论文部分内容阅读
患者女性,3岁。咳嗽、气促、乏力七个月。胸部正侧位片见右上后纵隔分叶状团块,胸_4椎体密度增高(图1a.b)。CT平扫右后纵隔具72×65×94mm大小分叶状团块,密度不均,内有钙化(图2)。B超探查肿块呈实质性,内有坏死液化区。于B超导向下作细针穿刺活检。组织病理学所见:肿瘤细胞较小淋巴细胞大,呈圆形或卵圆形,核深染,易见核分裂象。肿瘤细胞排列成菊形团,其中央有粉染的细纤维或血管。肿瘤组织内有明显出血伴有坏死,间质成分较少(图3)。病理诊断:神经母细胞瘤。讨论:神经母细胞瘤多数发生在肾上腺,少数发生在腹膜后交感神经节和后纵隔。小儿后纵隔肿瘤中,95％为神经源性肿瘤,多数起于交感神经节,其中以神经母细胞瘤最为
Patient female, 3 years old. Cough, shortness of breath, fatigue for seven months. In the chest, the right lateral posterior mediastinum showed lobulated clumps, and the thoracic _4 vertebral body increased in density (Figure 1a.b). CT plain right posterior mediastinum with size of 72 × 65 × 94mm lobulated clumps, uneven density, with calcification (Figure 2). B ultrasound probe mass was substantial, there are necrosis liquefaction area. B-guided fine needle aspiration biopsy. Histopathology seen: small lymphocytes of tumor cells, were round or oval, deep-stained nuclear, easily seen mitotic figure. Tumor cells arranged in a chrysanthemum group, the center of the powdery fine fibers or blood vessels. Tumor tissue with significant bleeding associated with necrosis, interstitial components less (Figure 3). Pathological diagnosis: neuroblastoma. Discussion: The majority of neuroblastomas occur in the adrenal gland, a minority in the retroperitoneal sympathetic ganglia and the posterior mediastinum. After pediatric mediastinal tumors, 95% of neurogenic tumors, most from the sympathetic ganglia, of which the most neuroblastoma