Kasantikul V, Netsky M G
J Neurosurg. 1979 Jan;50(1):81-7. doi: 10.3171/jns.1979.50.1.0081.
Eight cases are described of intracranial and peripheral neoplasms composed of mixed neurilemmoma and hemangioma. It is proposed that ectomesenchyme can differentiate into neurilemmoma and angioma. The latter may be related to recently described angiogenetic factors, or to developmental factors as in rare cases of arterial angiomas. The angiomatous part may be common, but has often been overlooked. The presence of abnormal vessels, whether in kind or in number, helps explain various biological features of neurilemmoma. These vessels frequently bleed within the tumor, which results in the characteristic hemosiderin-laden macrophages. Bleeding may also occur into the cerebrospinal fluid (CSF) to create xanthochromia. The frequent increase in CSF protein in cases of neurilemmoma is attributed to transudation of serum from abnormal vessels. Less commonly, bleeding may be sufficient to cause subarachnoid hemorrhage. The dense collagen usually associated with these angiomas accounts for the relative infrequence of major hemorrhages.
本文描述了8例由混合性神经鞘瘤和血管瘤组成的颅内及周围肿瘤。提出外胚间叶组织可分化为神经鞘瘤和血管瘤。后者可能与最近描述的血管生成因子有关，或与发育因素有关，如罕见的动脉血管瘤病例。血管瘤部分可能很常见，但常常被忽视。异常血管的存在，无论是种类还是数量，都有助于解释神经鞘瘤的各种生物学特征。这些血管在肿瘤内经常出血，导致特征性的含铁血黄素巨噬细胞。出血也可能进入脑脊液（CSF）导致黄变症。神经鞘瘤病例中脑脊液蛋白频繁升高归因于异常血管的血清渗出。较少见的情况是，出血可能足以引起蛛网膜下腔出血。通常与这些血管瘤相关的致密胶原导致大出血相对少见。
