病理學(xué)英文課件：Diseases of the nervous system

1、Diseases of the nervous system Consisting of Brain Spinal cord Meninges Grossly Grey matter & white matter Ventricles (cerebrospinal fluid Histoloy Neuron 神經(jīng)元神經(jīng)元 (nerve fiber) Neuroglia 膠質(zhì)細(xì)胞膠質(zhì)細(xì)胞 (glial fiber) FCells of the nervous system and the basic pathologic changes F Neuron (神經(jīng)元神經(jīng)元) F Neuroglia

2、 (膠質(zhì)細(xì)胞膠質(zhì)細(xì)胞) Astrocyte (星形細(xì)胞星形細(xì)胞) Oligodendrocyte (少突細(xì)胞少突細(xì)胞) Ependymal cell (室管膜細(xì)胞室管膜細(xì)胞) Schwann cell (雪旺細(xì)胞雪旺細(xì)胞) F Microglia (小膠質(zhì)細(xì)胞小膠質(zhì)細(xì)胞) CNS PNS Betz cell Nissl小體小體 小腦（小腦（ 50 m 65y Shanghai：3% in 65y，4.69% in 70y FClinical features Cortical dysfunction Insidious impairment of higher intellectual fun

3、ction Alterations in mood and behavior Progressive disorientation, memory loss, and aphasia 失語癥失語癥 Dead of intercurrent pneumonia or other infections within 5-10y Alzheimers disease FMorphology Gross：cortical atrophy Widening of the cerebral sulci Normal toxic Alzheimers disease FMicro Neurofibrilla

4、ry tangles (神經(jīng)原纖維纏結(jié)神經(jīng)原纖維纏結(jié)) Intracellular bundles of paired helical filaments Hyperphosphorylated forms of the protein tau Commonly found in cortical neurons A signal of cell death 老年斑老年斑) 淀粉樣血管病淀粉樣血管病) Vaculation (顆粒顆?？张葑冃钥张葑冃? FNon-specific, can be found in other degenerative diseases or brain agi

5、ng 神經(jīng)原纖維纏結(jié)神經(jīng)原纖維纏結(jié) tau Protein 老年斑老年斑 Amyloid angiopathy: amyloid deposition in arterioles Anti-Ab bCongo red toxic Genetic factors FPrimary intracranial tumors (50%-75%) Glioma (膠質(zhì)瘤膠質(zhì)瘤) Astrocytoma Oligodendroglioma Ependymoma Meningioma (腦膜瘤腦膜瘤) Medulloblastoma(髓母細(xì)胞瘤髓母細(xì)胞瘤) FPNS Schwannoma(神經(jīng)鞘瘤神經(jīng)鞘瘤)

6、 Neurofibroma(神經(jīng)纖維瘤神經(jīng)纖維瘤) MPNST(惡性周圍神經(jīng)鞘膜瘤惡性周圍神經(jīng)鞘膜瘤) FMetastatic tumors：commonly from lung, breast, etc Astrocytoma 星形細(xì)胞瘤 Astrocytoma Diffuse astrocytoma glioblastoma multiforme Astrocytoma 星形細(xì)胞瘤 Diffuse astrocytoma Diffuse astrocytoma, GFAP Gemistocytic astrocytoma 此患者經(jīng)放化療此患者經(jīng)放化療11個(gè)月后復(fù)發(fā)，進(jìn)展到膠質(zhì)母細(xì)胞瘤。個(gè)月

7、后復(fù)發(fā)，進(jìn)展到膠質(zhì)母細(xì)胞瘤。 Anaplastic astrocytoma Glioblastoma multiforme P53 mutation / loss of chr. 17p Loss of chr.22q Rb mutation / loss of chr.13q P16 deletion / loss of chr.3p Loss of chr.19q Loss of ch.10 EGFR gene amplification Genetic changes in astrocytoma Normal astrocyte Astrocytoma Anaplastic astro

8、cytoma Glioblastoma multiforme Oligodendroglioma Ependymoma Medulloblastoma 髓母細(xì)胞瘤髓母細(xì)胞瘤 FPrimary neuroectodermal tumor of CNS FPredominantly in children, peak age 10y FExclusively in the cerebellum FGross Often well circumscribed Gray and friable FMicro Extremely cellular Sheets of anaplastic (small

9、blue) cells Rosette FPrognosis and treatment Untreated patients: dismal Exquisitely radiosensitive Medulloblastoma Medulloblastoma Meningioma 腦膜瘤 FArising from the meningothelial cell of the arachnoid FMay be found along any of the external surfaces of the brain as well as within the ventricular sys

10、tem FGross Well-defined Usually attached to the dura, Grey, solid, gritty (psammoma body) FMicro Whorled clusters of cells Psammoma body (砂粒體砂粒體) may be seen FPredominantly benign meningioma Whorled clusters of cells Psammoma body Schwannoma 神經(jīng)鞘瘤 FArising from schwann cells (施萬細(xì)胞施萬細(xì)胞) FUsually localized in peripheral nerves FGross Encapsulated, nerve of origin Nodular, grey, may contain cystic areas FMicro Compos