Electron microscopy in the diagnosis of malignant schwannomas a report of six cases

Chitale, Arun R.; Dickersin, G. Richard

doi:10.1002/1097-0142(19830415)51:8<1448::aid-cncr2820510819>3.0.co;2-p

Cited by 60 publications

(22 citation statements)

References 30 publications

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“…However, this interpretation is contradicted by both the positive staining for smooth muscle markers and the lack of evidence of Schwann cell differentiation on electron microscopy. 5,12 In addition, we have not demonstrated origin from a nerve or a history of neurofibromatosis in any of these patients. Perhaps as important, the majority of MPNSTs arising elsewhere in the body are high-grade neoplasms with variable cellularity, significant nuclear pleomorphism, and a high mitotic index.…”

Section: Discussionmentioning

confidence: 54%

Low-grade Sinonasal Sarcoma With Neural and Myogenic Features

Lewis¹,

Oliveira²,

Nascimento

et al. 2012

American Journal of Surgical Pathology

139

196

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Sarcomas of the sinonasal region are rare. We describe a distinct spindle cell sarcoma of the sinonasal region characterized by concomitant neural and myogenic differentiation. Consultation files and surgical cases from Mayo Clinic were reviewed. Twenty-eight cases were identified that met the inclusion criteria. Clinical data were collected from medical records, consultation letters, and referring pathologists. Reverse transcriptase-polymerase chain reaction for synovial sarcoma fusion transcripts was performed on 18 cases. Cytogenetic studies were performed on 2 cases. The 21 female and 7 male patients ranged in age from 24 to 85 years (mean, 52 y). All cases showed a characteristic histology, which included a cellular spindle cell neoplasm with uniform, elongate nuclei and an infiltrative growth pattern. All tumors demonstrated expression of S-100 with actin positivity in 96% of cases tested. Reverse transcriptase-polymerase chain reaction for synovial sarcoma fusion transcripts was negative in all cases tested. Cytogenetic studies conducted on 2 cases demonstrated the chromosomal translocation t(2;4). The nasal cavity (54%) and ethmoid sinus (57%) were the most commonly involved areas, singly or in combination. Follow-up information was available for 57% (16/28) of cases, with a mean of 8.3 years. Of these, 44% (7/16) experienced at least 1 recurrence. No patient has developed metastases or died of disease. We describe a unique tumor with a characteristic morphologic, immunophenotypic, and cytogenetic profile. On the basis of the locally aggressive nature of this lesion we believe it is best considered a low-grade sarcoma and suggest the term low-grade sinonasal sarcoma with neural and myogenic features.

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Section: Discussionmentioning

confidence: 54%

Low-grade Sinonasal Sarcoma With Neural and Myogenic Features

Lewis¹,

Oliveira²,

Nascimento

et al. 2012

American Journal of Surgical Pathology

139

196

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“…Diagnostic features include branching cytoplasmic processes (which may contain microtubules and microfilaments), interdigitating cell membranes, and a basal lamina. [38][39][40][41][42] Unfortunately, in our experience, many tumors are poorly differentiated, thus precluding definitive diagnosis. Similar factors affect the expression of S-100 protein, a cytoplasmic marker useful in the identification of Schwann cells.…”

Section: Diagnosis and Nomenclaturcmentioning

confidence: 99%

Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases

Ducatman

Scheithauer

Piepgras

et al. 1986

Cancer

1,400

1,093

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A review was done of 120 cases of malignant peripheral nerve sheath tumor (MPNST) seen during a 71-year period. Of the 120 patients, 52 were males and 68 were females with a mean age at diagnosis of 35.3 years; 12 patients were younger than 20 years. The series included 62 (52%) patients with neurofibromatosis, 13 (11%) with postradiation sarcomas, and 19 (16%) with metaplastic foci. The incidence of MPNST arising in neurofibromatosis was 4.6% in the current series and 0.001% in the general clinic population. Tumors greater than 5 cm and the presence of neurofibromatosis adversely affected the prognosis (P less than 0.05). When both features were present, survival was greatly decreased. Patients with tumor in the extremities did better than those with head or neck lesions. Metaplastic foci or previous radiation at the tumor site did not alter the prognosis. Each tumor was graded 1 to 4 on the basis of cellularity, pleomorphism, mitotic index, and necrosis. No significant correlation was noted between survival and either grade or mitotic rate. Survival was improved when total rather than subtotal resection was done. This was most marked in patients with a small lesion, which may reflect the difficulty in adequately excising large tumors. Adjuvant radiation or chemotherapy did not appear to affect survival. The MPNST is an aggressive uncommon neoplasm, and large tumor size, the presence of neurofibromatosis, and total resection are the most important prognostic indicators.

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“…16 On light microscopy the arrangement of argyrophilic cells in an Antoni A and B pattern, the foci of palisading and Verocay body formation, and the microcystic spaces all pointed to Schwannian differentiation. S100 protein is a marker for normal and neoplastic Schwann cells and melanocytes, although not entirely specific: it is also present in skin, interdigitating reticulum cells, chondrocytes and adipocytes, but may be absent from malignant nerve sheath tumours.…”

Section: Discussionmentioning

confidence: 99%

“…Over 20 cases at various sites have been documented so far. 16 The behaviour of these tumours is extremely difficult to predict on histological grounds. The "paraxial" variant is the most common and arises in the roots of spinal nerves.…”

mentioning

confidence: 99%