良性腺性神经鞘瘤一例

患者男,33岁.左膝关节肿物伴疼痛1年.1年前发现左膝关节肿物伴疼痛,生长缓慢,活动.体检无神经纤维瘤病体征.2007年8月17日在门诊行左膝关节包块切除术,术中见肿物位于皮下,边界清楚,直径约2 cm.局部切除送病理.     

假腺性神经鞘瘤一例

患者女,４８岁。因左颈、肩和上肢间歇性疼痛,表现为活动加重,休息缓解约１年余,于１９９８年９月７日入院。体检：一般检查正常。神经系统检查仅发现左上肢尺侧感觉稍减弱,余未发现阳性定位体征。颈部ＭＲＩ检查显示颈６、７椎管内髓外占位影像。临床诊断：颈６、７椎管内髓外占位病变。入院后第３天行手术探查肿瘤摘除术。术中见在颈６、７硬脊膜下靠脊髓左侧及腹侧有２个肿瘤,肿瘤表面粘附着神经根,完整切除肿瘤。病理检查：肉眼见灰红色肿瘤２个,大小各为１．５ｃｍ×１．５ｃｍ×１．０ｃｍ,１．５ｃｍ×１．０ｃｍ×１．０ｃ…     

跖骨神经鞘瘤一例

患者女,38岁。因左足部包块5年于2000年2月20日入院。体检:左足第3、4跖骨处掌侧及背侧均可扪及结节状肿块,质硬、固定、有压痛。表面皮肤无发红、溃烂等。背侧肿块约3ｃｍ×3ｃｍ,掌侧肿块约2.0ｃｍ×1.5ｃｍ。Ｘ线摄片提示:左第3、4跖骨内生性软骨瘤。临床诊断:左足第3、4跖骨软骨瘤。足背入路行骨肿瘤切除术。术中见:第4跖骨基底部膨大,骨皮质变薄,打开骨皮质见肿块位于骨内,呈淡黄色分叶状,分叶之间有薄层的骨隔,肿块部分突破掌侧骨皮质在软组织内形成一直径2ｃｍ大小的肿块。整个肿块包膜完整,易分离。图1　肿瘤由长梭形和短梭形细胞组…     

肾神经鞘瘤一例

患者男，49岁。2年前体检发现右肾占位性病变，未进一步检查。2年来，无明显症状及体征，体重无明显下降。20d前再次体检发现右肾占位性病变增大，于2004年1月14日入院。体检：无异常。辅助检查：肾功能各项检测值均在正常范围：彩色超声：右肾上极实质内囊实性肿物，     

黑色素性神经鞘瘤三例

例 1　男 ,2 8岁。偶感右腮腺区不适 ,继而发现右腮腺区肿胀、逐渐增大 3个月 ,于 2 0 0 0年 1月入院。体检 :右腮腺区扪及 3ｃｍ× 3ｃｍ肿块 ,质硬 ,边界尚清 ,活动性差 ,无触痛。颈淋巴结未见肿大 ,右腮腺区皮肤正常肤色。腮腺ＣＴ示 :右腮腺内见直径约 2 .5ｃｍ大小的圆形、密度增高、实质性肿块 ,考虑混合瘤可能性大。手术所见 :腮腺浅叶见 4.5ｃｍ×5 .0ｃｍ黑色肿块 ,侵及外耳道 ,外耳道表皮正常 ,切除部分外耳道及腮腺浅叶。病理诊断 :恶性黑色素性神经鞘瘤。随访7个月。术后第 4个月 ,ＣＴ发现右肺 1ｃｍ阴影 ,性质不定。术后第 7…     

