纵隔巨大神经纤维鞘瘤病例报道并文献复习

Giant Neurilemmoma of Mediastinum:A Case Report and Literature Review

目的报道1例无症状纵隔巨大神经纤维鞘瘤,提高其认识。方法对2009年5月上海长海医院收治的1例纵隔神经纤维鞘瘤患者的临床、影像学及病理资料进行分析,并复习相关文献。结果患者体查发现右侧胸腔巨大占位1周就诊,经CT引导下行组织穿刺活检,病理结果证实为神经纤维鞘瘤,并行外科手术切除治疗。结论巨大纵隔神经纤维瘤发病率低,临床表现多不典型,易误诊、漏诊,多生长至体积巨大后才被发现,增加了手术风险。经皮穿刺组织活检或开胸活检病理检查可明确诊断。

Objective To describe a case of giant asymptomatic neurilemmoma of mediastinum. Methods The clinical, radiographic and pathological characteristics of a patient admitted to Changhai Hospital Affiliated to Second Military Medical University in May 2009 presenting with large shadow on chest radiograph was analyzed, and related literature was reviewed. Results Radiographic examination revealed a large mass occupying the right thoracic cavity. Then the pathological issue was obtained by percutaneous CT-guided needle biopsy. Neurilemmoma was proved by pathological study. Conclusions The low morbidity of giant neurilemmoma of mediastinum, with most of the cases remaining asymptomatic, is prone to misdiagnosis. The large mediastinal mass in the thoracic cavity increases the risk of thoracotomy. It can be pathologically diagnosed through percutaneous image-guided needle biopsy or surgical biopsy.