RESUMO
Intraneural perineurioma is a rare tumour that affects peripheral nerves and, based on its histological features, may be confused with hereditary motor and sensory neuropathies. Detailed neuropathology, including immunoperoxidase stains and electron microscopy, is vital to distinguish these conditions. We report two patients with intraneural perineurioma that demonstrate salient features of this tumour. The first patient is the longest reported follow-up of an intraneural perineurioma; extension of the lesion was observed over 14years. The second patient is an 11-year-old female whose treatment highlights some of the controversy surrounding the management of these lesions, and the importance of thorough macroscopic and microscopic assessment by pathologists, including the status of surgical resection margins.
Assuntos
Neoplasias de Bainha Neural/diagnóstico , Neoplasias do Sistema Nervoso Periférico/diagnóstico , Adolescente , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Microscopia Eletrônica de Transmissão/métodos , Nervos Periféricos/patologia , Nervos Periféricos/cirurgia , Nervos Periféricos/ultraestrutura , Neoplasias do Sistema Nervoso Periférico/cirurgia , Nervo Sural/transplanteAssuntos
Abscesso Encefálico/microbiologia , Resistência a Meticilina , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Abscesso Encefálico/diagnóstico por imagem , Abscesso Encefálico/cirurgia , Edema Encefálico/etiologia , Edema Encefálico/patologia , Hemorragia Cerebral/etiologia , Evolução Fatal , Forame Oval Patente/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Convulsões/etiologia , Infecções Estafilocócicas/diagnóstico por imagem , Infecções Estafilocócicas/cirurgia , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: The neuropathological findings of 32 progressive supranuclear palsy (PSP) cases over a period of 17 years were reviewed. RESULTS: Of the 26 cases with adequate clinical data, 20 patients either presented with cognitive dysfunction or developed a cognitive impairment subsequently during the course of the disease. Co-existing changes of argyrophilic grains and corticobasal degeneration (CBD) were found in 28% and 32% of the cases respectively. Alzheimer-related pathology was found in 69% of cases but only 18.75% of cases fulfilled the consortium to establish a registry for Alzheimer's disease (CERAD) criteria for either definite or probable Alzheimer's disease. Lewy bodies were noted in four cases (12.5%), all in the subcortical regions. Only seven cases of PSP showed no pathological evidence of other co-existing neurodegenerative diseases. The severity of the cerebrovascular pathology in this cohort was insufficient to explain any clinical symptomatology. CONCLUSIONS: As in previous studies, this study has demonstrated the frequent co-existence of pathological changes usually noted in other neurodegenerative diseases in PSP. Whether these co-existing pathological changes contribute to the cognitive impairment in PSP remains uncertain.