心脏恶性神经鞘瘤一例

患者女，１９岁。无明显诱因于１９９８年５月２７日出现双足水肿，１周后口唇紫绀，在当地医院以“急性肾炎”治疗后水肿消失，但口唇紫绀加重，伴活动后心悸、气促于１９９８年７月１８日入我院。体检：口唇明显紫绀，心浊音界向左扩大，心律齐，肝肿大。心电图示：窦性心律，全导联低电压。超声心动图示：右心房带蒂肿物，右室流出道阻塞。手术所见：肿瘤蒂部位于三尖瓣，呈浸润性生长，突入右心房和右心室。病理检查：巨检：手术切除肿瘤组织３块，体积分别为７．５ｃｍ×４．５ｃｍ×４．０、６．５ｃｍ×４．３ｃｍ×４．０、６．０…     

上皮样神经鞘瘤一例

患者男,34岁.因发现左腋下肿块5年于2008年9月10日就诊.体检:左腋下可触及直径约3.0 cm的肿块,位于皮下,呈椭圆形,境界清楚,行肿瘤切除术. 病理检查:肿块一个,椭圆形,3.5 cm×2.2 cm×2.2 cm,有菲薄包膜,切面呈灰白、淡黄色,实质性,部分区域水肿.镜下观察:肿瘤包膜完整,瘤细胞呈单一上皮样细胞.肿瘤由瘤细胞密集区与稀疏区交替构成(图1).密集区瘤细胞成片状、巢状排列(图2),并形成大量巨菊形团样结构(图3,4),菊形团中央为无细胞的纤维样胶原组织,周围有圆形、卵圆形上皮样细胞呈放射状排列.     

支气管内神经鞘瘤一例

支气管内神经鞘瘤一例汤南郑玉龙患儿男，６岁。因阵发性呛咳，少痰，无血；伴有左侧胸痛，不规则发热半个月，于１９９５年９月６日入院。体检：气管向左侧偏移，锁骨上凹淋巴结不肿大，左侧肋间隙变狭，胸廓轻度塌陷，呼吸运动消失，语颤未触及，叩呈实音，无呼吸音，右...     

细胞性神经鞘黏液瘤

细胞性神经鞘黏液瘤是一种特殊的组织发生不明确的良性皮肤肿瘤，由于含有不同程度的明显的黏液基质，原来把它归类于真皮的神经鞘黏液瘤（DNSMs）（所谓的黏液样神经鞘黏液瘤）。事实上，尽管没有足够的证据显示其神经鞘分化，但是这些罕见病变却成了病理学家应该诊断什么的问题，甚至有时误诊为恶性肿瘤，由于报道的病例相对较少及有限的随访资料，其临床特点和形态学谱仍未完全明了，其不典型组织学特征的意义尚不清楚。作者分析了1987～2003年间收集的133例细胞性神经鞘黏液瘤的临床病理和免疫组化特征。女性和男性发病比为1．8：1．0，[第一段]     

假腺性神经鞘瘤

目的：探讨假腺性神经鞘瘤的临床和病理学特征,诊断与鉴别诊断及其发生原因。方法：对2例假腺性神经鞘瘤的组织形态和免疫组化表现进行观察与分析。结果：肿瘤组织具有通常型神经鞘瘤结构外,尚有类似上皮细胞衬覆的腺样或囊样腔隙特征,但衬覆腔隙的细胞下面无基膜存在,而与邻近的梭形瘤细胞移行;黏液和免疫组化CK、EMA、CEA染色均阴性,而S-100蛋白和MBP阳性,结论：衬覆腺样或囊样腔隙的细胞仍系神经鞘细胞,肿瘤内的腺样或囊样腔隙及其内衬覆有似上皮细胞的改变可能与肿瘤的变性有关。     

Benign glandular schwannoma.

The vast majority of reported glandular schwannomas, the rarest type of divergent differentiation in nerve sheath neoplasms, have been malignant tumors. We describe a benign glandular schwannoma, less than 1 cm in diameter, that developed in the deep subcutaneous region of the left flank of a 36-year-old woman. The glandular component occurred as a single large cyst with an undulating lining occupying the central one third of the lesion and was lined in large part by a well-oriented, flattened, single cell layer of cuboidal to low columnar cells with a basement membrane. This extremely unusual lesion, apparently the fourth benign instance reported, is important for several reasons: (1) it does not appear to be a result of inclusion of previously postulated dermal adnexal glands; (2) it further establishes the existence of a true benign counterpart of the glandular schwannoma, of which pathologists should be aware; (3) it can be distinguished from the recently reported pseudoglandular schwannoma; and (4) it lends additional support to the concept of a direct metaplastic origin of the epithelial element from the schwannian component because of the focal presence of a maloriented pseudoglandular element.     

