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头颈部神经源性肉瘤累及颅底(作者译)

[Neurogenic sarcoma of the head and neck with contact to the skull base (author's transl)].

作者信息

Naujoks J H, Wünsch P H, Ratzka M, Uffenorde J

出版信息

Arch Otorhinolaryngol. 1981;233(3):271-300. doi: 10.1007/BF00454391.

Abstract

The neurogenic sarcoma is a neoplasm found seldom. It descends from the sheaths of peripheric nerves. If this tumor develops from a solitary or multiple neurofibroma, it might also be called a neurofibrosarcoma. All other synonyms, especially that of the malignant schwannoma, should better be abandoned for histogenetic reasons. Today the classification of all tumors of the peripheral nervous system is based on a suggestion of the WHO from 1969. The tabular summary of the literature shows that only a little more than a hundred cases of neurogenic sarcoma of the head and neck were reported during the last 50 years. Differential diagnosis of this malignant tumor includes nearly all other malignant neoplasms of soft tissue, sometimes even anaplastic carcinoma. Histopathology, including electron microscopy, is described in general and also in detail with regard to three cases. Three forms of micro-morphological variants are dealt with, too. For diagnosis histological examination will be absolutely successful only in cases of neurofibromatosis or in cases where the nerve from which the tumor originates may be identified. Otherwise, conventional and computerized X-ray tomography may be helpful. Finally, some therapeutic and prognostic principles are discussed.

摘要

神经源性肉瘤是一种罕见的肿瘤。它起源于周围神经鞘。如果这种肿瘤由孤立性或多发性神经纤维瘤发展而来,也可称为神经纤维肉瘤。出于组织发生学原因,所有其他同义词,尤其是恶性施万细胞瘤,最好弃用。如今,外周神经系统所有肿瘤的分类都基于世界卫生组织1969年的一项提议。文献的表格总结显示,在过去50年里,头颈部神经源性肉瘤仅报告了一百多例。这种恶性肿瘤的鉴别诊断包括几乎所有其他软组织恶性肿瘤,有时甚至包括间变性癌。本文总体描述了组织病理学,包括电子显微镜检查,并详细描述了三个病例。还讨论了三种微观形态学变异形式。对于诊断,只有在神经纤维瘤病病例或能确定肿瘤起源神经的病例中,组织学检查才绝对成功。否则,传统的和计算机断层扫描可能会有所帮助。最后,讨论了一些治疗和预后原则。

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