A benign neoplasm with histopathological features of both schwannoma and retiform perineurioma (benign schwannoma-perineurioma): a report of six cases of a distinctive soft tissue tumor with a predilection for the fingers

Michal, Michal; Kazakov, Dmitry V.; Белоусова, И. Э.; Bisceglia, Michele; Zámečnı́k, Michal; Mukenšnábl, Petr

doi:10.1007/s00428-004-1102-5

Cited by 70 publications

(59 citation statements)

References 39 publications

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“…Although perineurioma has been first described in 1978 [19], it still represents a poorly recognised neoplasm in the spectrum of peripheral nerve sheath tumours [25], and, especially, examples of unusual histological variants cause considerable diagnostic problems and may be mistaken for different or more aggressive soft tissue tumours. Interestingly, rare examples of benign peripheral nerve sheath tumours showing a combination of perineurioma and schwannoma as well as of perineurioma and neurofibroma have been reported most recently [18,23]. In this review one case each of reticular and plexiform perineurioma is reported, and a review of perineurial neoplasms of skin and soft tissues is given.…”

Section: Introductionmentioning

confidence: 94%

Reticular and plexiform perineurioma: clinicopathological and immunohistochemical analysis of two cases and review of perineurial neoplasms of skin and soft tissues

Mentzel

Kutzner

2005

Virchows Arch

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Perineurioma represents a recently described and relatively rare neoplasm in the spectrum of benign peripheral nerve sheath tumours composed of perineurial cells staining immunohistochemically positive for epithelial membrane antigen (EMA). In addition to intraneural, extraneural and sclerosing perineurioma, rare variants of perineurioma may occur, and their knowledge is important in the differential diagnosis of mesenchymal tumours of different lines of differentiation and clinically more aggressive neoplasms. We present a case of deep-seated reticular perineurioma arising on the upper arm of a 34-year-old female and a case of a dermal plexiform perineurioma arising on the lower lip of a 60-year-old female. The diagnosis was confirmed in both cases immunohistochemically; neoplastic cells stained positively for EMA and for the newly described perineurial markers, claudin-1 and glut-1. The morphological spectrum and the differential diagnosis of perineurial neoplasms of skin and soft tissues are discussed.

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Section: Introductionmentioning

confidence: 94%

Reticular and plexiform perineurioma: clinicopathological and immunohistochemical analysis of two cases and review of perineurial neoplasms of skin and soft tissues

Mentzel

Kutzner

2005

Virchows Arch

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“…As previously noted, at the immunohistochemical and ultrastructural level, perineurial cells may participate substantially in the formation of peripheral nerve sheath tumors, both neurofibromas [5] and schwannomas [6,7]. On the other hand, perineuriomas are entirely perineurial in cell composition.…”

Section: Discussionmentioning

confidence: 89%

“…These include Schwann cells [2], and fibroblasts [3], both components of endoneurium, and even arachnoid cap cells [4]. Microscopically, obvious perineurial cells with typical immunohistochemical and ultrastructural features may be a conspicuous component of so-called mixed or ''hybrid'' peripheral nerve tumors, including neurofibroma [5] and schwannoma [6,7]. Perineurial cells have also been encountered in a rare example of multiple granular cell tumors [8].…”

Section: Introductionmentioning

confidence: 97%

Intraoral Perineurioma, Soft Tissue Type: Report of Five Cases, Including 3 Intraosseous Examples, and Review of the Literature

Koutlas

Scheithauer

Folpe

2010

Head and Neck Pathol

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Soft tissue type perineuriomas (STP) are uncommon tumors, oral examples being very rare. They have been described in the mandible, gingiva, lips, retrotonsillar mucosa and maxillary vestibule. Herein, we report the clinicopathologic features of five STP, two affecting the buccal mucosa and three the mandible. Three patients were women and two men. All tumors were characterized by a proliferation of cytologically bland, mitotically inactive spindled cells with round, ovoid or spindled nuclei, embedded in a variably collagenous and myxoid matrix. Interestingly, two mandibular tumors featured psammoma bodies and one, in addition, contained irregular calcifications. Tumor cells showed the immunohistochemical profile of perineurial cells including epithelial membrane antigen, Glut-1, claudin-1 and collagen type IV. S100 and neurofilament proteins were not expressed by the tumor cells. A few minute, peripherally situated, entrapped nerves were identified. All tumors were reported gross-totally excised and no recurrences have taken place. The clinical characteristics of STP are summarized and its differential diagnosis relative to other spindle cells tumors and meningioma is discussed.

