Case 82

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Clinical history

49 year old woman. Sudden hearing loss of the left side.

Primary image

Neuropathology case I-Gomorri 03.jpg
Cerebellopontine angle. Low magnification. H&E stain.
Intermediate magnification 
Neuropathology case I-Gomorri 02.jpg
Intermediate magnification. H&E stain.
High magnification 
Neuropathology case I-Gomorri 04.jpg
High magnification. H&E stain.

Differential diagnosis

Differential diagnosis 
meningioma, malignant peripheral nerve sheath tumor

Additional tests

More history

More history 
There is dizziness/loss of balance.

Ask a friend

Ask a friend 
It looks like a benign nerve sheath tumor.

Stains

Alcian blue/PAS to Bilirubin
Test Result
Alcian blue/PASI'm sorry but this is of no help.
Alican blue pH 1.0I'm sorry but this is of no help.
Alcian blue pH 2.5I'm sorry but this is of no help.
AuramineI'm sorry but this is of no help.
BielchowskyI'm sorry but this is of no help.
BilirubinI'm sorry but this is of no help.
Colloidal iron to Fontana-Masson
Test Result
Colloidal ironI'm sorry but this is of no help.
Congo redI'm sorry but this is of no help.
Cresyl violetI'm sorry but this is of no help.
DieterleI'm sorry but this is of no help.
Diff QuikI'm sorry but this is of no help.
Fontana-MassonI'm sorry but this is of no help.
Gallyas to Gremelius
Test Result
GallyasI'm sorry but this is of no help.
GiemsaI'm sorry but this is of no help.
GMSI'm sorry but this is of no help.
Gomori's trichromeI'm sorry but this is of no help.
GramI'm sorry but this is of no help.
GremeliusI'm sorry but this is of no help.
JMS to Mucicarmine
Test Result
JMSI'm sorry but this is of no help.
JonesI'm sorry but this is of no help.
KinyounI'm sorry but this is of no help.
Luxol fast blueI'm sorry but this is of no help.
Masson trichromeI'm sorry but this is of no help.
M-MASI'm sorry but this is of no help.
MovatI'm sorry but this is of no help.
MucicarmineI'm sorry but this is of no help.
Oil red O to Prussian blue
Test Result
Oil red OI'm sorry but this is of no help.
OreceinI'm sorry but this is of no help.
PASI'm sorry but this is of no help.
PASDI'm sorry but this is of no help.
PASFI'm sorry but this is of no help.
PTAHI'm sorry but this is of no help.
Prussian blueI'm sorry but this is of no help.
Reticulin to Ziehl-Neelsen
Test Result
Reticulin
Neuropathology case I-Gomorri 01.jpg
Sudan black BI'm sorry but this is of no help.
Toluidine blueI'm sorry but this is of no help.
VerhoeffI'm sorry but this is of no help.
Von KossaI'm sorry but this is of no help.
Warthin-StarryI'm sorry but this is of no help.
Ziehl-NeeslenI'm sorry but this is of no help.

