Prudhomme M, Marchand P, Orcel M, Rodier M, Petitjean C, Godlewski G
Département de chirurgie digestive, hôpital Caremeau, CHU de Nîmes, France.
Chirurgie. 1998 Jun;123(3):300-3. doi: 10.1016/s0001-4001(98)80124-4.
The authors report one case of schwannoma of diaphragmatic topography. This lesion is exceptional and, to our knowledge, only seven cases have been published in the literature. The first diagnosis was a suprarenal tumour. Magnetic resonance imaging provided more detail about the juxta diaphragmatic topography of the tumour, which was subsequently confirmed by surgery. The diagnosis of benign schwannoma was made at the pathological and immuno-histochemical examination of the specimen. The schwannoma corresponded to the type B of the classification of Antoni. Pathogeny and origin of the tumour are discussed. The sympathetic nervous para-vertebral system, the phrenic or intercostal nerves could be the origin of the tumour. In the eight cases reported, the tumoural removal was performed through thoracotomy (n = 5) or laparotomy (n = 3). The preoperative exact location of the juxta diaphragmatic tumours remains difficult to specify.
作者报告了1例膈肌部位的神经鞘瘤。该病变较为罕见，据我们所知，文献中仅发表过7例。最初诊断为肾上腺肿瘤。磁共振成像提供了有关肿瘤毗邻膈肌部位的更多细节，随后经手术得以证实。通过对标本进行病理和免疫组织化学检查确诊为良性神经鞘瘤。该神经鞘瘤符合Antoni分类的B型。文中讨论了肿瘤的发病机制和起源。交感神经椎旁系统、膈神经或肋间神经可能是肿瘤的起源。在所报告的8例病例中，肿瘤切除通过开胸手术（n = 5）或剖腹手术（n = 3）进行。毗邻膈肌肿瘤的术前确切位置仍难以明确。
