Often numbness and pain in distal limbs
Introduction
Introduction Frequent numbness on the far side of the limb is a symptom of neuroma. Neuroma usually refers to schwannomas from nerve sheath tissue, most of which are located in the limbs, armpits, and also on the clavicle, neck and other parts. It is a benign tumor with slow growth and generally no recurrence after resection. Located in the limb mass, it is fusiform, and its nerves often have numbness, pain, and hyperesthesia on the far side of the dominant limb. Compression of the tumor can also cause numbness. The diagnosis of the disease is based on symptoms and signs. For example, a fusiform solid tumor is found on the limb, and there is a distal numbness of the limb, pain, hyperesthesia, and numbness in the oppressed tumor. The disease is first considered. When the examination showed that the tumor was pink or grayish white, the base was not easy to move or pedicled, and the quality was hard. It was confirmed by pathological examination.
Cause
Cause
Caused by the production of neuroma.
Examine
an examination
Related inspection
Electromyography joint examination
The diagnosis of the disease is based on symptoms and signs. For example, a fusiform solid tumor is found on the limb, and there is a distal numbness of the limb, pain, hyperesthesia, and numbness in the oppressed tumor. The disease is first considered. When the examination showed that the tumor was pink or grayish white, the base was not easy to move or pedicled, and the quality was hard. It was confirmed by pathological examination.
Diagnosis
Differential diagnosis
1. Acoustic neuroma: early vertigo should be differentiated from inner ear vertigo, vestibular neuronitis, labyrinthitis and various drug-induced vestibular nerve damage. The former has progressive deafness with facial nerve dysfunction.
2. Deafness should be differentiated from internal ear sclerosis and drug-induced deafness. Acoustic neuroma has vestibular dysfunction.
3. Identification with other tumors of the cerebellopontine angle:
1 Epidermoid cyst: the first symptom is mostly trigeminal nerve root irritation, the hearing loss is not obvious, and the vestibular function is mostly normal. CT, MRI can assist in identification.
2 meningioma: tinnitus and hearing loss are not obvious, the inner ear canal does not expand. 10% occurred in the saddle, the flat sweep was evenly high density, there may be calcification, the capsule became rare, the tumor was usually in the position of the saddle, and the saddle nodule was hyperplasia.
3 brain stem or cerebellar hemisphere glioma: short course of disease, brain stem or cerebellar symptoms appear earlier, early appearance of pyramidal tract signs. 4 metastatic tumor, acute onset, short course of disease, other parts may find primary cancer.
4 astrocytoma: astrocytoma above the third ventricle often appears as a solid mass on the saddle, generally does not extend into the saddle, and the calcification rate is lower than that of the craniopharyngioma. However, it is sometimes difficult to give a different type of craniopharyngioma with a saddle.
5 aneurysm: There may be calcification on the wall of the giant aneurysm, and the wall of the tumor is strengthened by the organic tissue during the scanning. However, the strengthening of the blood in the aneurysm is very significant, consistent with the enhancement of the intracranial artery, and occasionally strengthen the uniform artery. It is difficult to distinguish from parenchymal craniopharyngioma. It is necessary to carefully analyze the relationship between the tumor and the blood vessels in the cerebral artery. When there is no distinction, MR examination or cerebral angiography is required.
4. Neurofibroma: The histopathology of neurofibromatosis has the following characteristics:
(1) It is tough, elastic and non-enveloped.
(2) Tumor cell evacuation, occasional fence or spiral structure.
(3) The god of origin in the tumor is often interspersed with it.
(4) sweat glands and adipose tissue are often seen in the tumor, and there are no thick-walled blood vessels.
(5) Alcian blue staining positive.
5. Malignant schwannomas and cell-rich schwannomas should be noted. The former capsule is incomplete, the tumor tissue is often accompanied by necrosis, and there is often infiltration into the surrounding tissue; the nucleus is pleomorphic and has obvious abnormal shape, and the giant cells of the tumor are visible, and the mitotic figures are easy to see.
6. Sclerosing schwannomas resemble leiomyomas or fibroids, but the typical structure of schwannomas can always be found in multiple sections. Cell characteristics and VG staining are helpful for identification.
7. The pain should be differentiated from glomus tumors.
The diagnosis of the disease is based on symptoms and signs. For example, a fusiform solid tumor is found on the limb, and there is a distal numbness of the limb, pain, hyperesthesia, and numbness in the oppressed tumor. The disease is first considered. When the examination showed that the tumor was pink or grayish white, the base was not easy to move or pedicled, and the quality was hard. It was confirmed by pathological examination.
