Solitary fibrous tumor of central nervous system masquerading as meninigioma: Report of a rare case

IntroductionSolitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin that occurs most often in the visceral pleura. It rarely occurs in the central nervous system (CNS). If they occur intracranially, they are extra-axially located and develop from the meninges.Case ReportHerein, we present a case of SFT in a 45 years old female. MR imaging showed isointense to hypointense signal intensity, and marked enhancement. Microscopically, the tumors showed characteristic “patternless-pattern” architecture. Elongated tumor cells formed fascicles alternating with hypocellular densely collagenous stroma. Immunohistochemistry for STAT6, CD34, BCL2 and CD99 favours the definitive diagnosis of SFT.ConclusionIn general, complete surgical resection may offer the best chance of a favourable clinical outcome. Their biological features remain largely unknown. Hence, the clinical management and prognosis is often challenging due to the lack of comprehensive data.     

Primary malignant lymphoma of the central nervous system

The occurrence of primary malignant lymphomas of the central nervous system in a population of approximately 1 million people has been analyzed retrospectively. Over a 12-year period, about 1000 tumors of the central nervous system were registered. Among these, 22 were primary malignant lymphomas; incidence, 1.83 per million per year. Thirteen of these tumors were of high-grade malignancy and nine were of low-grade malignancy (Kiel classification of non-Hodgkin lymphomas). The majority of the tumors were B-cell lymphomas, and there were no Hodgkin lymphomas. Neither spinal nor meningeal lymphomas occurred. Nine patients were treated only surgically, whereas 11 received postoperative irradiation or chemotherapy, or both. Of the latter patients, six are alive and well at the time of writing. The importance of making a correct diagnosis preoperatively is stressed, inasmuch as radical operation is unfavorable for these patients. A better prognosis is obtained with combinations of irradiation and chemotherapy.     

Epithelial cysts in the central nervous system,characteristic expression of cytokeratins in an immunohistochemical study

Summary Nineteen epithelial cysts in the central nervous system including six colloid cysts of the third ventricle, seven Rathke's cleft cysts in the sella, two enterogenous cysts in the posterior fossa, two epithelial cysts in the spinal canal and two neuroectodermal cysts in the cerebrum were examined immunohistochemically for expression of intermediate filament proteins-simple type, stratified type and skin type cytokeratins and GFAP. Colloid cysts of the third ventricle, Rathke's cleft cysts in the sella and epithelial cysts in the spinal canal expressed complex type cytokeratins while enterogenous cysts and neuro-ectodermal cysts showed only simple type cytokeratins. In addition, Rathke's cleft cysts expressed GFAP in occasional lining cells. The characteristic composition and distribution of cytokeratins in various kinds of epithelial cysts in the central nervous system are demonstrated and discussed with regard to their origins.     

小胶质细胞活化对中枢神经系统功能的影响

背景 小胶质细胞(microglia,MG)是中枢神经系统(central nervous system,CNS)中一种重要的免疫细胞,MG的活化可对CNS功能产生重要影响.目的 通过探讨活化状态的MG生物学特性和临床应用前景,总结出关于MG活化有价值的研究方向.内容 对MG细胞活化状态的生物学特性进行探讨,并总结在何种情况下MG活化发挥神经损伤作用,在何种情况发挥神经保护作用及MG活化的可能临床应用及面临问题.趋势 MG的活化对CNS既可产生保护作用,又可产生损伤作用,如何通过调节MG的活化状态,趋利避害,是今后的研究方向.     

69例新生儿中枢神经系统感染的颅脑超声结果分析

目的观察新生儿中枢神经系统感染颅脑超声声像图改变的特点。 方法选取69例中枢神经系统感染新生儿为研究对象,采用便携式索诺声M-turbo超声诊断仪经前囟门型颅脑超声检查,观察脓性脑膜炎、病毒性脑膜炎和结核性脑膜炎声像图改变特点及差异。 结果化脓性脑膜炎及结核性脑膜炎脑膜回声异常阳性率为92.7%和100.0%,高于病毒性脑膜炎的20.0%,脑室扩张阳性率均为100.0%,高于病毒性脑膜炎的55.0%,积液阳性率为63.4%和75.0%,高于病毒性脑膜炎的5.0%,硬膜下积液阳性率为26.8%和12.5%,低于病毒性脑膜炎的95.0%,差异均具有统计学意义（χ²= 39.031、25.358、21.058、29.087,P均<0.01）。 结论颅脑超声检查是新生儿中枢神经系统感染有效的诊断手段,对化脓性脑膜炎、结核性脑膜炎和病毒性脑膜炎影像学检查声像图改变较为清晰,诊断准确、方法简便、无创伤,是新生儿中枢神经系统感染辅助诊断及动态观察的有效手段。     

