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中华临床医师杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 467 -470. doi: 10.3877/cma.j.issn.1674-0785.2023.04.017

综述

Shamblin Ⅱ型颈动脉体瘤的诊疗及文献综述
马四海(), 杨剑, 马显武, 张敏, 吕明礼, 李启菊, 杨轶声, 刘海生   
  1. 100144 北京大学首钢医院神经外科;553000 首钢水钢医院脑科病区
    553000 首钢水钢医院脑科病区
    553000 首钢水钢医院影像
    553000 首钢水钢医院超声科
    553000 首钢水钢医院病理科
  • 收稿日期:2023-02-07 出版日期:2023-04-15
  • 通信作者: 马四海
  • 基金资助:
    首钢水钢医院脑科中心建设项目的资助(黔财社[2019]82号)

Diagnosis and treatment of Shamblin Ⅱ carotid body tumor: a case report and literature review

Sihai Ma(), Jian Yang, Xianwu Ma, Min Zhang, Mingli Lv, Qiju Li, Yisheng Yang, Haisheng Liu   

  1. Department of Neurosurgery, Shougang Hospital of Peking University, Beijing 100144, China; Department of Brain Diseases, Shougang Shuigang Hospital, Liupanshui 553000, China
    Department of Brain Diseases, Shougang Shuigang Hospital, Liupanshui 553000, China
    Department of Imaging, Shougang Shuigang Hospital, Liupanshui 553000, China
    Department of Ultrasound, Shougang Shuigang Hospital, Liupanshui 553000, China
    Department of Pathology, Shougang Shuigang Hospital, Liupanshui 553000, China
  • Received:2023-02-07 Published:2023-04-15
  • Corresponding author: Sihai Ma
引用本文:

马四海, 杨剑, 马显武, 张敏, 吕明礼, 李启菊, 杨轶声, 刘海生. Shamblin Ⅱ型颈动脉体瘤的诊疗及文献综述[J]. 中华临床医师杂志(电子版), 2023, 17(04): 467-470.

Sihai Ma, Jian Yang, Xianwu Ma, Min Zhang, Mingli Lv, Qiju Li, Yisheng Yang, Haisheng Liu. Diagnosis and treatment of Shamblin Ⅱ carotid body tumor: a case report and literature review[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(04): 467-470.

颈动脉体瘤(CBT)是以颈部无痛包块为主要表现的副神经节瘤。因CBT多包绕颈部重要血管和神经,手术难度高、风险大。本文报道1例Shamblin Ⅱ型CBT的诊疗,并综述CBT的病因、临床表现、诊断分型、手术治疗等方面文献进展。

Carotid body tumor (CBT) is a paraganglioma, which is mainly characterized by painless mass in the neck. Because CBT often wraps around important blood vessels and nerves in the neck, the operation is difficult and risky. This paper reports the diagnosis and treatment of a case of Shamblin Ⅱ CBT, and reviews the literature to discuss the etiology, clinical manifestations, diagnosis and classification, and surgical treatment of CBT, with an aim to provide a basis for standardized diagnosis and treatment of this tumor.

图1 颈动脉体瘤患者术前和术后头颈部CT扫描及CTA检查结果。图a为术前头颈部CT扫描提示右侧颈部占位病变,均匀强化。T:占位病变;图b为术前头颈部CTA检查提示占位病变起始于右侧颈动脉分叉部,部分包绕颈外动脉;图c为术前头颈部CTA检查提示占位病变部分包绕右侧颈内动脉;图d为术后头颈部CT扫描提示右侧颈部占位病变完全切除;图e为术后头颈部CTA检查提示右侧颈动脉分叉部占位病变完全切除
图2 颈动脉体瘤术前超声及造影检查结果。图a为术前颈部超声检查提示右侧颈部占位病变;图b为术前颈部超声检查提示右侧颈部占位病变血供丰富;图c为术前DSA检查提示右侧颈部占位病变动脉期血供丰富;图d为术前DSA检查提示右侧颈部占位病变毛细血管期血供丰富;图e为术前DSA检查提示右侧颈部占位病变主要血供来源于咽升动脉(→);图f为术前介入栓塞占位病变主要供血动脉后DSA造影检查提示病变血供明显减少。
图3 颈动脉体瘤术中所见和病理结果。图a为术中见肿瘤部分包绕颈内、外动脉;图b为术中自颈部血管和神经仔细分离肿瘤;图c为完整切除的颈动脉体瘤;图d为肿瘤免疫组化病理HE染色(×20)结果符合副神经节瘤病理特征;图e为肿瘤免疫组化病理染色(×40)Syn(+),符合副神经节瘤病理特征;图f为肿瘤免疫组化病理染色(×40)CgA(+),符合副神经节瘤病理特征 注:T为肿瘤;CCA为颈总动脉;ICA为颈内动脉;ECA为颈外动脉
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