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M55YMovementdisorderofleftfacefor6months.mastoidprocess(乳突)operation5yearsago.T1T2T1+c颈静脉球瘤GlomusJugulareTumor,GJTOutlineGTJsarethemostcommontumorsofthemiddleear.GTJArisesfromtheglomusbodies(球样小体)locatedwithintheear,itaffectsthejugularforamen(颈静脉孔)onthetemporalbone,andsomeleisionviolatethetympanum(鼓室).Thesetumorsareslow-growingandveryvascular,withbloodsupplyfromtheexternalcarotidartery(颈外动脉)andinternalcarotidartery(颈内动脉).Thesetumorsaremostcommoninwomen.Thesetumorsarenearlyalwaysbenign.ThecausesofGJTarenotentirelyunderstood,butgeneticfactorsaresuspected.ClinicalsymptomsSymptomsmayinclude:Difficultyswallowing(dysphagia)(吞咽困难)Dizziness(头晕)HearingproblemsorlossHearingpulsationsintheear(搏动性耳鸣)Hoarseness(声音嘶哑)PainWeaknessorlossofmovementintheface(facialnervepalsy)麻痹PathologicalappearanceGJTsarisefromtheparaganglioncell(副神经节细胞)oftheoutermembraneofGlomusJugulare,mostarenonchromaffin(非嗜铬性).GJTshaverichnetworkofbloodvesselsandbloodsinus(血窦).Epithelial-likecellsarethechiefcellsofthetumor,andhavethesecretoryfunctionorpotentialsecretoryfunction.Diagnosis(CT)Thelesionsarisefromjugularforamenandextendintotheadjacentstructures.Thelesionscausetheenlargementofthejugulareforamenwithadjacentmouth-eaten(虫蚀状)orirregularbonedestruction.Eventuallyasthetumourenlargesthejugularspineiserodedandthemassextendsintothemiddleear,aswellasinferiorlyintotheinfratemporalfossa(颞下窝).Thelesionsappareasaisodensitymasscomparedwithbraintissue,andthelesionappearshomogeousenhancement.CTADiagnosis(MRI)T1WI:tumorsappearhypointenseorisointensesignalcomparewiththegraymatter.T2WI:tumorsappearhyperintensesignal.T1+c:tumorsappearmarkednonhomogeneousenhancement.Saltandpepperpattern:thesaltrepresentingbloodproductsfromhaemorrhageorslowflowandthepepperrepresentingflowvoids(血管流空)duetohighvascularity.MRA:thetumorshavealotofsmallvesselsfromexternalcarotidarteryandinternalcarotidartery.MRV:thesigmoidsinus(乙状窦)andtheinternalcarotidvein(颈内静脉)arepressed.T1T2T1+cDifferentialdiagnosisschwannoma(神经鞘瘤)sharplydemarcatedsmoothbonymargins.nointernalflowvoids.nosaltandpepperpatternappearance.ThelesionisnohomogeneousonT1WIandT1+C,becauseofAntoniAandBcells.meningioma(脑膜瘤)homogenoussignalandhomogeneousenhancement.duraltailsign.bonedestructionnotasseriousasGJT,andherhapshasScleroticrim(硬化边).
本文标题:颈静脉球瘤英文PPT
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