线粒体跨细胞转运参与中枢神经系统疾病研究进展

线粒体是细胞氧化磷酸化及合成ATP的主要场所,在维持钙稳态、调节活性氧自由基产生、能量平衡与代谢、诱导程序性细胞死亡中均发挥重要作用。越来越多的证据提示线粒体可在细胞间发生转移,对机体产生保护或有害的影响。多种转运方式介导线粒体的跨细胞转运,然而深入的转运机制仍未完全阐明。目前发现线粒体跨细胞转运在多种中枢神经系统疾病损伤修复中具有重要意义。文章主要就线粒体功能、线粒体跨细胞转运及其转运机制、线粒体跨细胞转运与中枢神经系统疾病进行概述。     

腹腔高压症对中枢神经系统影响的研究进展

腹腔高压症是腹腔内压持续或反复病理性升高并〉12mmHg的病理状态,不仅可以引起腹腔脏器的变化,而且会损害心、肺及中枢神经系统功能,在危重患者中发病率和死亡率高。阐明其对中枢神经系统损害的影像表现、具体病理表现、分子水平变化和引起这些变化的具体机制,可进一步提高合并有颅脑损伤患者的治愈率。     

细菌性中枢神经系统感染的实验室诊断研究进展

细菌性中枢神经系统感染是常见且严重的颅内感染性疾病,其早期实验室诊断对治疗和预后有重要作用。细菌性中枢神经系统感染的实验室诊断由脑脊液常规和生化等传统检测,逐渐发展为PCR技术、核酸杂交、16S r RNA测序以及基因芯片技术的多方法、多指标联合检测和多学科合作,促进了该病早期、快速的实验室诊断发展。本文就细菌性中枢神经系统感染的流行病学、常见致病菌及实验室诊断等方面进行了综述。     

The different faces of central nervous system metastases

Cerebral metastases are the commonest central nervous system tumors. The MR assessment should include T1-weighted images with and without enhancement and T2/FLAIR images. They usually appear as multiple lesions with nodular or annular enhancement and are surrounded by edema. They are hypervascularized and have no restriction of their diffusion coefficient in their necrotic area and contain lipids on 1H spectroscopy. Metastases can be distinguished from primary tumors by the lack of malignant cell infiltration around the tumor. Stereotactic radiotherapy may temporarily increase tumor volume, although this is not of adverse oncological value. Less commonly, spinal disease may be asymptomatic and should be examined by MR.     

The central nervous system in childhood chronic kidney disease

Neurodevelopmental deficits in pediatric and adult survivors of childhood onset chronic kidney disease (CKD) have been documented for many years. This paper reviews the available literature on central nervous system involvement incurred in childhood CKD. The studies reviewed include recent work in neuroimaging, electrophysiology, and neuropsychology, along with commentary on school functioning and long-term outcomes. The paper concludes with suggestions for monitoring the neurodevelopmental status and pursuing appropriate early interventions for children with CKD.     

Maintenance of cell volume in the central nervous system

Maintenance of the ionic and osmotic composition and volume of intra- and extracellular fluids in the brain is crucial for normal functioning of the central nervous system (CNS). Osmoregulation in the CNS is mediated by solute and water transport across the blood-brain barrier, choroid plexus and plasma membrane of glial cells and neurons. Despite its clinical and physiological significance, however, little is known about the underlying cellular and molecular mechanisms by which CNS osmotic and ionic balance is maintained. In this review, I will discuss our current understanding of cell volume regulation in the CNS and how it relates to various disease processes, such as hyponatremia, renal failure and hypernatremia. A detailed understanding of brain osmoregulatory processes represents a fundamental physiological problem and is required for the treatment of numerous disease states, particularly those encountered in the practice of nephrology.     

