Pou Serradell A
Servei de Neurología, Hospital del Mar, Universitat Autónoma de Barcelona, Espaã.
Rev Neurol (Paris). 1991;147(1):17-27.
The National Institute of Health Consensus Panel on Neurofibromatosis (NF) recently recognized 2 distinct forms of NF (NF-1 and NF-2) and stated that variant forms may exist. We selected 30 patients who fulfilled the criteria of NF-1 or whose condition was consistent with NF-2. All patients showed pathological magnetic resonance images (MRI), and in 19 cases confirmation was obtained from histopathology. We established correlations between the site and nature of the lesions on the one hand and the diagnostic criteria of NF on the other hand, there by hoping to contribute to a better knowledge and classification of neurofibromatosis. Nineteen patients had only intraparenchymatous lesions of the central nervous system (CNS) and fulfilled the criteria of NF-1; histopathological examination demonstrated pilocytic astrocytoma in 8 cases. Eleven patients showed only extra-axial lesions; 8 of them had criteria suggestive of NF-2, except for familial history. Pathological examination revealed either acoustic, pluriradicular, peripheral or mixed schwannomas (7/8) or pluriradicular ganglioneuromas (1/8). Two patients had unilateral extra-axial pluriradicular cervical lesions and fulfilled the diagnostic criteria of NF-1; pathological examination revealed neurofibroma in both cases. One female patient had both intra- and extra-axial lesions that fulfilled the criteria of NF-1 and NF-2, suggesting the existence of a mixed form (NF-3).
美国国立卫生研究院神经纤维瘤病(NF)共识小组最近确认了两种不同形式的NF(NF - 1和NF - 2),并指出可能存在变异形式。我们选择了30例符合NF - 1标准或病情符合NF - 2的患者。所有患者均有病理磁共振成像(MRI)表现,19例经组织病理学证实。我们建立了病变部位和性质与NF诊断标准之间的相关性,希望有助于更好地认识和分类神经纤维瘤病。19例患者仅有中枢神经系统(CNS)实质内病变,符合NF - 1标准;组织病理学检查显示8例为毛细胞型星形细胞瘤。11例患者仅表现为轴外病变;其中8例除家族史外有提示NF - 2的标准。病理检查显示为听神经、多根性、周围性或混合性神经鞘瘤(7/8)或多根性神经节瘤(1/8)。2例患者有单侧轴外多根性颈部病变,符合NF - 1诊断标准;病理检查显示两例均为神经纤维瘤。1例女性患者既有轴内病变又有轴外病变,符合NF - 1和NF - 2标准,提示存在混合形式(NF - 3)。