medigraphic.com
ISSN 0016-3813 (Print)

2011, Number 2

<< Back Next >>

Gac Med Mex 2011; 147 (2)

A 33 year old woman with a six-year history of slight thoracic-abdominal pain

Cárdenas-Escudero MA, Shuchleib-Chaba S, Muruchi-Garrón GW, León-Bojorge B, Ortiz-Hidalgo C

Language: Spanish
References: 18
Page: 163-168
PDF size: 131.73 Kb.


ABSTRACT

We present a case of a benign hybrid nerve sheath tumor showing features of both cellular schwannoma and perineurioma. The patient was a 33 year-old female who presented with a 6 month history of pain in the thorax-lumbar region. Axial CT and MIR images showed and homogeneously enhancing solid oval mass involving the left paravertebra region in contact with the vertebral foramina T9-T11. Morphologically the tumor presented a well formed capsule and showed a uniform highly spindle cell proliferation. The spindle cells were arranged in whorls and intersecting fascicles with focal intervening sclerosis and relatively uniform cellularity with a prominent perivascular lymphocytic infiltrate. No cytological atypia, necrosis or mitoses were present. A second cell component was present composed of spindle-shaped cells with inconspicuous bipolar, pale, eosinophilic cytoplasm with oval nuclei. By immunohistochemistry there was a diffuse staining for S-100, and the elongated bipolar cells were EMA, Glut-1 and Claudin-1. To our knowledge this is the first reported case of a hybrid cellular schwannoma/perineurioma.


REFERENCES

  1. Kurtyaka-Yapicier O, Scheithauer B, Woodruff JM. The pathobiologic spectrum of Schwannomas. Histol Histopathol. 2003;18:924-34.

  2. Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A. Neuropathology for neuroradiologist; Antoni A and Antoni B tissue Patterns. Am J Neuroradiol. 2007;28:1633-8.

  3. Piña-Oviedo S, Ortiz-Hidalgo C. The Normal and neoplastic perineruium: A Review. Adv Anat Pathol. 2008;15:147-64.

  4. Scheithauer BW, Woodruff JM, Erlandson RA. Cellular Scwhannoma. En: Atlas of tumor pathology. Tumors of the peripheral nervous system. Scheithauer BW, Woodruff JM, Erlandson RA (Eds.). Armed Forces Institute of Pathology. Third Series. Fascicle, Washington DC. 1997. p. 138-51.

  5. Feany MB, Anthony CD, Fletcher CDM. Nerve sheath tumor with hybrid features of neurofibroma and schwannoma: a conceptual challenge. Histopathology. 1998;32:405-10.

  6. Michal M, Kazakov DV, Belousova I, Bisceglia M, Zamecknic M, Mekunsnabl P. A benign neoplasm with histological features of both schwannoma and retiforme perineurioma (benign schwannoma-perineruioma): a report of six cases of a distinct soft tissue tumor with predilection for the fingers. Virchow Arch. 2004;445:347-53.

  7. Zamecknick M, Michal M. Perineurial cell differentiation in neurofibromas. Report of eight cases including a case with composite perineuriomaneurofibroma features. Pathol Res Prac. 2001;197:537-44.

  8. Woodruff JM, Godwin TA, Erlandson RA, Susin M, Martini N. Celluar schwannoma. A variety of schwannomas sometimes mistaken for malignant tumor. Am J Surg Pathol. 1981;5:733-44.

  9. Fletcher CD, Davies SE, McKee PH. Cellular schwannoma: a distinct pseudosarcomatous entity. Histopathology. 1987;11:21-35.

  10. Woodruff JM. Cellular schwannoma and its necessary distinction form malignant peripheral nerve sheath tumors and sarcomas. Path Case Rev. 1998;3:118-22.

  11. Hajdu SI. Cellular schwannoma: a clinicopathologic DNA flow cytometric, and proliferation markers study of 70 patients. Cancer. 1996;77:591-3.

  12. Koizumi Y, Utsunomiya T, Yamamoto H. Cellular schwannoma in the oral mucosa. Acta Otolaringol. 2002;122:458-62.

  13. Green AL, Yeh JS, Brydon HL, Carey MP. Cellular Schwannoma of the posterior fossa. J Neurol Neurosurg Psychiatry. 2002;72:677-8.

  14. Nesbitt JC, Vega DM, Burke T, Mackay B. Cellular schwannoma of the bronchus. Ultrastruct Pathol. 1996;20:349-54.

  15. Ellison DW, MacKenzie IZ, McGee JO. Cellular schwannoma of the vagina. Gynecol Oncol. 1992;46:119-21.

  16. Sada-Mier y Terán A, Padilla-Longoria R, Toussaint-Caire S, Ortiz-Hidalgo C. Expresión difusa de EMA y GLUT-1 en tres casos de neurofibromas. Evidencia inmunohistoquímica de diferenciación perineural extensa. Rev Esp de Patol. 2005;38:83-6.

  17. Shelekhova KV, Michal M. Hybrid neurofibroma-perineurioma: an additional example of an extradigital tumor. Ann Diagn Pathol. 2008;12:233-4.

  18. Hornick JL, Bundock E, Fletcher CD. Hybrid schwannoma/perineurioma. Clinicopathologic analysis of 42 distinct benign nerve sheath tumors. Am J Surg Pathol. 2009;33:1554-61.




2020     |     www.medigraphic.com