Breast cancer subtypes and outcomes of central nervous system metastases

Central nervous system (CNS) metastases are detected in up to one third of patients with advanced breast cancer, but their incidence and outcomes by breast cancer subtypes are not precisely documented. Herein, we retrospectively analyzed clinicopathologic data of 259 breast cancer patients with CNS metastases to evaluate the association between breast cancer subtypes and CNS metastasis. The patient groups were classified according to their hormone receptor status and HER-2 expression. Median follow-up time among the patients was 42 months and median survival after CNS metastasis detection was 7.8 months. In HER-2 overexpressing group, median time period between the diagnosis of breast cancer and the detection of CNS metastasis (15.9 months) was significantly shorter compared to the other groups (p = 0.01). The triple negative group had the shortest median survival time after CNS metastasis (6.6 months), although statistically not significant (p = 0.3). In multivariate Cox regression analyses, having solitary CNS metastasis (HR 0.4, 95% CI; 0.2–0.7, p = 0.004), and receiving chemotherapy after CNS metastasis (HR 0.4, 95% CI; 0.287–0.772, p = 0.003) were independent prognostic factors for increasing survival after CNS metastasis. In conclusion, new and effective treatment strategies are required for breast carcinoma patients with brain metastasis considering the positive effect of the treatment on survival.     

原发性中枢神经系统淋巴瘤的诊断和治疗

目的探讨原发性中枢神经系统淋巴瘤（PCNSL）的临床特点,提高对PCNSL的认识。方法回顾性分析43例PCNSL患者的临床表现、实验室检查、影像学特点、组织病理类型以及治疗方法。结果单发病灶36例,多发病灶7例,共手术治疗47次。首发症状为颅内压增高22例（51．2％）,肢体偏瘫、抽搐、语言障碍16例（37．2％）,记忆力下降、意识情感障碍10例（23．3％）。脑脊液蛋白含量高于正常者66．7％（8／12）。B细胞型淋巴瘤40例（97．6％）,T细胞型1例（2．4％）。Ki-67阳性表达指数42．8％±23．3％。结论CT、MRI及脑脊液检查是术前诊断PCNSL的重要方法,外周血淋巴细胞增高不能作为诊断PCNSL的依据。手术在于缓解症状和确定病变的病理类型,术后化疗加全脑放疗是治疗PCNSL的有效方法。     

中枢神经系统胃动素的分布及其对胃肠动力调控的机制

背景 研究表明胃动素为一种脑肠肽,除胃肠道和血浆以外,在中枢神经系统也有广泛分布,于多水平参与机体胃肠及其他功能的调控,并发挥重要作用. 目的 探讨中枢胃动素的分布及对胃肠动力的调控机制. 内容 综述胃动素的分子生物学特性、信号转导通路以及在中枢神经系统的分布和作用等. 趋向 中枢胃动素的分布及其对胃肠动力的作用机制正在成为新的研究热点,特别是各种疼痛诱发的中枢及外周水平胃动素表达的变化及其信号转导通路值得我们深入研究.     

高迁移率族蛋白1在中枢神经系统疾病中的作用

高迁移率族(high mobiliby group box,HMGB)蛋白是一类核蛋白,释放至细胞外的HMGBI参与了外周诸多疾病的发生.近年来研究表明,HMGBI也参与了中枢神经系统疾病的发生.现简要阐述HMGB1的外周作用,着重介绍其在中枢神经系统疾病,特别脑缺血中的作用.     

62例行神经外科手术治疗的获得性免疫缺陷综合征合并中枢神经系统感染者的临床特点

目的探讨经神经外科手术治疗的获得性免疫缺陷综合征（AIDS）合并中枢神经系统感染者的临床特点。 方法回顾性分析2012年1月至2018年12月于首都医科大学附属北京地坛医院神经外科行手术治疗的62例AIDS合并中枢神经系统感染者的临床资料。 结果经手术治疗的62例AIDS合并中枢神经系统感染者占神经外科同期收治的AIDS合并中枢神经系统病变患者的28.4%（62/218），主要临床表现为发热、颅内高压、功能障碍、头晕以及癫痫。32例（51.6%）患者接受分流术，11例（17.7%）患者行病变活检术，19例（30.6%）患者开颅行颅内占位切除术。经实验室检测及术后病理确诊的62例患者中真菌感染33例（53.2%），病毒及梅毒肉芽肿感染各1例（1.6%），寄生虫感染5例（8.1%），结核分枝杆菌感染8例（12.9%），细菌感染4例（6.5%），不明原因感染9例（14.5%），混合性感染1例（1.6%）。经手术治疗后，46例（74.2%）患者好转，14例（22.6%）患者无变化，2例（3.2%）患者放弃治疗。 结论AIDS合并中枢神经系统感染病原谱广泛，临床表现以发热、颅内高压、功能障碍、头晕、癫痫为主，真菌感染发病率最高，手术干预为此类疾病诊疗的重要手段之一，可提高其诊疗效率。     

