Paraganglioma

Paraganglioma (paraganglioma) - the tumor from paraganglia of various localization. Depending on the peculiarities of parenchymal cells of tumors and clinical manifestations of paraganglioma divided into chromaffin (see Pheochromocytoma) and necromania.
Necromania of paraganglioma have a large number of synonyms; some of them reflect the characteristics of histological structure (adenoma, alveolar tumor, epidemiologichna tumor, perihelion, carcinoid), others take into account the histogenesis (Globus-angioma, angioedema), others emphasize morphofunctional features of the original fabric decorated and unformed reprompting of paraganglia (see)relating to the chemoreceptor system (retseptora, chemodectoma). On the basis of embryogenesis of paraganglia P. referred to neuroectodermal tumors of nature. Systematization on, are not developed. A separate classification relate tumors of this or that Department chemoreceptor system, such as tumors carotid Taurus, pomozov skin (see Glamurnye tumors).
Among the cases is dominated by persons of young age. Localized paraganglioma respectively location reprompting of paraganglia. Mature tumors usually encapsulated, but may have and mestnoanesteziruyuschee growth; protoliticheskie, makedonskogo or fibrous structure, whitish-grey, white-pink or yellowish-brown color. Color P. depends on the degree of vascularization, fibrosis and deposits of various pigments (lipochrome, melanin, hemosiderin), there is a tendency to intravascular distribution, and therefore the tumor recurs. Growing P. slowly. Its sizes range from a few millimeters to large. Described primary multiple P., symmetric, and also members of one family.
Mature paraganglioma inherent organichnosti structure. Some of them are identical tumors carotid knots. Specific units such on, are microscopic slices of compactly located parenchymal cells, surrounded by a sinusoidal blood vessels and divided fibrous tissue on individual cells (Fig.). Parenchymal cells of P. quite varied; the largest of them polygon "light" vakuolyarnyi form simplest, sometimes apart drop secret; others oval epitelialna with homogeneous or granulated cytoplasm; others small polygonal or round; all tumors can trace transitional forms. The relative positions of cells and blood vessels in separate paraganglioma quite different. On this basis, allocate alveolar, adenomatous and angiomatous forms of P.
Some types of tumors are distinguished by a specific orientation epithelioid cells longitudinal axis of the lumen of the blood vessel, and therefore formed sockets and parazitarnye patterns. Epithelioid cells form also like bands, presents a series of oval cells; the cell rows are separated fibrous, sometimes galinadiamond, layers; these areas tumors are fully consistent histological structure of the carcinoids. Some authors have succeeded to reveal complex nerve endings and neurofibrillar, surrounding the individual cells of paraganglia.
Specific histochemical reaction for detection facilities of the tumor to P. unknown. Argentina reaction gives a non-permanent effect. Sometimes it is possible to prove the existence of serotonin and its derivatives: catecholamines, melanin, lipochromes.
Were found nonspecific and acetylcholine esterase, acid phosphatase, lactic dehydrogenase. In the fat cells stroma found latinamericana, in vascular endothelium - alkaline phosphatase.
Mature P. characteristic of dystrophic processes that result in the histological structure of tumor changes significantly. Among the main elements and walls of vessels is delayed a large number Galina, the parenchyma of the tumor is exposed to atrophy, and bright spots of blood vessels fully obliteriruta.
Meet the inclusion of lime, impregnating drops extracellular located secret.
Immature ways tumor is malignant necromania P., the malignant chemodectoma have a structure or alveolar polimervolokno sarcoma, malignant perechitay; often, however, retain the structure, typical of the Mature forms.
Clinically of paraganglioma give symptoms of a local nature, but can be a General phenomenon in the form of vascular dystonia, migraine, nausea, bradycardia, cyanosis of the extremities; sometimes have attacks of shortness of breath, chronic, or fulminant, stomach ulcers, serotonin crises. Metastasize malignant., in regional lymph nodes, and further impaginatore.
Treatment of P. surgery. When non-radical operations relapse.

Paraganglioma (chemodectoma) lattice labyrinth: 1 - low magnification; 2 - a large increase.