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The CT manifestations and corresponding pathologic basis of cervical neurilemmoma

GU Yajia , WANG Jiuhua, CHEN Tongzhen. Department of Radiology, the Affiliated Cancer Hospital of Shanghai Medical University, Shanghai 200032,China  
Objective To compare the special CT manifestations with corresponding pathologic tissue slices of cervical neurilemmoma and to investigate the pathologic fundament of those special findings. Methods Seventy two cervical neurilemmomas in 71 cases which were proved by operation and pathology from 1988,8 to 1999,3 were investigated.Of these tumors, 57 were scaned in enhancement, the other 15 tumors were examined with both unenhancement and enhancement. The manifestations of CT scans were compared with the results of pathology. Results The special manifestations of enhanced scans of cervical neurilemmoma were:(1) the high density corpses on the homogeneous low density background(24/72). (2)Diffuse spot changes which varied as high and low density(20/72).(3)Low density circle accompanied by diffuse spots in central area(5/72).(4)Different thick circles and the low density center(8/72).(5)12 tumors were homogeneous in density.Of them,5 cases were isodensity, 5 cases were low density, and 2 cases showed cystic changes.(6)3 cases were strongly enhanced. The main manifestations of unenhanced scans were homogeneous in density(10/15).The characteristic spots and crops enhancement was detected after the contrast was given(9/10). All of above CT manifestations were corresponding to pathology of cervical neurilemmoma. Antoni B, obsolete bleeding, and cystic changes showed the areas of low density. Antoni A and collagen were attributed to high density. Different cell distribution showed different CT image. There was a close relationship between Antoni A and enhanced scan. Conclusion The spacial CT manifestations of cervical neurilemmoma is due to its varied pathologic changes. The correct diagnosis could be established on the bases of understanding of pathology.
【CateGory Index】: R739.4
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