醫學五：80題 ( 包括外科,骨科,泌尿科等科目及其相關臨床實例與醫學倫理 )題庫下載題庫

The term neuroblastoma is commonly used to refer to a spectrum of neuroblastic tumors (including neuroblastomas, ganglioneuroblastomas, and ganglioneuromas) that arise from primitive sympathetic ganglion cells. The neuroectodermal cells that comprise neuroblastic tumors originate from the neural crest during fetal development, and are destined for the adrenal medulla and sympathetic nervous system. By contrast, pheochromocytomas and paragangliomas arise from a different type of cell, the chromaffin cell, which also migrates from the neural crest to the adrenal gland

Neuroblastomas can arise anywhere throughout the sympathetic nervous system. The adrenal gland is the most common primary site (40 percent), followed by abdominal (25 percent), thoracic (15 percent), cervical (5 percent), and pelvic sympathetic ganglia (5 percent)
Degradation of norepinephrine, epinephrine, and dopamine lead to the final end products VMA and HVA. Elevated levels of VMA and HVA can be detected in the serum and urine of approximately 70 to 90 percent of patients with neuroblastoma

(C)當懷疑小兒罹患神經母細胞瘤時，須收集24小時尿液檢測其中的兒苯酚氨（catecholamine）或其代謝產物 （例如：dopamine, homovanillic acid, vanillylmandelic acid），通常會發現數據上升

I131-MIBG scan – Evaluation for metastatic bone disease is required for patients with diagnosed neuroblastoma. For such patients, I131 MIBG is preferred to technetium scan for evaluation of the bone, given its higher sensitivity and specificity for detection of metastatic disease. Among patients with known neuroblastoma, I131 MIBG has a sensitivity of approximately 90 percent