退行性神经鞘瘤的临床病理学特征

Clinicopathologic characteristics of degenerated neurilemoma

目的报道4例退行性神经鞘瘤,分析其病理组织形态学特点及临床表现。方法组织形态学结合免疫组织化学研究,对4例退行性神经鞘瘤的临床表现、病理形态学特点进行探讨。结果本组4例退行性神经鞘瘤患者均为中年患者;组织学检查,病变具有广泛的粘液样变、囊腔形成、血管壁透明变性和缺乏核分裂相等特点。免疫组织化学染色显示,病变组织不同程度表达S-100、CD68和actin等。结论退行性神经鞘瘤为良性肿瘤,发病率低;较之普通型神经鞘瘤,退行性神经鞘瘤一般具有退行性、不典型性特点,病变缺乏明显的AntoniA区,易被误诊为其他间叶组织肿瘤,导致临床处理不当。组织学检查临床资料与免疫组化三者相结合是诊断所需要的。

Objective To report 4 eases of degenerated neufilemoma and discuss the histological and clinical features. Methods The clinical characteristics and histological features of degenerated neurilemoma were discussed in combination with immunohistochenfical studies. Results Four patients, who were middle-aged adults, were found to have degenerated neurilemoma. Histologically, the tumors were characterized by widespread myxoid, cyst formation, vessel wall hyalillization, and absence of mitoses, hnmunohistochemical staining, the tumors showed positive expression of S-100, CD68 and aetin. Conclusion Degenerated neurilemoma are uncommon and benign tumors. To compare with common neurilemoma, Antoni A areas are usually absent and the disease shows noticeable degenerative atypia. The tumor are frequently confused with other mesenchynkal tumors,resulting in inappropriate clinical management. As a consequence, the diagnosis is often confirmed by way of system testing via clinic, histologyic and immuuohistoehemical studies.