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第八神经的两个非常小的管内孤立性神经鞘瘤的组织学发现。

Histologic findings in two very small intracanalicular solitary schwannomas of the eighth nerve.

作者信息

Neely J G, Hough J

出版信息

Ann Otol Rhinol Laryngol. 1986 Sep-Oct;95(5 Pt 1):460-5. doi: 10.1177/000348948609500505.

Abstract

Two very small intracanalicular tumors, resected en bloc with the complete eighth nerve, were serially sectioned in order to study the relationship between the tumors and the nerves of origin. Both cases met the size criteria for hearing conservation surgery; however, the patient with the smaller tumor and the better hearing had no recognizable cochlear nerve fibers passing the tumor. The cochlear nerve in the patient with poorer hearing was completely free of tumor. The tumor with the infiltrated cochlear nerve seemed to originate from the inferior vestibular nerve. The other tumor seemed to arise from the superior vestibular nerve. Proximally, the tumors occupied a more central location in the involved nerves, but they abruptly became eccentric and exophytic as they proceeded laterally. Nerve fibers remaining about the tumors were displaced to the periphery. These nerve fiber aggregates became quite thin and attenuated, frequently separating into smaller aggregates which, ultimately, were incorporated into the tumors. As fibers came closer to the tumors, they tended to change from their longitudinal direction toward a more circumferential orientation about the surface of the tumors. The tumor-nerve fiber interfaces were quite variable throughout the course of the tumor, ranging from large aggregates of nerve fibers distinctly separate from the tumors to aggregates separate but tightly applied to the tumors without a tissue plane between, to aggregates partially incorporated within the periphery of the tumors, to aggregates completely incorporated into the periphery of the tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

两个非常小的管内肿瘤与完整的第八对脑神经一起整块切除,然后进行连续切片,以研究肿瘤与起源神经之间的关系。两例均符合听力保留手术的大小标准;然而,肿瘤较小且听力较好的患者没有可识别的耳蜗神经纤维穿过肿瘤。听力较差的患者的耳蜗神经完全没有肿瘤。侵犯耳蜗神经的肿瘤似乎起源于前庭下神经。另一个肿瘤似乎起源于前庭上神经。在近端,肿瘤在受累神经中占据更中心的位置,但随着它们向外侧延伸,它们突然变得偏心并向外生长。肿瘤周围残留的神经纤维被挤到了周边。这些神经纤维聚集体变得非常细且变薄,经常分成较小的聚集体,最终被肿瘤吸收。当纤维靠近肿瘤时,它们倾向于从纵向方向转变为围绕肿瘤表面的更圆周方向。在肿瘤的整个过程中,肿瘤与神经纤维的界面变化很大,从与肿瘤明显分开的大神经纤维聚集体到分开但紧密贴附在肿瘤上且其间没有组织平面的聚集体,再到部分纳入肿瘤周边的聚集体,最后到完全纳入肿瘤周边的聚集体。(摘要截于250字)

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