椎管内神经节细胞瘤的临床病理分析并文献复习

Clinicopathologic analysis of intraspinal ganglioneuromas and review of the literature

目的探讨椎管内神经节细胞瘤的临床与病理特性,并复习文献,提高对该疾病的认识。方法回顾性分析安徽省立医院2010年6月至2016年8月经手术和病理证实的6例原发于椎管内神经节细胞瘤的临床、影像和病理资料,分析其临床和病理特征。结果 6例原发于椎管内神经节细胞瘤患者,男性2例,女性4例,发病年龄33~70岁,平均51.8岁。术前均行MRI检查,均诊断为神经源性肿瘤。肿瘤通过椎间孔内外生长,1例由椎间孔外向硬脊膜下生长,4例由椎间孔外向硬脊膜外生长,另1例位于椎间孔处。其中颈段3例,胸腰段1例,腰段1例,骶段1例。6例患者中,2例主诉肢体乏力伴麻木,2例主诉颈肩腰背部和肢体疼痛、1例主诉腰痛伴肢体麻木,另1例为体检发现。手术采用后正中入路肿瘤全切除术。术后病理诊断为神经节细胞瘤,HE染色可见基质内散在特征性的成熟神经节细胞,无核分裂像。术后随访6~80个月,无肿瘤复发。结论椎管内神经节细胞瘤属于生长缓慢的良性肿瘤,病理具有特征性,易于诊断。手术切除后,预后良好。

Objective To investigate the clinical and pathological characteristics of spinal ganglioneuromas in order to improve the knowledge of the disease. Methods Retrospective analysis of clinical,imaging and pathological data of 6 patients who underwent surgery and confirmed with pathology of ganglioneuroma in Anhui Provincial Hospital from June 2010 to August 2016. Results Six cases of spinal ganglioneuromas, identified with pathology were collected, including 2male and 4 female patients with the average age of 51.8 years（range 33~70 years）. All patients performed MRI examination before operation, and all of them were diagnosed as neurogenic tumors. There were 3 lesions located in the cervical segment, 1 lesion in the thoracolumbar segment, llesion in the lumbar segment and 1 lesion in the sacral segment. The tumor grew through the intervertebral foramen, 1 cases grew from the intervertebral foramen to the intradural and 4 cases from the intervertebral foramen to the extradural and the other 1 case were located in the in- tervertebral foramen of the spinal cord. In 6 patients, 2 patients with limb weakness and numb- ness,2 cases of patients with neck and waist back and limb pain, 1 patients complained of back pain and numbness,another 1 cases of physical examination found. All patients were examined by MRI before operation. All of them were diagnosed as neurogenic tumors. Total resection of the tumor via the posterior median approach. The pathological diagnosis of the patients after opera- tion showed that the tumor cells were characterized by HE, and scattered in the mature ganglion cells. All patients were followed up for 6~80 months. Conclusion The intraspinal ganglioneuro- mas is a benign tumor with slow growth. After surgery,the prognosis is good.