神經(jīng)系統(tǒng)常見腫瘤

1、1.神經(jīng)系統(tǒng)常見腫瘤中樞神經(jīng)系腫瘤周圍神經(jīng)腫瘤膠質(zhì)瘤神經(jīng)鞘膜腫瘤星形膠質(zhì)細(xì)胞瘤1-4神經(jīng)鞘瘤少突膠質(zhì)細(xì)胞瘤1-3神經(jīng)纖維瘤室管膜細(xì)胞瘤1-3神經(jīng)細(xì)胞源性腫瘤脈絡(luò)叢乳頭狀瘤1神經(jīng)母細(xì)胞瘤原始神經(jīng)上皮源性腫瘤節(jié)細(xì)胞神經(jīng)瘤髓母細(xì)胞瘤4轉(zhuǎn)移性腫瘤腦膜瘤1-3松果體腫瘤2-4垂體腫瘤2.發(fā)病率：10-12/10萬?膠質(zhì)瘤最多見40%,第二腦膜瘤13-19%惡性（膠質(zhì)母細(xì)胞瘤）50%-60%膠質(zhì)瘤良性膠質(zhì)瘤25%-30%?兒童顱內(nèi)腫瘤發(fā)病率高，僅見于白血病位居第二位，20-25%?發(fā)生率：膠質(zhì)瘤、髓母細(xì)胞瘤多見；腦膜瘤和神經(jīng)鞘瘤那么罕有3.部位常見腫瘤小腦星形細(xì)胞瘤、髓母細(xì)胞瘤、血管網(wǎng)織細(xì)胞瘤大腦半球星形

2、細(xì)胞瘤、膠質(zhì)母細(xì)胞瘤、少支膠質(zhì)瘤、腦膜瘤腦干星形細(xì)胞瘤、膠質(zhì)母細(xì)胞瘤月并版體星形細(xì)胞瘤、膠質(zhì)母細(xì)胞瘤、脂肪瘤枕大孔區(qū)腦膜瘤、表皮樣囊腫鞍區(qū)垂體瘤、顱咽管瘤、腦膜瘤、脊索瘤皮樣囊腫視交叉區(qū)星形細(xì)胞瘤、顱咽管瘤、腦膜瘤、生殖細(xì)胞瘤、表皮樣囊腫橋小腦角區(qū)聽神經(jīng)瘤、頸靜脈球瘤、室管膜瘤、表皮樣囊腫、腦膜瘤、蛛網(wǎng)膜囊腫四腦室室管膜瘤、脈絡(luò)叢乳頭狀瘤、皮樣或表皮樣囊腫三腦室室管膜瘤、膠樣囊腫4. 中樞神經(jīng)系統(tǒng)腫瘤包括起源于腦、脊髓或腦膜的原發(fā)性和轉(zhuǎn)移性腫瘤兩大類。?原發(fā)性腫瘤中，40私膠質(zhì)瘤，15%；腦膜瘤，約8班聽神經(jīng)瘤。轉(zhuǎn)移性腫瘤以轉(zhuǎn)移性肺癌為多見。?兒童顱內(nèi)惡性腫瘤僅次于白血病，常見為膠質(zhì)瘤和髓母細(xì)

3、胞瘤。?一起特點：局部神經(jīng)病癥，顱內(nèi)高壓病癥，分化良好的腫瘤也可因壓迫重要的部位致死，分化很差的腫瘤也很少顱外轉(zhuǎn)移。5. WHO中樞神經(jīng)系統(tǒng)腫瘤病理(7類)?神經(jīng)上皮組織腫瘤(Neuroepithelialtumours)?腦膜腫瘤(Meningealtumours)?顱內(nèi)和外周神經(jīng)腫瘤(Tumoursofcranialandperipheraltumours)?淋巴造血系統(tǒng)腫瘤(Tumoursoftheheamopoieticsystem)?生殖細(xì)胞腫瘤(Germcelltumours)?鞍區(qū)腫瘤(Tumoursofthesellarregion)?轉(zhuǎn)移性腫瘤(Metastatictumou

4、rsoftheCNS)6. 神經(jīng)上皮組織腫瘤(10類)?星形細(xì)胞腫瘤(Astrocytictumours)?少突膠質(zhì)細(xì)胞腫瘤(Oligodendroglialtumours)?混合性膠質(zhì)瘤(Mixedgliomas)?室管膜腫瘤(Ependymaltumours)?脈絡(luò)叢腫瘤(Choroidplexustumours)?起源不定的膠質(zhì)腫瘤(Neuroepithelialtumoursofuncertainorigin)?神經(jīng)元和混合性神經(jīng)元-膠質(zhì)腫瘤(Neuronalandmixedneuronal-glialtumours)?神經(jīng)母細(xì)胞瘤?松果體實質(zhì)腫瘤(Pinealparenchymalt

5、umours)?胚胎性腫瘤(Embryonaltumours)7. 星形膠質(zhì)細(xì)胞瘤(astrocytictumours)顱內(nèi)最多見的膠質(zhì)瘤G:境遇不清的灰白色浸潤性腫瘤，或硬，或軟，或呈膠凍狀，可形成含有清亮液體的囊腔。M星形細(xì)胞瘤(纖維型原漿型肥胖型混合細(xì)胞型)間變型星形細(xì)胞瘤膠質(zhì)母細(xì)胞瘤星形細(xì)胞瘤胞質(zhì)表達(dá)膠質(zhì)纖維酸性蛋白(GFAP*)，S-100和波形蛋白。8. 纖維型星形細(xì)胞瘤(fibrillaryastrocytoma)最多見，瘤細(xì)胞分化好，但呈浸潤型生長。瘤細(xì)胞間可見紅染的原纖維性背景。原漿型星形膠質(zhì)細(xì)胞瘤(protoplasmicastrocytoma)為少見類型，瘤細(xì)胞體小，胞突少而短。肥胖型星形膠質(zhì)細(xì)胞瘤(gemistocyticastrocytoma)瘤細(xì)胞體大，胞質(zhì)豐碩。間變性星形細(xì)胞瘤(anaplasticastrocytoma)瘤細(xì)胞密度增加，多形性，核異態(tài)及核割裂像等，為惡性腫瘤。此型常常表