病理学英文课件：Diseases of the nervous system

1、Diseases of the nervous system Consisting of Brain Spinal cord Meninges Grossly Grey matter & white matter Ventricles (cerebrospinal fluid Histoloy Neuron 神经元神经元 (nerve fiber) Neuroglia 胶质细胞胶质细胞 (glial fiber) FCells of the nervous system and the basic pathologic changes F Neuron (神经元神经元) F Neuroglia

2、 (胶质细胞胶质细胞) Astrocyte (星形细胞星形细胞) Oligodendrocyte (少突细胞少突细胞) Ependymal cell (室管膜细胞室管膜细胞) Schwann cell (雪旺细胞雪旺细胞) F Microglia (小胶质细胞小胶质细胞) CNS PNS Betz cell Nissl小体小体 小脑（小脑（ 50 m 65y Shanghai：3% in 65y，4.69% in 70y FClinical features Cortical dysfunction Insidious impairment of higher intellectual fun

3、ction Alterations in mood and behavior Progressive disorientation, memory loss, and aphasia 失语症失语症 Dead of intercurrent pneumonia or other infections within 5-10y Alzheimers disease FMorphology Gross：cortical atrophy Widening of the cerebral sulci Normal toxic Alzheimers disease FMicro Neurofibrilla

4、ry tangles (神经原纤维缠结神经原纤维缠结) Intracellular bundles of paired helical filaments Hyperphosphorylated forms of the protein tau Commonly found in cortical neurons A signal of cell death 老年斑老年斑) 淀粉样血管病淀粉样血管病) Vaculation (颗粒颗粒空泡变性空泡变性) FNon-specific, can be found in other degenerative diseases or brain agi

5、ng 神经原纤维缠结神经原纤维缠结 tau Protein 老年斑老年斑 Amyloid angiopathy: amyloid deposition in arterioles Anti-Ab bCongo red toxic Genetic factors FPrimary intracranial tumors (50%-75%) Glioma (胶质瘤胶质瘤) Astrocytoma Oligodendroglioma Ependymoma Meningioma (脑膜瘤脑膜瘤) Medulloblastoma(髓母细胞瘤髓母细胞瘤) FPNS Schwannoma(神经鞘瘤神经鞘瘤)

6、 Neurofibroma(神经纤维瘤神经纤维瘤) MPNST(恶性周围神经鞘膜瘤恶性周围神经鞘膜瘤) FMetastatic tumors：commonly from lung, breast, etc Astrocytoma 星形细胞瘤 Astrocytoma Diffuse astrocytoma glioblastoma multiforme Astrocytoma 星形细胞瘤 Diffuse astrocytoma Diffuse astrocytoma, GFAP Gemistocytic astrocytoma 此患者经放化疗此患者经放化疗11个月后复发，进展到胶质母细胞瘤。个月

7、后复发，进展到胶质母细胞瘤。 Anaplastic astrocytoma Glioblastoma multiforme P53 mutation / loss of chr. 17p Loss of chr.22q Rb mutation / loss of chr.13q P16 deletion / loss of chr.3p Loss of chr.19q Loss of ch.10 EGFR gene amplification Genetic changes in astrocytoma Normal astrocyte Astrocytoma Anaplastic astro

8、cytoma Glioblastoma multiforme Oligodendroglioma Ependymoma Medulloblastoma 髓母细胞瘤髓母细胞瘤 FPrimary neuroectodermal tumor of CNS FPredominantly in children, peak age 10y FExclusively in the cerebellum FGross Often well circumscribed Gray and friable FMicro Extremely cellular Sheets of anaplastic (small

9、blue) cells Rosette FPrognosis and treatment Untreated patients: dismal Exquisitely radiosensitive Medulloblastoma Medulloblastoma Meningioma 脑膜瘤 FArising from the meningothelial cell of the arachnoid FMay be found along any of the external surfaces of the brain as well as within the ventricular sys

10、tem FGross Well-defined Usually attached to the dura, Grey, solid, gritty (psammoma body) FMicro Whorled clusters of cells Psammoma body (砂粒体砂粒体) may be seen FPredominantly benign meningioma Whorled clusters of cells Psammoma body Schwannoma 神经鞘瘤 FArising from schwann cells (施万细胞施万细胞) FUsually localized in peripheral nerves FGross Encapsulated, nerve of origin Nodular, grey, may contain cystic areas FMicro Compos