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目的探讨椎管内神经节细胞瘤的临床与病理特性,并复习文献,提高对该疾病的认识。方法回顾性分析安徽省立医院2010年6月至2016年8月经手术和病理证实的6例原发于椎管内神经节细胞瘤的临床、影像和病理资料,分析其临床和病理特征。结果 6例原发于椎管内神经节细胞瘤患者,男性2例,女性4例,发病年龄33~70岁,平均51.8岁。术前均行MRI检查,均诊断为神经源性肿瘤。肿瘤通过椎间孔内外生长,1例由椎间孔外向硬脊膜下生长,4例由椎间孔外向硬脊膜外生长,另1例位于椎间孔处。其中颈段3例,胸腰段1例,腰段1例,骶段1例。6例患者中,2例主诉肢体乏力伴麻木,2例主诉颈肩腰背部和肢体疼痛、1例主诉腰痛伴肢体麻木,另1例为体检发现。手术采用后正中入路肿瘤全切除术。术后病理诊断为神经节细胞瘤,HE染色可见基质内散在特征性的成熟神经节细胞,无核分裂像。术后随访6~80个月,无肿瘤复发。结论椎管内神经节细胞瘤属于生长缓慢的良性肿瘤,病理具有特征性,易于诊断。手术切除后,预后良好。
Objective To investigate the clinical and pathological characteristics of spinal ganglioneuromas and review the literature to improve their understanding of the disease. Methods The clinical, imaging and pathological data of 6 primary ganglioneuroblastomas confirmed by surgery and pathology from June 2010 to August 2016 in Anhui Provincial Hospital were analyzed retrospectively. The clinical and pathological features were analyzed. Results 6 cases of primary ganglioneuroblastoma patients, 2 males and 4 females, the age of onset 33 to 70 years, mean 51.8 years. Preoperative MRI examination were diagnosed as neurogenic tumors. The tumor grew inside and outside the foramen, one from the foramen of the foramen into the epidural growth, four from the foramen outside to the epidural growth, and the other one was located at the foramen. There were 3 cases of cervical segment, 1 case of thoracolumbar segment, 1 case of lumbar segment and 1 case of sacral segment. Of the 6 patients, 2 complained of limb weakness with numbness, 2 complained of neck, shoulder, back and limb pain, 1 complained of back pain with limb numbness, and the other 1 were physical examination. Surgical removal of the median approach after total tumor resection. Postoperative pathological diagnosis of ganglioneuroma, HE staining showed stromal disseminated features of mature ganglion cells, mitotic image. All patients were followed up for 6 to 80 months without tumor recurrence. Conclusion Spinal ganglioneurocytoma is a benign tumor with slow growth. The pathology is characteristic and easy to diagnose. After surgery, the prognosis is good.