The Neurosurgical Aspects of Seventh Nerve Neurilemmoma

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Figures

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    Case 1. Long-standing facial paralysis with muscular atrophy and eversion of lower lid.

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    Case 1. Roentgenogram showing thin curvilinear calcific line suggesting mass in middle fossa (retouched).

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    Case 1. Angiograms showing displacement of middle cerebral artery anteriorly, superiorly, and medially.

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    Case 1. Photomicrograph of tumor in the region where it extended into bone. The cells have elongated, slightly irregular nuclei which are arranged parallel to one another and form palisades, so common to these tumors. Hematoxylin and eosin, ×220.

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    Case 1. This photomicrograph demonstrates the large foamy cells with eccentric nuclei which were present in the tumor. Their cytoplasm was filled with sudanophilic material. Numerous large pale cells of this type interspersed among elongated cells similar to those shown in Fig. 4 made up the histologic pattern of a major portion of the tumor. Hematoxylin and eosin, ×400.

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    Case 2. Facial paralysis of long duration.

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    Case 2. Ventriculogram showing displacement of ventricles to the left, and air over tumor.

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    Case 2. Elevation of temporal horn on the right with air over tumor beneath temporal horn.

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    Case 2. Photomicrograph of neurinoma of 7th nerve. The histologic picture is that of bands of cells with eosinophilic cytoplasm and a tendency to palisading of the elongated nuclei. Some of the cells are arranged in loose whorls, as is seen in the upper portion of the figure. Hematoxylin and eosin, ×150.

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    Case 2. Electron micrograph of characteristic cells in same tumor as shown in Fig. 9. The cells have prominent nuclei (N) of irregular outline. The cytoplasm is profuse and has a characteristic arrangement of complicated folding and interdigitation. A distinct basement membrane is usually evident (arrows). These cells are considered to be neoplastic Schwann cells. The presence of a basement membrane and the complexity of the cytoplasmic indentations set them apart from fibroblasts. ×8000.

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    Case 2. Electron micrograph of one of the rare fibroblasts present in the tumor shown in Figs. 9 and 10. It is an elongated cell with an ovoid uniform nucleus. The cytoplasmic outline is smooth. A basement membrane is absent. Scattered collagen fibrils are evident. At the upper right is a part of the cytoplasm of an adjacent neoplastic Schwann cell. ×8000.

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    Case 2. Spontaneous pneumocephalus with fluid level.

References

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