Histomorphological Spectrum of Peripheral Nerve Sheath Tumors From a Secondary Care Hospital

Abstract

Background The peripheral nervous system tumours exhibit a diverse range of morphological characteristics and biological behaviour, ranging from benign to locally aggressive such as plexiform neurobroma to highly malignant (MPNST) Aims and Objectives This study aims to examine the morphological variations of PNST and investigate the accompanying degenerative changes. The study also aims to determine the relative incidence of benign, locally aggressive, and malignant tumours, including their location, age of presentation, and gender distribution. Materials and Methods This study was conducted at the Department of Pathology, ESIC Hospital, from January 2020 to December 2022. It includes 29 cases presented and diagnosed at our institute on both clinical and pathological basis. The slides stained with hematoxylin and eosin were evaluated, and the lesions were categorized and classied following the World Health Organization's 2020 classication of soft tissue and bone tumours. The tumours were also assessed for secondary degenerative changes. Results Out of 29 cases, 28 were benign, and only one case (%) was malignant in nature. The commonest age group was 14-62 years, Male and female ratio being 1.64:1. Our study comprised 29 cases of PNST. The age range with the highest frequency of occurrence was found to be 21 to 30 years, with the head and neck region being the most commonly affected site. The peripheral nerve sheath tumours (PNSTs) analyzed in the study included neurobroma (62.07%), schwannoma (31.03%), and malignant PNST (6.90%). Approximately 10% of neurobromas met the criteria for neurobromatosis type 1 (NF1). Malignant tumours were larger in dimension than benign ones. Myxoid, cystic, and hyaline changes were commonly associated with benign tumours, while necrosis, haemorrhage, and mitotic activity were seen with malignant tumours. Conclusion This study emphasizes the different pathological forms of PNST and the morphological modications and association with NF1. Familiarity with the various forms of PNST is crucial for precise diagnosis due to their varying biological characteristics