Difference between revisions of "Peripheral nerve sheath tumours"
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===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=pmid17893219>{{cite journal |author=Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A |title=Neuropathology for the neuroradiologist: Antoni A and Antoni B tissue patterns |journal=AJNR Am J Neuroradiol |volume=28 |issue=9 |pages=1633–8 |year=2007 |month=October |pmid=17893219 |doi=10.3174/ajnr.A0682 |url=http://www.ajnr.org/cgi/reprint/28/9/1633}}</ref> | Features:<ref name=pmid17893219>{{cite journal |author=Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A |title=Neuropathology for the neuroradiologist: Antoni A and Antoni B tissue patterns |journal=AJNR Am J Neuroradiol |volume=28 |issue=9 |pages=1633–8 |year=2007 |month=October |pmid=17893219 |doi=10.3174/ajnr.A0682 |url=http://www.ajnr.org/cgi/reprint/28/9/1633}}</ref> | ||
*Antoni | *Antoni A: | ||
**Cellular. | |||
**'Fibrillary, polar, elongated'. | |||
*Antoni B: | |||
**Pauci-cellular. | |||
**Loose microcystic tissue. | |||
*Verocay bodies - paucinuclear area surrounded by nuclei. | *Verocay bodies - paucinuclear area surrounded by nuclei. | ||
*In the GI tract: classically have a ''peripheral lymphoid cuff''.<ref name=pmid15728600>{{cite journal |author=Levy AD, Quiles AM, Miettinen M, Sobin LH |title=Gastrointestinal schwannomas: CT features with clinicopathologic correlation |journal=AJR Am J Roentgenol |volume=184 |issue=3 |pages=797–802 |year=2005 |month=March |pmid=15728600 |doi= |url=http://www.ajronline.org/cgi/content/full/184/3/797}}</ref> | *In the GI tract: classically have a ''peripheral lymphoid cuff''.<ref name=pmid15728600>{{cite journal |author=Levy AD, Quiles AM, Miettinen M, Sobin LH |title=Gastrointestinal schwannomas: CT features with clinicopathologic correlation |journal=AJR Am J Roentgenol |volume=184 |issue=3 |pages=797–802 |year=2005 |month=March |pmid=15728600 |doi= |url=http://www.ajronline.org/cgi/content/full/184/3/797}}</ref> | ||
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Notes: | Notes: | ||
*Tumour does ''not'' smear well.<ref>MUN. 24 November 2010.</ref> | *Tumour does ''not'' smear well.<ref>MUN. 24 November 2010.</ref> | ||
*Antoni A: may look somewhat like scattered matchsticks. | |||
Micrographs: | Micrographs: | ||
*[http://www.pathguy.com/~lulo/lulo0003.htm Antoni A (pathguy.com)]. | *[http://www.pathguy.com/~lulo/lulo0003.htm Antoni A (pathguy.com)]. | ||
*[http://www.ajnr.org/cgi/content/full/28/9/1633/F8 Antoni A & Antoni B side-by-side (ajnr.org)]. | *[http://www.ajnr.org/cgi/content/full/28/9/1633/F8 Antoni A & Antoni B side-by-side (ajnr.org)]. | ||
====Subtypes==== | |||
There are four:<ref name=pmid12792904>{{cite journal |author=Kurtkaya-Yapicier O, Scheithauer B, Woodruff JM |title=The pathobiologic spectrum of Schwannomas |journal=Histol. Histopathol. |volume=18 |issue=3 |pages=925–34 |year=2003 |month=July |pmid=12792904 |doi= |url=}}</ref> | |||
#Conventional. | |||
#*Most common. | |||
#Cellular. | |||
#*May mimic [[MPNST]]. | |||
#Plexiform. | |||
#*May mimic [[MPNST]] if cellular - esp. in childhood. | |||
#Melanotic. | |||
#*May be confused with [[melanoma]]. | |||
#*Psammomatous form associated with a heritable disorder (Carney complex). | |||
Notes: | |||
*Carney complex:<ref name=pmid12792904/> | |||
**Cutaneous lentigines. | |||
**Myxomas (skin (subcutaneous), subcutanous, [[Cardiac tumours#Atrial myxoma|heart]]). | |||
**Endocrine neoplasms. | |||
==Traumatic neuroma== | ==Traumatic neuroma== | ||
Revision as of 02:19, 7 January 2011
Peripheral nerve sheath tumours, abbreviated PNSTs, are common in neuropathology and occasionally show-up elsewhere. A very common PNST is the schwannoma.
Classification
A classification:[1]
- Benign:
- Schwannoma.
- Neurofibroma.
- Perineurioma.
- Traumatic neuroma.
- Malignant:
- Malignant peripheral nerve sheath tumour (MPNST).
Schwannoma
General
- A common neuropathology tumour that occasionally shows-up elsewhere.
- Tumour of tissue surrounding a nerve.
- Axons adjacent to the tumour are normal... but may be compressed.
- May be a part of neurofibromatosis type 2.
Microscopic
Features:[1]
- Antoni A:
- Cellular.
- 'Fibrillary, polar, elongated'.
- Antoni B:
- Pauci-cellular.
- Loose microcystic tissue.
- Verocay bodies - paucinuclear area surrounded by nuclei.
- In the GI tract: classically have a peripheral lymphoid cuff.[2]
Notes:
- Tumour does not smear well.[3]
- Antoni A: may look somewhat like scattered matchsticks.
Micrographs:
Subtypes
There are four:[4]
- Conventional.
- Most common.
- Cellular.
- May mimic MPNST.
- Plexiform.
- May mimic MPNST if cellular - esp. in childhood.
- Melanotic.
- May be confused with melanoma.
- Psammomatous form associated with a heritable disorder (Carney complex).
Notes:
- Carney complex:[4]
- Cutaneous lentigines.
- Myxomas (skin (subcutaneous), subcutanous, heart).
- Endocrine neoplasms.
Traumatic neuroma
General
- Consequence of trauma -- diagnosis requires history of trauma.
Microscopic
Features:
- Nerve with adjacent small organized micro-fascicles in collagen - as seen in regeneration.
Neurofibroma
General
- May be a part of neurofibromatosis 1.
- Composed of Schwann cells, axons, fibrous material.[1]
Microscopic
Features:[1]
- Plexiform growth pattern - "bag of worms".
Image:
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Malignant peripheral nerve sheath tumours
General
- Malignant - as the name implies.
Microscopic
Features:
- Mitoses.
Image(s):
See also
References
- ↑ 1.0 1.1 1.2 1.3 Wippold FJ, Lubner M, Perrin RJ, Lämmle M, Perry A (October 2007). "Neuropathology for the neuroradiologist: Antoni A and Antoni B tissue patterns". AJNR Am J Neuroradiol 28 (9): 1633–8. doi:10.3174/ajnr.A0682. PMID 17893219. http://www.ajnr.org/cgi/reprint/28/9/1633.
- ↑ Levy AD, Quiles AM, Miettinen M, Sobin LH (March 2005). "Gastrointestinal schwannomas: CT features with clinicopathologic correlation". AJR Am J Roentgenol 184 (3): 797–802. PMID 15728600. http://www.ajronline.org/cgi/content/full/184/3/797.
- ↑ MUN. 24 November 2010.
- ↑ 4.0 4.1 Kurtkaya-Yapicier O, Scheithauer B, Woodruff JM (July 2003). "The pathobiologic spectrum of Schwannomas". Histol. Histopathol. 18 (3): 925–34. PMID 12792904.
- ↑ URL: http://www.sarctrials.org/SARC006MPNST. Accessed on: 5 December 2010.