Miller D C
Department of Pathology, New York University School of Medicine, and the Kaplan Comprehensive Cancer Center of NYU, 10016, USA.
J Neurooncol. 2000 May;47(3):189-94. doi: 10.1023/a:1006496204396.
The surgical pathology of intramedullary spinal cord neoplasms is most accurately based on radical resection specimens rather than on small biopsies, which may be highly misleading. A review of the neuropathology files at NYU Medical Center revealed 294 surgical specimens of intramedullary cord lesions examined between January 1, 1991 and December 31, 1998. Of these 117 were from children (age less than 21 years) and 177 were from adults (21 and over). While most types of central nervous system tumors known to occur in the brain also occur in the spinal cord, the different proportions of these tumors by histologic type, and the differences in the proportions of tumor types in children compared to adults, are both significant. In adults ependymomas are the predominant tumor type (93 total) while in children astrocytomas and mixed neuronal-glial tumors are virtually equally common and outnumber ependymomas. In this period no cord Primitive Neuroectodermal Tumors were identified. Among the astrocytic neoplasms and other gliomas, high grade tumors were distinctly uncommon in children and only slightly more common in adults, in sharp contrast with the brain, where the majority of adult intra-axial tumors are high grade.
脊髓髓内肿瘤的外科病理学诊断最准确的依据是根治性切除标本，而非小活检标本，因为小活检标本可能会产生极大的误导。回顾纽约大学医学中心的神经病理学档案发现，在1991年1月1日至1998年12月31日期间共检查了294例脊髓髓内病变的手术标本。其中117例来自儿童（年龄小于21岁），177例来自成人（21岁及以上）。虽然已知大多数发生于脑内的中枢神经系统肿瘤类型在脊髓中也会出现，但这些肿瘤按组织学类型划分的不同比例，以及儿童与成人肿瘤类型比例的差异，都很显著。在成人中，室管膜瘤是主要的肿瘤类型（共93例），而在儿童中，星形细胞瘤和混合性神经元 - 胶质肿瘤实际上同样常见，且数量超过室管膜瘤。在此期间未发现脊髓原始神经外胚层肿瘤。在星形细胞肿瘤和其他胶质瘤中，高级别肿瘤在儿童中明显少见，在成人中仅略为常见，这与脑内情况形成鲜明对比，在脑内大多数成人轴内肿瘤为高级别肿瘤。
