【双语病例】脑室神经鞘瘤

病史

A 33-year-old woman with headache, right upper quadrant visual cut, and difficulty reading

33岁女性,头痛、右上方视野缺损、阅读困难。

【双语病例】脑室神经鞘瘤

【双语病例】脑室神经鞘瘤

【双语病例】脑室神经鞘瘤

图例Coronal postcontrast T1WI (A) and sagittal postcontrast T1WI (B) demonstrate an enhancing lesion along with left periatrial/posterior temporal lobe region.增强扫描T1WI冠状位及矢状位示左侧颞枕叶、侧脑室旁结节明显强化。

【双语病例】脑室神经鞘瘤

Reticulin staining (C) is more consistent with schwannoma than either meningioma or ependymoma. Reticulin staining was found to be strong in greater than 50% of the tumor.

网状细胞染色考虑许旺氏细胞瘤可能性大于脑膜瘤或室管膜瘤,超过50%的许旺氏细胞瘤在网状细胞染色时可见胞质淡染。

【双语病例】脑室神经鞘瘤
Vimentin staining (D) is somewhat less likely to be positive in an ependymoma.

波形蛋白染色也不符合室管膜瘤。

【双语病例】脑室神经鞘瘤

Intraventricular Schwannoma脑室神经鞘瘤

背景

  • Schwannomas are benign nerve sheath tumors that are often found in extra-axial locations and commonly involve the eight cranial nerve.神经鞘瘤是起源于神经鞘的良性肿瘤,通常位于脑外,易累及第8颅神经。
  • Intraventricular schwannomas, however, are exceedingly rare.脑室神经鞘瘤特别罕见。
  • Of the few cases of intraventricular schwannomas, it is noted that they present earlier in life.仅有的几例脑室神经鞘瘤都发生于年轻人。
临床表现Although clinical presentation depends on the location of the intraventricular schwannoma, patients commonly present with headaches, intracranial hypertension, seizures, and other focal neurological deficits.脑室神经鞘瘤的临床症状通常与病灶的位置有关,常表现为头疼、颅内高压、癫痫、及其他局部神经功能缺失症状。

影像诊断要点

  • No defining characteristic is noted of an intraventricular schwannoma on radiologic evaluation.脑室神经鞘瘤影像学检查缺乏特征性表现。
  • It may be cystic in nature and may present with calcifications or perilesional edema and gliosis.病灶可囊变、钙化,瘤周可见水肿及胶质增生。
  • It may enhance homogeneously or in-homogeneously post contrast administration.增强扫描可以均匀或不均匀强化。
鉴别诊断

  • Meningiomas脑膜瘤
  • Choroid plexus papillomas or carcinomas脉络丛乳头状瘤/癌
  • Ependymomas室管膜瘤
治疗要点If possible, gross total resection of the tumor should be performed.如果条件允许,尽可能选择手术全切。

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