中枢神经损伤对大鼠股骨骨折愈合影响观察

摘要：[目的] 观察中枢神经损伤后大鼠股骨骨折愈合速度和骨痂量的变化，分析中枢神经损伤对大鼠股骨骨折愈合速度影响的机制。[方法] 54只雄性Wistar大鼠随机分成3组，（1）脑外伤合并股骨骨折组18只；（2）脊髓损伤合并股骨骨折18只；（3）单纯股骨骨折18只。术后7、14、28d分批处死动物，大体体积测量骨痂，X线片评分，并做HE染色比较。[结果] 脑外伤组，脊髓损伤组形成骨痂体积、X线片评分高于单纯股骨骨折组，差异有显著性（P〈0．05）。HE染色结果显示脑外伤组、脊髓损伤组骨折愈合速度较单纯骨折组加快。[结论] 中枢神经损伤后大鼠骨折愈合加速，骨痂量增多，中枢神经损伤后引起骨痂量和骨折愈合速度的改变，表明中枢神经损伤对骨折愈合有促进作用。     

Intraparenchymal schwannomas of the central nervous system: An additional case report and review

Intraparenchymal location of schwannomas in the central nervous system (CNS) is rare. Occasional cases involving the cerebrum, cerebellum, brain stem, and spinal cord have been reported. We report here an additional case of thoracic intramedullary schwannoma in a 42 year old woman. The literature concerning intraparenchymal schwannomas in the CNS is reviewed and discussed.     

髓样细胞激发受体-2在中枢神经系统疾病中的研究进展

背景 髓样细胞激发受体(triggering receptor expressed by myeloid cells,TREM)是一种免疫球蛋白超家族受体,TREM-2在中枢神经系统(central nervous system,CNS)主要表达于小胶质细胞.研究发现TREM-2的激活可产生抑制小胶质细胞过度活化、减少促炎症因子分泌进而减轻CNS炎症损伤程度的作用.因此,TREM-2的激活可能产生神经保护作用.目的 探讨TREM-2在CNS疾病中的研究进展,通过减轻CNS炎症,进而为治疗CNS疾病提供新的治疗策略.内容 介绍TREM家族的特性,阐述TREM-2在不同CNS疾病中的功能,探讨其发挥作用的相关机制.趋向 TREM-2可能成为减轻CNS炎症反应的新靶点,为CNS疾病的治疗提供新的方向.     

反向眼球扫视运动检查在心脏外科术后中枢神经功能评估中的应用

目的 探讨反向眼球扫视运动检查（Antisaccadic eye movement test,ASEM）在心脏外科术后中枢神经系统功能障碍评估中的应用价值。方法 根据术后中枢神经系统功能障碍,将921例心脏外科术后病人分为三组;I组术后合并脑血管病、脑病等神经系统局灶体征;Ⅱ组术后仅表现迟钝、定向力差、谵妄、激惹、抽搐等神经系统症状;Ⅲ组术后神经系统既无症状也无体征。全部病人均进行术后 ASEM和简短精神状态量表（Mini-mental state examination,MMSE）检查。结果 ASEM检查完成分数与MMSE分数密切相关（γ=0.67,P<0.01）。I组 ASEM不能完成率（ASEM分数=0）明显高于Ⅱ组（P<0.05）,I组和Ⅱ组ASEM不能完成率明显高于Ⅲ组（P<0.01）,Ⅲ组ASEM全部完成率（ASEM分数=10）明显高于I组和Ⅱ组（P<0.01）。结论ASEM检查不仅能反映心脏外科术后神经功能障碍,而且也可反映术后高级认知功能障碍。