出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2016/01/29 20:51:43」(JST)
Ependymoma | |
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Micrograph of an ependymoma. H&E stain.
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Classification and external resources | |
Specialty | Oncology |
ICD-10 | C71 |
ICD-9-CM | 191.9, 225.0, 237.5 |
ICD-O | M9391/3-9394/1 |
DiseasesDB | 29452 |
eMedicine | med/700 |
MeSH | D004806 |
[edit on Wikidata]
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Ependymoma is a tumor that arises from the ependyma, a tissue of the central nervous system. Usually, in pediatric cases the location is intracranial, while in adults it is spinal. The common location of intracranial ependymoma is the fourth ventricle. Rarely, ependymoma can occur in the pelvic cavity.
Syringomyelia can be caused by an ependymoma. Ependymomas are also seen with neurofibromatosis type II.
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Ependymomas are composed of cells with regular, round to oval nuclei. There is a variably dense fibrillary background. Tumor cells may form gland-like round or elongated structures that resemble the embryologic ependymal canal, with long, delicate processes extending into the lumen; more frequently present are perivascular pseudorosettes in which tumor cells are arranged around vessels with an intervening zone consisting of thin ependymal processes directed toward the wall of the vessel.[2]
It has been suggested that ependymomas are derived from radial glia.[3]
Ependymomas make up about 5% of adult intracranial gliomas and up to 10% of childhood tumors of the central nervous system (CNS). Their occurrence seems to peak at age 5 years and then again at age 35. They develop from cells that line both the hollow cavities of the brain and the canal containing the spinal cord, but they usually arise from the floor of the fourth ventricle, situated in the lower back portion of the brain, where they may produce headache, nausea and vomiting by obstructing the flow of cerebrospinal fluid. This obstruction may also cause hydrocephalus. They may also arise in the spinal cord, conus medularis and supratentorial locations.[4] Other symptoms can include (but are not limited to): loss of appetite, difficulty sleeping, temporary inability to distinguish colors, uncontrollable twitching, seeing vertical or horizontal lines when in bright light, and temporary memory loss. It should be remembered that these symptoms also are prevalent in many other illnesses not associated with ependymoma.
About 10% of ependymomas are benign myxopapillary ependymoma (MPE)[citation needed]. MPE is a localized and slowly growing, low-grade tumor. Although some ependymomas are of a more anaplastic and malignant type, most of them are not anaplastic. Well-differentiated ependymomas are usually treated with surgery. For other ependymomas, total surgical removal is the preferred treatment in addition to radiation therapy. The malignant (anaplastic) varieties of this tumor, malignant ependymoma and the ependymoblastoma, are treated similarly to medulloblastoma but the prognosis is much less favorable. Malignant ependymomas may be treated with a combination of radiation therapy and chemotherapy. Ependymoblastomas, which occur in infants and children younger than 5 years of age, may spread through the cerebrospinal fluid and usually require radiation therapy. The subependymoma, a variant of the ependymoma, is apt to arise in the fourth ventricle but may occur in the septum pellucidum and the cervical spinal cord. It usually affects people over 40 years of age and more often affects men than women.
Extraspinal ependymoma (EEP), also known as extradural ependymoma, may be an unusual form of teratoma[5] or may be confused with a sacrococcygeal teratoma.[6]
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リンク元 | 「脳腫瘍」「神経膠腫」「上衣腫」「上衣細胞腫」「脳室上衣腫」 |
拡張検索 | 「myxopapillary ependymoma」「papillary ependymoma」「anaplastic ependymoma」 |
腫瘍別発生頻度 | 小児 | 成人 | |
神経膠腫 | 33% | 星状細胞腫 | 髄膜腫 |
髄膜腫 | 22% | 髄芽腫 | 膠芽腫 |
下垂体腺腫 | 15% | 頭蓋咽頭腫 | 下垂体腺腫 |
神経鞘腫 | 9% | 胚細胞腫 | 神経鞘腫 |
頭蓋咽頭腫 | 5% | 上衣腫 | 転移性脳腫瘍 |
部位 | 種類 | 小児 | 成人 |
頭蓋骨 | 頭蓋骨腫瘍 | ○ | ○ |
大脳半球 | 神経膠腫 | ○ | |
髄膜腫 | ○ | ||
松果体 | 胚細胞腫 | ○ | |
小脳半球 | 星細胞腫 | ○ | |
血管芽腫 | ○ | ||
小脳虫部 | 髄芽腫 | ○ | |
第四脳室 | 上衣腫 | ○ | |
鞍上部・ 視交叉部・ 下垂体部 |
頭蓋咽頭腫 | ○ | |
視神経膠腫 | ○ | ||
胚細胞腫 | ○ | ||
下垂体腺腫 | ○ | ||
髄膜腫 | ○ | ||
小脳橋角部 | 聴神経鞘腫 | ○ | |
脳幹部 | 神経膠腫 | ○ | ○ |
後発年齢 | 好発部位 | |
小脳星細胞腫 | 5~10歳 | 小脳半球 |
髄芽腫 | 5~10歳(男児に多い) | 小脳虫部から発生 |
頭蓋咽頭腫 | 10~15歳 | トルコ鞍上部 |
上衣腫 | 10~15,30~40歳 | 第四脳室、側脳室 |
髄芽腫 | 10~30歳 | 松果体部、トルコ鞍上部 |
脳幹部膠腫 | ~15歳 | 橋 |
視神経膠腫 | ~15歳 | 視神経視交叉 |
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