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[口腔神经鞘瘤(施万瘤)。2例临床病例报告]

[Neurilemmoma (schwannoma) of the oral cavity. A report of 2 clinical cases].

作者信息

Chiapasco M, Ronchi P, Scola G

机构信息

Divisione di Odontostomatologia e Chirurgia Maxillo-Facciale, Ospedale S. Anna, Como.

出版信息

Minerva Stomatol. 1993 Apr;42(4):173-8.

PMID:8413099
Abstract

Neurilemmoma (schwannoma) is a benign, encapsulated perineural tumor of neuroectodermal derivation that originates from the Schwann cells of the neural sheath of motor and sensitive peripheral nerves; the etiology is still unknown. The tumor is normally solitary, smooth-surfaced, slow growing and generally asymptomatic. It may develop at any age and there is no gender predilection. Head and neck are one of the most frequent localizations, but intraoral development is quite uncommon. In this area the mobile portion of the tongue, and in a decreasing order, the palate, the cheek mucosa, the lip and gingiva are the most frequent locations. Although it origins from the nervous tissue, only in 50% of the cases a direct relation with a nerve is demonstrated. The term schwannoma has been attributed in the past either for neurofibroma and neurilemmoma. Their histogenesis remain anyway a controversial argument. Some authors think that both tumors originate from Schwann cells and perineural connective cells. Others think that the first one originate from perineural cells, while the latter from Schwann cells. Diagnosis is confirmed by microscopic examination. Neurilemmoma shows two different components: Antoni type A and Antoni type B tissue. The first one consists of Schwann cells arranged in compact, twisted bundles, associated with delicate reticulin fibres and spindle-shaped nuclei aligned in parallel rows forming a typical palisading pattern. Between the rows there are fine cytoplasmatic fibrils with acellular, eosinophilic masses called Verocay bodies. The second one is formed by irregularly arranged masses of elongated cells and fibers similar in appearance to neurofibroma, with areas of cystic degeneration and edema.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

神经鞘瘤是一种起源于神经外胚层的良性、有包膜的神经周围肿瘤,由运动和感觉外周神经神经鞘的施万细胞产生;病因尚不清楚。该肿瘤通常为单发,表面光滑,生长缓慢,一般无症状。可发生于任何年龄,无性别倾向。头颈部是最常见的发病部位之一,但口腔内发生较为少见。在该区域,舌的可动部分最常受累,其次依次为腭、颊黏膜、唇和牙龈。虽然它起源于神经组织,但只有50%的病例显示与神经有直接关系。过去,神经鞘瘤一词曾被用于指代神经纤维瘤和神经鞘瘤。然而,它们的组织发生仍然是一个有争议的问题。一些作者认为这两种肿瘤都起源于施万细胞和神经周围结缔细胞。另一些人认为前者起源于神经周围细胞,而后者起源于施万细胞。诊断通过显微镜检查确诊。神经鞘瘤有两种不同的成分:Antoni A型和Antoni B型组织。前者由紧密排列、扭曲成束的施万细胞组成,伴有纤细的网状纤维和纺锤形核,平行排列形成典型的栅栏状结构。在这些行列之间有细小的细胞质纤维,伴有无细胞的嗜酸性团块,称为Verocay小体。后者由不规则排列的细长细胞和纤维团块组成,外观与神经纤维瘤相似,有囊性变和水肿区域。(摘要截选至250字)

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