1/21. optic nerve glioma in an 18-month-old child.An optic nerve glioma in an 18-month-old child was examined by both light and electron microscopy. The tumor revealed the characteristic features of uniform benign and fibrillary astrocytoma. Rosenthal fibers and calcium depostis were found within numerous intracellular glial processes. The above features indicated a slow-growing tumor of long duration, confirming the generally supported assumption of the congenital nature of optic nerve glioma. One unsuspected feature was the presence of fenestrated blood vessels.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/21. Intracranial esthesioneuroblastoma. A light and electron microscopic study.A 31 year-old black woman with unilateral facial dysesthesia was found to have an intracranial parasellar mass that extended into the sphenoid sinus. By light microscopy, the neoplasm appeared as nests of poorly differentiated neuroblasts in a finely fibrillary stroma and was diagnosed as an esthesineuroblastoma. Electron microscopy confirmed the neuroblastic nature of the tumor with demonstration of neurites containing neurofilaments and neurotubules, synapses and dense cored biogenic amine granules in perikarya and processes. This neoplasm was further characterized by the presence of numerous dystrophic axons that were evident only by electron microscopy.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/21. Amyloidoma of the brachial plexus.BACKGROUND: Amyloidomas of the peripheral nervous system are rare lesions. Most commonly, they involve the gasserian ganglion and the branches of the fifth cranial nerve. No association with systemic amyloidosis has been reported. CASE DESCRIPTION: We describe an amyloidoma of the lower trunk of the right brachial plexus. At the age of 34 years, this 71-year-old female had undergone radical right mastectomy for breast cancer with axillary lymph node dissection followed by radiotherapy. On admission, she presented with burning pain to the right hand and mild motor deficit to the ulnar-innervated intrinsic hand muscles. A palpable lesion was found in the supraclavicular region. On surgical inspection, the lesion appeared to originate from the lower trunk of the right brachial plexus. The middle and upper trunks were dislocated. Histologically, fibrous connective tissue embedded small nerve bundles featuring perineurial and endoneurial fibrosis as well as amyloid. Amyloid featured immunoreactivity for both lambda and kappa chains. DISCUSSION: Localized amyloidoma of brachial plexus has never been reported. Because of compressive rather than infiltrative growth of the present lesion, a conservative surgery was achieved. Our immunohistochemical findings indicated that peripheral nerve amyloidomas are not, by definition, monoclonal in nature.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/21. Non-malignant perineural spread of epithelial tissue in the orofacial region.A 48 year-old male had two operations because of severe neuralgic pains in the region of the right infraorbital nerve. The first operative specimen consisted of connective tissue, striated muscle fibers and two myelinated nerve bundles, surrounded by a ring of well differentiated squamous epithelium. Initially the lesion was assumed to show perineural spread of cancer in this region. As the pain was not alleviated, a second operation was performed. The framework of the second specimen also consisted of connective tissue and muscle. It contained in addition an atheromalike cyst and some nerve bundles, ensheathed by well differentiated epithelial cells partly in a ring-, partly in a horseshoe-like pattern. The perineural epithelial sheaths could be traced to a rupture of the cyst, and to benign proliferation of its epithelial lining in the connective tissue and along the nerve bundles. Following the second operation the patient was relieved of his complaints. During the last five years he had repeated control examinations but no sign of malignant disease could be found; his state of health was perfect. Our finding of benign perineural spread of squamous epithelium has not been described previously. The nature of the so-called perineural lymph spaces is also discussed.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/21. Lesion of the common peroneal nerve during arthroscopy.Arthroscopic knee surgery has been well accepted worldwide and has become an important part of orthopaedic surgery. The use of arthroscopy has reduced the duration of hospitalization, overall costs, and time required for the patient to return to sports activities or work. However, because of the closed nature of the procedure and proximity of neurovascular structures to instruments, substantial risk of injuries exists. Significant anatomic variability in the nerve course has not been reported in previous literature as a cause of a knee arthroscopy complication. We present a case of complete transection of an unusually located common peroneal nerve during a knee arthroscopy for lateral meniscal repair in a 22-year-old football player.