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[后颅窝无硬脑膜附着的脑膜瘤:病例报告]

[A meningioma in the posterior fossa without dural attachment: case report].

作者信息

Nakahara S, Yoshino K, Hasegawa Y, Tani S, Numoto R T, Tanaka J

机构信息

Department of Neurosurgery, Jikei University School of Medicine.

出版信息

No Shinkei Geka. 1993 Sep;21(9):849-52.

PMID:8377906
Abstract

An extremely rare case of a meningioma in the posterior fossa without dural attachment has been reported. The patient was a 56-year-old male whose chief manifestation was the abnormality of his CT scan. His past history included gastric and colonic polyp when he was 54, 55 years old, and non-Hodgkin's lymphoma before hospitalization in our department. CT scan showed a small round non-enhancing lesion located at the lateral site of the right cerebellar cortex. T1 weighted image of MRI showed a homogeneous low intensity lesion with partial enhancing with Gd-DTPA. Proton image showed a remarkable low intensity lesion which showed an extramedullary mass. Right retromastoid craniectomy was performed. The mass was an extramedullary tumor which had no relation with the cerebellar cortex and dura matter. The arachnoid membrane around the tumor was intact. The tumor was totally resected and the patient had no neurological deficits. Histopathologically, the tumor was delineated into laminar structures by collagen fiber. Tumor cells were spindle in shape and made a whorling formation. There was no psammoma body and it had a hyperchromatic nuclei without mitotic features. Electron microscopic studies revealed no typical interdigitation but irregularity of the cell membrane. Abundant collagen fibers were in contact with basement membrane of the tumor. According to these findings, we diagnosed fibroblastic meningioma with atypical forms. Meningiomas without dural attachment are rare in adults, especially extremely rare of the posterior fossa. There are only 23 previous reports of "meningioma of the posterior fossa without dural attachment". Cantore divided these meningiomas into three groups (IV ventricle, inferior tela choroidea and cisterna magna).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

据报道,有一例极为罕见的后颅窝脑膜瘤,其无硬脑膜附着。患者为一名56岁男性,主要表现为CT扫描异常。他既往病史包括54岁和55岁时患胃息肉和结肠息肉,以及在我院住院前患非霍奇金淋巴瘤。CT扫描显示一个小的圆形无强化病灶,位于右侧小脑皮质外侧。MRI的T1加权像显示一个均匀的低强度病灶,经钆喷酸葡胺(Gd-DTPA)增强后有部分强化。质子像显示一个明显的低强度病灶,提示为髓外肿块。行右侧乳突后颅骨切除术。肿块为髓外肿瘤,与小脑皮质和硬脑膜无关。肿瘤周围的蛛网膜完整。肿瘤被完全切除,患者无神经功能缺损。组织病理学上,肿瘤被胶原纤维分隔成层状结构。肿瘤细胞呈梭形,形成漩涡状结构。无砂粒体,细胞核深染,无有丝分裂特征。电子显微镜研究显示无典型的细胞间交错,但细胞膜不规则。大量胶原纤维与肿瘤基底膜接触。根据这些发现,我们诊断为非典型形式的纤维母细胞性脑膜瘤。无硬脑膜附着的脑膜瘤在成人中罕见,尤其是在后颅窝极为罕见。此前仅有23篇关于“后颅窝无硬脑膜附着脑膜瘤”的报道。坎托雷将这些脑膜瘤分为三组(第四脑室、脉络丛下和小脑延髓池)。(摘要截短于250字)

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