Difference between revisions of "Perineurioma"

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#redirect [[Peripheral_nerve_sheath_tumours#Perineurioma]]
'''Perineurioma''' is an uncommon benign [[peripheral nerve sheath tumour]].
 
==General==
*Benign tumour derived from perineurial cells (intraneural or soft tissue).
**ICD-O 9571/0
** WHO grade I
*Rarely malignant soft tissue perineurioma.
 
Variant:
*Reticular perineurioma.<ref name=pmid11257623>{{Cite journal  | last1 = Graadt van Roggen | first1 = JF. | last2 = McMenamin | first2 = ME. | last3 = Belchis | first3 = DA. | last4 = Nielsen | first4 = GP. | last5 = Rosenberg | first5 = AE. | last6 = Fletcher | first6 = CD. | title = Reticular perineurioma: a distinctive variant of soft tissue perineurioma. | journal = Am J Surg Pathol | volume = 25 | issue = 4 | pages = 485-93 | month = Apr | year = 2001 | doi =  | PMID = 11257623 }}</ref>
 
==Macroscopy==
*Intraneural perineurioma: segmental tubular enlargement of the nerve.
*Soft tissue perineurioma: Well circumscribed, but not encapsulated.
 
==Microscopic==
Features:<ref name=Ref_Sternberg5_424>{{Ref Sternberg5|424}}</ref>
*Perineural epithelioid cells.
**Abundant pale, fluffy appearing cytoplasm.
 
Note:
*May be intraneural.<ref name=Ref_Sternberg5_424>{{Ref Sternberg5|424}}</ref>
**Typical pseudo-onion bulbs.
**Long considered hypertrophic neuropathy.
**Rare (less than 1% of all nerve sheath tumours).
 
DDx:
*[[Neuroma]].
*[[Neurofibroma]].
*[[Schwannoma]].
**S100 +ve, EMA -ve.<ref name=Ref_Sternberg5_424>{{Ref Sternberg5|424}}</ref>
*[[Liposarcoma]] - reticular perineurioma.
 
Images:
*[http://www.conganat.org/seap/reuniones/almagro2000/scruz/tnerviog5.htm Perineurioma (conganat.org)].
 
<gallery>
File:Perineurioma,_HE_stain.jpg | Pseudo-onion bulbs in a intraneural perioneurioma (WC/jensflorian)
</gallery>
 
==IHC==
Features:<ref name=pmid15958848>{{Cite journal  | last1 = Hornick | first1 = JL. | last2 = Fletcher | first2 = CD. | title = Soft tissue perineurioma: clinicopathologic analysis of 81 cases including those with atypical histologic features. | journal = Am J Surg Pathol | volume = 29 | issue = 7 | pages = 845-58 | month = Jul | year = 2005 | doi =  | PMID = 15958848 }}</ref><ref name=pmid1497116>{{Cite journal  | last1 = Tsang | first1 = WY. | last2 = Chan | first2 = JK. | last3 = Chow | first3 = LT. | last4 = Tse | first4 = CC. | title = Perineurioma: an uncommon soft tissue neoplasm distinct from localized hypertrophic neuropathy and neurofibroma. | journal = Am J Surg Pathol | volume = 16 | issue = 8 | pages = 756-63 | month = Aug | year = 1992 | doi =  | PMID = 1497116 }}</ref>
*S100 -ve.
*EMA +ve.
*CD34 ~65% +ve.<ref name=pmid15958848/>
 
==See also==
*[[Peripheral nerve sheath tumours]].
 
==References==
{{Reflist|1}}
 


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Neuropathology tumours]]
[[Category:Neuropathology tumours]]
[[Category:Peripheral nerve sheath tumours]]
[[Category:Peripheral nerve sheath tumours]]

Revision as of 14:17, 29 August 2018

Perineurioma is an uncommon benign peripheral nerve sheath tumour.

General

  • Benign tumour derived from perineurial cells (intraneural or soft tissue).
    • ICD-O 9571/0
    • WHO grade I
  • Rarely malignant soft tissue perineurioma.

Variant:

  • Reticular perineurioma.[1]

Macroscopy

  • Intraneural perineurioma: segmental tubular enlargement of the nerve.
  • Soft tissue perineurioma: Well circumscribed, but not encapsulated.

Microscopic

Features:[2]

  • Perineural epithelioid cells.
    • Abundant pale, fluffy appearing cytoplasm.

Note:

  • May be intraneural.[2]
    • Typical pseudo-onion bulbs.
    • Long considered hypertrophic neuropathy.
    • Rare (less than 1% of all nerve sheath tumours).

DDx:

Images:

IHC

Features:[3][4]

  • S100 -ve.
  • EMA +ve.
  • CD34 ~65% +ve.[3]

See also

References

  1. Graadt van Roggen, JF.; McMenamin, ME.; Belchis, DA.; Nielsen, GP.; Rosenberg, AE.; Fletcher, CD. (Apr 2001). "Reticular perineurioma: a distinctive variant of soft tissue perineurioma.". Am J Surg Pathol 25 (4): 485-93. PMID 11257623.
  2. 2.0 2.1 2.2 Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H (2009). Sternberg's Diagnostic Surgical Pathology (5th ed.). Lippincott Williams & Wilkins. pp. 424. ISBN 978-0781779425.
  3. 3.0 3.1 Hornick, JL.; Fletcher, CD. (Jul 2005). "Soft tissue perineurioma: clinicopathologic analysis of 81 cases including those with atypical histologic features.". Am J Surg Pathol 29 (7): 845-58. PMID 15958848.
  4. Tsang, WY.; Chan, JK.; Chow, LT.; Tse, CC. (Aug 1992). "Perineurioma: an uncommon soft tissue neoplasm distinct from localized hypertrophic neuropathy and neurofibroma.". Am J Surg Pathol 16 (8): 756-63. PMID 1497116.