例；肿瘤位于眼眶底2例，眼眶上方6例。以眼球突出为主诉，病程1～10年。肿瘤直径1 cm～5 cm，平均3 cm，呈灰白淡黄色。组织学上：经典型神经鞘瘤6例：5例Antoni A型，1例Antoni B型。陈旧性神经鞘瘤2例，1例具有经典型神经鞘瘤的组织学结构，但其内有较多瘤细胞肥大，异型性明显。1例细胞排列杂乱，以细纹状细胞为主，其内有较多散在大的深染异型性细胞。免疫组化：S-100（＋）、Vimentin （＋）、Ki67（-）。结论陈旧性神经鞘瘤较少见，组织学特点复杂，并有较多异型性细胞，需结合临床并做免疫组化可确诊。

Clinicopathological analysis of orbital neurilemoma：a report of 8 cases

Objective The purpose of this study is to study the clinical and pathological features of neurilemoma .Methods We observed the clinicopathologic features and immunohistochemical staining from eight patients with orbital neurilemoma between 2010.1-2012.12.Results Eight patients with classic neurilemoma were included in the study ,in which there were five males and three females ,aged between 21 and 63,mean age 35.The main symptom of the patients was exophthalmos ,including five cases of right eyes and three left eyes;2 cases of orbital floor and six above orbit ,lasting for one to ten years .The tumor diameter ranged between 1cm and 5 cm,an average of 3 cm,being pale and light yellow color .There were five cases of type Antoni A and one case of type was Antoni B among the six classic type neurilemoma .Two cases of ancient were neurilemoma ,in which one case was the histological structure of the classic type neurilemoma ,but there were more hypertrophy tumor cells , chromatin was coarse block atypia cells .The other one case with cells arranged disorderly ,which was mainly fine striated cells with scattered deeply stained atypia cells ,stromal transparent degeneration ,cystic degeneration .Im-munohistochemistry results showed that S -100（＋）,vimentin（＋）,ki67（-）.Conclusion Antoni type B and ancient schwannoma are rare ,with complicated histologic characteristics .Combined with clinical features and im-munohistochemistry staining ,it can be diagnosed .