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/21. Bilateral intraneural perineurioma presenting as ulnar neuropathy at the elbow.We describe a 36-year-old woman with progressive bilateral ulnar neuropathy. Sonographic and magnetic resonance imaging studies revealed extensive focal ulnar nerve enlargement at the elbow. Histological studies gave evidence of an intraneural perineurioma. Because intraneural perineurioma usually appears as a single mass lesion at sites other than typical entrapment sites, this mode of presentation is unusual. We discuss the nature of this benign tumor and the differential diagnosis of nerve enlargement. knowledge of possible causes of nerve thickening is crucial when performing imaging in patients with neuropathies.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/21. Malignant peripheral nerve sheath tumour with annulate lamellae mimicking pleomorphic malignant fibrous histiocytoma.The nature and nosologic status of malignant fibrous histiocytoma (MFH), or at least its most common pleomorphic variant, are a matter of controversy and it is possible that this entity represents the shared morphologic phenotype of a range of other dedifferentiated neoplasms. An unusual case of malignant peripheral nerve sheath tumour which very closely mimicked pleomorphic MFH is presented. Its true nature was only disclosed by ultrastructural examination. A further interesting and previously unreported feature in tumours of this type was the presence of annulate lamellae in many of the tumour cells. This case adds weight to the assertion that the light microscopic features of pleomorphic MFH may not be specific.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
8/21. Benign metastasizing leiomyomatosis with massive brachial plexus involvement mimicking neurofibromatosis type 1.We report the case of a patient who presented with right arm and shoulder pain due to compression of the infraclavicular brachial plexus due to benign metastasizing leiomyomatosis (BML). She was initially and had been repeatedly misdiagnosed as having neurofibromatosis type 1 (NF 1). The diagnosis of BML was not obvious due to its rare nature, the patient's not detailing the specifics of her gynecologic history of having undergone resection of a large uterine leiomyoma and followed by disseminated pelvic leiomyomatous nodules, histologic misinterpretation of an extrauterine lesion of the spine and the brachial plexus as a neurofibroma and the radiologic diagnosis of lung nodules as being "non-specific" in nature. In addition and importantly, no clinical, radiographic or histologic features of NF 1 were present. Although a rare condition, BML should be considered in the differential diagnosis of NF and in patients having a history of uterine leiomyoma. The remarkable, selective involvement of the brachial plexus in this case is unexplained.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |
9/21. cauda equina compression associated with breast cancer. A case study in differential diagnosis.The determination of the etiology of spinal cord compression in cancer patients is essential for appropriate therapy. patients with metastatic disease are not immune to the development of superimposed nonmalignant disease. Although metastatic epidural compression may occur in up to 9% of breast cancer patients, care must be taken to rule out other nonmetastatic lesions causing compression. The association of concurrent breast carcinoma and a spinal neurilemoma simulating a metastatic lesion seems not to have been previously reported. A neurilemoma was observed in a 50-year-old woman. A neurilemoma suspected to be a metastatic lesion may produce the clinical features of pain, neurologic deficit, and weakness. Differentiation will be aided by roentgenograms, radionuclide bone scans, computed tomography, and possible magnetic resonance imaging. Radiologic differentiation hinges on the recognition and the slow-growing nature and noninvasive boundaries of the nonmalignant lesion. Ultimate verification is by biopsy. Treatment should consist of neurectomy, if severely symptomatic, and stabilization as indicated.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/21. Nerve tumors of the hand and forearm.Peripheral nerve tumors comprise less than 5% of all tumors of the hand. The most common solitary nerve tumor is the neurilemmoma, which arises from the neural sheath, is well encapsulated, minimally symptomatic, and may be surgically enucleated without producing a neurological deficit. Neurofibromas may be solitary, multiple, or associated with von Recklinghausen's disease. They are usually centrally placed with nerve fibers traversing the tumor mass making it more difficult to remove the tumor without producing permanent neurological damage. Malignant tumors include neurofibrosarcomas which often are very aggressive, requiring wide excision or amputation, and the rare neuroepitheliomas. Reported nerve tumors, intraneural in location but nonneural in origin, include fibrofatty infiltration of the median and digital nerves, intraneural lipoma, hemangioma, and ganglion cysts. These lesions may be treated by decompression or excision, depending on the nature of the tumor. Four unusual cases are described.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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