Plexiform intraneural granular cell tumour of a digital cutaneous sensory nerve

Weinreb, Ilan; Bray, Peter; Ghazarian, Danny

doi:10.1136/jcp.2005.035972

Cited by 16 publications

(19 citation statements)

References 11 publications

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“…Granular cell tumor is a rare, but major category of tumors with presumed peripheral nerve sheath derivation, based on S100 expression and frequent nerve association including plexiform patterns[6, 139], that may be incorporated in upcoming schemes. Although most behave in a benign fashion, a small subset acts in a bona fide malignant fashion, with scant predictive histologic features.…”

Section: Recommended Updates For the Who Classificationmentioning

confidence: 99%

Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems

et al. 2012

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Peripheral nerve sheath tumors are common neoplasms, with classic identifiable features, but on occasion, they are diagnostically challenging. Although well defined subtypes of peripheral nerve sheath tumors were described early in the history of surgical pathology, controversies regarding the classification and grading of these tumors persist. Advances in molecular biology have provided new insights into the nature of the various peripheral nerve sheath tumors, and have begun to suggest novel targeted therapeutic approaches. In this review we discuss current concepts and problematic areas in the pathology of peripheral nerve sheath tumors. Diagnostic criteria and differential diagnosis for the major categories of nerve sheath tumors are proposed, including neurofibroma, schwannoma, and perineurioma. Diagnostically challenging variants, including plexiform, cellular and melanotic schwannomas are highlighted. A subset of these affects the childhood population, and has historically been interpreted as malignant, although current evidence and outcome data suggests they represent benign entities. The growing current literature and the authors experience with difficult to classify borderline or “hybrid tumors” are discussed and illustrated. Some of these classification gray zones occur with frequency in the gastrointestinal tract, an anatomical compartment that must always be entertained when examining these neoplasms. Other growing recent areas of interest include the heterogeneous group of pseudoneoplastic lesions involving peripheral nerve composed of mature adipose tissue and/or skeletal muscle, such as the enigmatic neuromuscular choristoma. Malignant peripheral nerve sheath tumors (MPNST) represent a diagnostically controversial group; difficulties in grading and guidelines to separate “atypical neurofibroma” from MPNST are provided. There is an increasing literature of MPNST mimics which neuropathologists must be aware of, including synovial sarcoma and ossifying fibromyxoid tumor. Finally, we discuss entities that are lacking from the section on cranial and paraspinal nerves in the current WHO classification, and that may warrant inclusion in future classifications. In summary, although the diagnosis and classification of most conventional peripheral nerve sheath tumors are relatively straightforward for the experienced observer, borderline and difficult to classify neoplasms continue to be problematic. In the current review, we attempt to provide some useful guidelines for the surgical neuropathologist to help navigate these persistent, challenging problems.

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Section: Recommended Updates For the Who Classificationmentioning

confidence: 99%

Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems

et al. 2012

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“…2 Weinreib et al biopsied one of a patient's numerous small digital nodules; it was consistent with a granular cell tumor arising from a cutaneous sensory nerve. 9 The differential diagnosis for these extremely rare nerve tumors includes the more common neurofibroma and schwannoma, which cannot be differentiated on clinical grounds or by imaging. The true recurrence rate following resection is unknown.…”

Section: Discussionmentioning

confidence: 99%

Granular Cell Nerve Tumor in the Hand: Case Report

Slutsky¹

2009

The Journal of Hand Surgery

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“…Granular cell tumors are typically diffuse in nature and are most common beneath squamous‐lined epithelia. A handful of granular cell tumors have been entirely intraneural and an example of a plexiform intraneural granular cell tumor has been reported 9–13 …”

Section: Discussionmentioning

confidence: 99%

“…There is a growing list of NST with at least partial intraneural location, including classic neurofibromas, plexiform neurofibromas, granular cell tumors and the newly described, dendritic cell neurofibroma with pseudorosettes 7–13 …”

Section: Introductionmentioning

confidence: 99%

Cutaneous melanocytoneuroma: the first case of a distinctive intraneural tumor with dual nerve sheath and melanocytic differentiation

Weinreb

Labonté

Goli³

et al. 2007

J Cutan Pathol

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Many melanocytic nevi contain areas similar to nerve sheath tumors (NST) and NSTs with melanin have been described. There are some NSTs with at least partial intraneural location, including neurofibromas, plexiform neurofibromas, granular cell tumors and the recently described, dendritic cell neurofibroma with pseudorosettes. We describe the case of an NST with melanocytic differentiation and intraneural location, for which we suggest the term 'melanocytoneuroma' (MCN). It arose in the skin of a 67-year-old woman with no previous history of melanoma or neurofibromatosis. The lesion presented as a papule and histologically consisted of a dermal nodule without junctional melanocytic activity. The lesion comprised an intraneural proliferation of large epithelioid eosinophilic cells with prominent cell borders imparting a 'plant-like' appearance. The cells were also seen within adjacent nerve twigs and were positive for S100, Melan-A, HMB-45, microphthalmia transcription factor and PGP 9.5. The lesion was entirely surrounded by an epithelial membrane antigen-positive-perineurial coat and the individual tumor cells were invested by laminin and collagen type-IV-positive basal lamina-like material. The lesion did not show any evidence of atypia and following complete excision, no recurrence has been documented. In conclusion, this unusual lesion represents an intraneural proliferation with melanocytic and nerve sheath cell differentiation, to which we have accorded the appellation, MCN.

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Plexiform intraneural granular cell tumour of a digital cutaneous sensory nerve

Cited by 16 publications

References 11 publications

Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems

Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems

Granular Cell Nerve Tumor in the Hand: Case Report

Cutaneous melanocytoneuroma: the first case of a distinctive intraneural tumor with dual nerve sheath and melanocytic differentiation

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