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“…1,2 Complicating in differential diagnosis is the observation of collision tumors like schwannoma and perineurinoma. 6 …”

Section: Discussionmentioning

confidence: 99%

Isolated plexiform schwannoma of the hand

Wollina¹,

Langner²,

Gruner³

et al. 2008

J Dermatol Case Rep

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Background: The plexiform schwannoma, a peripheral nerve sheath tumor, is a very rare entity. But dermatologists should be familiar with since they may be the first who make diagnosis possible by taking a deep biopsy.Main observation: A 24-year-old male presented with multiple asymptomatic subcutaneous nodules of the palmar side of his right hand. Histologic investigations revealed a plexiform schwannoma with numerous Antoni-A areas. There was no evidence of neurofibromatosis type 1 or 2.Conclusions: Plexiform schwannoma of the hand is a rare nerve sheath tumor. In individual (symptomatic) cases hand surgery is an option that needs a critical indication. In every case histologic investigations are mandatory to confirm the diagnosis and not to overlook the malignant variant of this disease. Imaging diagnostics like 3-dimensional ultrasound and MRI do not allow a sufficient discrimination of schwannomas form other nerve sheath tumors. 4 The only way to confirm the diagnosis is by histopathology. Isolated plexiform schwannoma of the handWe present an unusual case of a large unilateral plexiform schwannoma of the hand in a young male patient. Case ReportA 24-year-old male patient experienced asymptomatic subcutaneous nodules of his right hand since 2000. There was a slow progress in size and number.On examination we found soft, yellowish subcutaneous nodules of variable size of the volar site of the fingers and the palm of his right hand ( Fig. 1A and B).Histology of two biopsies showed spindle-shaped cell proliferations in the dermis and upper subcutaneous tissue with a capsule formation. Cells were characterized by neurogenic differentiation like Antoni-A-areas (Fig. 2).Clinical examination and consiliae did not reveal any sign of neurofibromatosis type 1 or type 2.After confirmation of the diagnosis of a plexiform schwannoma of the right hand the patient was referred to the hand surgeon. He advised not to intervene by surgery because of the risk of paresis and the completely asypto- DOI: 10.3315/jdcr.2008DOI: 10.3315/jdcr. .1011 28 matic course without functional handicap in this patient.Follow-up has been recommended by us. DiscussionSchwannomas are benign tumors of the nerve sheath occuring either peripheral, visceral, intraspinal or intracranial. Peripheral schwannomas represent as asymptomatic and painless papules or nodules. Their colour can be yellowish to light brown. Cysts and haemorrhages may occur. Schwannomas of the hands are rare. Patient's mean age at diagnosis is 38.4 years. 5 Histology is characterized by a biphasic pattern with tightly packed spindle-shaped cells (Antoni A area) and with loose, less cellular patterns with myxoid areas with thickened "hyalinized" vessel walls (Antoni B) and lipidcontaining cells. 3 Mitoses are usually absent but pleomorphism of nuclei is common. Immunohistochemistry is helpful in differential diagnosis ( Table 1). The tumor cells express S-100 protein. 1,2 Complicating in differential diagnosis is the observation of collision tumors like schwannoma and peri...

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A benign neoplasm with histopathological features of both schwannoma and retiform perineurioma (benign schwannoma-perineurioma): a report of six cases of a distinctive soft tissue tumor with a predilection for the fingers

Cited by 70 publications

References 39 publications

Reticular and plexiform perineurioma: clinicopathological and immunohistochemical analysis of two cases and review of perineurial neoplasms of skin and soft tissues

Reticular and plexiform perineurioma: clinicopathological and immunohistochemical analysis of two cases and review of perineurial neoplasms of skin and soft tissues

Intraoral Perineurioma, Soft Tissue Type: Report of Five Cases, Including 3 Intraosseous Examples, and Review of the Literature

Isolated plexiform schwannoma of the hand

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