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[一例颈段脊髓内神经肠囊肿]

[A case of cervical intramedullary neurenteric cyst].

作者信息

Takemi K, Kubo S, Ibayashi N, Ikeda M, Ohta T, Yonezawa T

出版信息

No Shinkei Geka. 1984 Mar;12(4):539-43.

PMID:6738801
Abstract

A case of cervical intramedullary neurenteric cyst was reported. A 12-year-old girl was admitted with severe pain over the nape and shoulders, and weakness of all extremities. At the age of 4 years, she had suffered from the nape pain and paraparesis which, however, cleared later spontaneously. Neurological examination revealed evidences of presumptive cervical intramedullary lesion, and myelography showed a complete block at the third cervical level accordingly. Surgical exploration through C3-C5 laminectomy disclosed an intramedullary cyst situated within the right half of the cord. The cyst was removed except for its upper and lower apices. Excellent clinical results followed the operation. The cyst was composed of collagen fibers with an inner epithelial lining, which consisted of single or pseudostratified layer of columnar, cuboidal or squamous cells. Cells were ciliated at some parts. The base of the epithelial cells rested upon the basement membrane. Nuclei were positioned near the base of the cells, to present a row. The cytoplasm in the majority of cells contained abundant mucin positive to PAS staining. Pathological diagnosis of neurenteric cyst was made on the basis of these histological findings. Usually intraspinal neurenteric cyst is located in the subarachnoid space and ventrally to the spinal cord. Neurenteric cyst appears histologically similar to ependymal cyst, though, in the latter the epithelial cells seldom contain mucin, and only in scanty amount, if any present. Embryogenesis during the third week of embryonic life was discussed in relation to the development of neurenteric cyst.

摘要

报告了一例颈髓内神经肠囊肿病例。一名12岁女孩因颈后部和肩部剧痛以及四肢无力入院。4岁时,她曾出现颈后部疼痛和双下肢轻瘫,但后来自行缓解。神经学检查显示有颈髓内病变的迹象,脊髓造影相应显示在第三颈椎水平完全梗阻。通过C3 - C5椎板切除术进行手术探查,发现脊髓右半侧有一个髓内囊肿。除囊肿的上下尖端外,将囊肿切除。术后临床效果良好。囊肿由胶原纤维组成,内部有上皮衬里,上皮衬里由单层或假复层柱状、立方或鳞状细胞组成。部分细胞有纤毛。上皮细胞底部附着于基底膜。细胞核位于细胞底部附近,呈一排。大多数细胞的细胞质含有丰富的对PAS染色呈阳性的粘蛋白。根据这些组织学发现做出神经肠囊肿的病理诊断。通常脊髓内神经肠囊肿位于蛛网膜下腔且在脊髓腹侧。神经肠囊肿在组织学上与室管膜囊肿相似,不过,在室管膜囊肿中,上皮细胞很少含有粘蛋白,即使有也只是少量。结合神经肠囊肿的发育讨论了胚胎生命第三周的胚胎发生。

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