NLS-research With Biophilia Tracker Can Be The Main Method Of Peripheral Nerves Tumors Diagnostics

Neurofibroma (fibroneuroma) is a benign tumor of a peripheral nerve developing from Schwann cells and fibroblasts, more often located on a surface, in depth or under a layer of hypoderm. Single neurofibromas are extremely rare as independent nosological unit. More frequently presence of neurofibromas is a sign of a hereditary disease – neurofibromatous.

In 1822 Scottish surgeon Wishart J.H. for the first time has described neurofibromatous of 2nd type (NF2). In 1882 von Recklinghausen F.D. has studied and described neurofibromatous of 1st type (NF1). Despite distinctions in the description of diseases, Cushing H.W. in 1916 in the scientific work has united them under a single name “Recklinghausen disease”. Only after many years, after molecular genetic testing, results of which have been published in 1985 and 1987, basic differences in pathogenesis of NF1 and NF2 have been revealed. It has been proved that these are absolutely different diseases demanding different diagnostic and medical tactics.

Scientific references have descriptions of 8 types of NF, however majority of them, except NF2, are considered to be an abortive form of NF1 and are not considered as independent nosological forms. Exceptions are segmentary NF (NF of 5th type) (NF5) at which typical displays of NF1 are located in one or several neighboring dermatomes (registered extremely seldom, usually it is not inherited), and not included into number 8 spinal NF at which all spinal roots are affected symmetrically (several observations are described).

NF2, as well as NF1, is an autosomal dominant disease. In patients NF2 is registered less often, than NF1, in 1 of 50000 newborns. Gene NF2 is located in 22th chromosome (22q12) and codes synthesis of tumoral growth suppressor – merlin protein, or schwannomin which functions as membranous organizer and provides, first of all, construction and functioning of a cellular skeleton. This protein has the greatest importance for proliferation regulation of cells with neuroectodermal origins. If NF2 allelic gene is damaged due to symmetric mutation or loss of heterozygosity in 22nd chromosome, synthesis of normal merlin in a cell stops, dynamic balance of growth regulation is shifted to proliferation, and therefore benign tumoral growth appears. NF2 gene has high penetrance. Practically in all of its carriers the disease develops by 60 years. Developing at NF2 tumors are benign, but more biologically aggressive, than at NF1.

Neurosurgeons and traumatologists-orthopedists at diagnosing base mainly on clinical manifestations of a pathology, anamnestic data and results of patient check-up, however it is not enough for revealing mass-occupying soft-tissue neoplasms of peripheral nerves. For specification of a tumor location during planning of operative treatment, additional instrumental methods of research is required. Application of electroneuromyography in diagnostics of this pathology often does not give accurate results, as often patients do not suffer from nervous trunks conductivity abnormality, or, if tumors are located next to the main nervous trunks, only insignificant or moderate abnormality of conductivity comes to light. Application of ray diagnostics methods at peripheral nerves tumors is often limited by possibilities of research techniques. In case of a nervous trunk or soft tissues tumor roentgenography has no importance for diagnostics and it can be carried out only for elimination of bone pathology.

Computer tomography, as well as roentgenography, does not give a required amount of information at this pathology. Magnetic resonance imaging (MRI) is a method of choice in diagnostics of soft-tissue mass-occupying neoplasms, including those connected with large nervous trunks and plexuses. However, if a mass-occupying neoplasm is of a small size and is located with a skew angle to tomographic slices, interpretation of received results can be complicated. Therefore recently appeared method of NLS-research with biophilia tracker, in our opinion, can become both screening, and the main method of peripheral nerves tumors diagnostics.