Benign schwannoma of the liver: a case report

A primary benign schwannoma of the liver is extremely rare. Only nine cases have been reported in the medical literature worldwide and no case has been reported in Korea previously. A 36-yr-old woman was admitted to our hospital with vague epigastric pain. The ultrasound and computed tomography scan revealed a multi-septated cystic mass in the right lobe of the liver. The mass was resected; it was found to be a 5 x 4 x 2 cm mass filled with reddish yellow fluid. The histological examination confirmed the diagnosis of a benign schwannoma, proven by positive immunoreaction with the neurogenic marker S-100 protein and a negative response to CD34, CD117 and smooth muscle actin. This is the first report of a benign schwannoma of the liver parenchyma in a Korean patient.     

Malignant glandular schwannoma: a case with favourable prognosis

A solitary malignant schwannoma with glandular differentiation occurred in the forearm of a 54-year-old man. The patient displayed no stigmata of von Recklinghausen's neurofibromatosis. He did well after conservative surgery and there are no signs of recurrence 5 years after operation. The rarity of the tumour and the unusually long survival are points of interest. The histogenesis of the glandular component is discussed.     

So-called glandular schwannoma: ependymal differentiation in a case

A cervical root tumor in a patient with neurofibromatosis showed a biphasic pattern of spindle and epitheloid cells with prominent "gland" formation, characteristic of the so-called glandular schwannoma. Electron microscopy and histochemistry of the "glands" disclosed features consistent with an ependymal differentiation. It is noted that there is a curious preferential association of ependymal lesions and neurofibromatosis, the pathogenesis of which is not understood.     

An unusual case of glandular schwannoma

Glandular differentiation is exceedingly rare in peripheral nerve sheath tumors. In this report, an exceptional case of retroperitoneal glandular schwannoma is described in which the glandular element is markedly atypical, whereas the schwannian component is benign by morphologic analysis. To the best of our knowledge, the biologic behavior for such a lesion is unknown because similar cases have not yet been described in the literature.     

心脏许旺细胞瘤一例

患者女,51岁。因头晕、耳鸣、步态不稳2个月于2005年2月28日入院。患者症状逐渐加重,且出现饮水呛咳、双眼畏光、不能安坐及行走。体检:窦性心律、心律齐,心率80次/min,各瓣膜听诊区未闻及明显杂音。神志清楚,双眼畏光,双侧瞳孔等大正圆;双侧听力减弱,三大常规检查除血白细胞14.74×109/L,中性粒细胞11.69×109/L高出正常值外,其余未见明显异常。外院头颅MRI示:双侧桥小脑角区占位病变,双侧听神经瘤。术前常规心电图:大致正常,电轴右偏。B超:右心房10.9cm×8.0cm实性混合性光团,边界尚清,内部回声不均匀。遂行CT检查,结果:右心房巨大类…     

Intrasellar schwannoma mimicking pituitary adenoma: a case report

Intrasellar location of schwannoma is extremely rare, although intracranial schwannomas account for up to 8% of all primary brain tumors. An unusual case of an intrasellar schwannoma radiographically and clinically simulating a pituitary adenoma is reported. A 39-yr-old man presented a 10-month history of visual disturbance and decreased libido. Neurological examination showed poor visual acuity of both eyes with bitemporal hemianopsia. Computed tomography and magnetic resonance imaging showed a sellar tumor with suprasellar extension. Pituitary adenoma was considered as a preoperative diagnosis. The tumor was removed through a trans-sphenoidal approach. Microscopic examination of the tumor revealed schwannoma.