IHC

Alpha-1 AT to Cathepsin K
Test Result
alpha-1 AT I'm sorry but this is of no help.
ACTH I'm sorry but this is of no help.
AE1/AE1NEGATIVE
alpha-fetoprotein I'm sorry but this is of no help.
Alk-I I'm sorry but this is of no help.
AMACRI'm sorry but this is of no help.
ARI'm sorry but this is of no help.
ATRXI'm sorry but this is of no help.
Beta2-microglobulin I'm sorry but this is of no help.
B72.3 I'm sorry but this is of no help.
Beta-cateninI'm sorry but this is of no help.
BCL2 I'm sorry but this is of no help.
BCL6 I'm sorry but this is of no help.
BCLxL I'm sorry but this is of no help.
C3 comp I'm sorry but this is of no help.
CA9I'm sorry but this is of no help.
Calcitonin I'm sorry but this is of no help.
Calponin I'm sorry but this is of no help.
Calretinin NEGATIVE
CAM5.2I'm sorry but this is of no help.
Cathepsin KI'm sorry but this is of no help.
CD10 to Chromogranin
Test Result
CD10 I'm sorry but this is of no help.
CD117 I'm sorry but this is of no help.
CD138I'm sorry but this is of no help.
CD15 I'm sorry but this is of no help.
CD1a I'm sorry but this is of no help.
CD20 I'm sorry but this is of no help.
CD21 I'm sorry but this is of no help.
CD23 I'm sorry but this is of no help.
CD3 I'm sorry but this is of no help.
CD30 I'm sorry but this is of no help.
CD31 I'm sorry but this is of no help.
CD34 NEGATIVE
CD35 I'm sorry but this is of no help.
CD4 I'm sorry but this is of no help.
CD43 I'm sorry but this is of no help.
CD45 (LCA)very few cells positive
CD5 I'm sorry but this is of no help.
CD56 I'm sorry but this is of no help.
CD57I'm sorry but this is of no help.
CD68 I'm sorry but this is of no help.
CD7 I'm sorry but this is of no help.
CD79a I'm sorry but this is of no help.
CD8 I'm sorry but this is of no help.
CD99 I'm sorry but this is of no help.
CDX2I'm sorry but this is of no help.
CEA-m I'm sorry but this is of no help.
Chromogranin I'm sorry but this is of no help.
CK17 to Glypican 3
Test Result
CK17I'm sorry but this is of no help.
CK19I'm sorry but this is of no help.
CK20 I'm sorry but this is of no help.
CK34betaE12 I'm sorry but this is of no help.
CK5/6I'm sorry but this is of no help.
CK7 I'm sorry but this is of no help.
CMV I'm sorry but this is of no help.
c-MYC I'm sorry but this is of no help.
Cyclin D1 I'm sorry but this is of no help.
D2-40I'm sorry but this is of no help.
Desmin I'm sorry but this is of no help.
DOG1I'm sorry but this is of no help.
EBV I'm sorry but this is of no help.
EMANEGATIVE
ER and PR I'm sorry but this is of no help.
Factor VIII I'm sorry but this is of no help.
Factor XIIIa I'm sorry but this is of no help.
Fascin I'm sorry but this is of no help.
FHI'm sorry but this is of no help.
FSH I'm sorry but this is of no help.
Gastrin I'm sorry but this is of no help.
GATA3I'm sorry but this is of no help.
GCDFP-15 (BRST2)I'm sorry but this is of no help.
GFAPI'm sorry but this is of no help.
GH I'm sorry but this is of no help.
Glucagon I'm sorry but this is of no help.
Glypican-3I'm sorry but this is of no help.
HBME-1 to IgM
Test Result
HBME-1 I'm sorry but this is of no help.
HBV core I'm sorry but this is of no help.
HBV surface I'm sorry but this is of no help.
H-caldesmonI'm sorry but this is of no help.
HCG I'm sorry but this is of no help.
HelicobacterI'm sorry but this is of no help.
Hepatocyte I'm sorry but this is of no help.
HER2/neu I'm sorry but this is of no help.
HHV-8I'm sorry but this is of no help.
HMB-45I'm sorry but this is of no help.
HNF1betaI'm sorry but this is of no help.
HPV I'm sorry but this is of no help.
HSV-I I'm sorry but this is of no help.
HSV-II I'm sorry but this is of no help.
IDH-1I'm sorry but this is of no help.
Inhibin I'm sorry but this is of no help.
INI1 (BAF47)I'm sorry but this is of no help.
Insulin I'm sorry but this is of no help.
Kappa I'm sorry but this is of no help.
Ki-67
Neuropathology case I-Gomorri 06.jpg
Lambda I'm sorry but this is of no help.
Leu 7 I'm sorry but this is of no help.
IgA I'm sorry but this is of no help.
IgG I'm sorry but this is of no help.
IgM I'm sorry but this is of no help.
LH to PDGFR
Test Result
LH I'm sorry but this is of no help.
LIN28 I'm sorry but this is of no help.
Lysozyme I'm sorry but this is of no help.
mammoglobinI'm sorry but this is of no help.
MAP2I'm sorry but this is of no help.
MCVI'm sorry but this is of no help.
Melanin A I'm sorry but this is of no help.
MHC class I I'm sorry but this is of no help.
MITFI'm sorry but this is of no help.
MUM1I'm sorry but this is of no help.
Myeloperoxidase I'm sorry but this is of no help.
MYO D1 I'm sorry but this is of no help.
MyoglobinI'm sorry but this is of no help.
NapsinI'm sorry but this is of no help.
NF
Neuropathology case I-Gomorri 05.jpg
NKX3.1I'm sorry but this is of no help.
NSE I'm sorry but this is of no help.
OCT3/4I'm sorry but this is of no help.
p16I'm sorry but this is of no help.
P501SI'm sorry but this is of no help.
p53 I'm sorry but this is of no help.
p57I'm sorry but this is of no help.
p63 I'm sorry but this is of no help.
PankeratinI'm sorry but this is of no help.
PAX2I'm sorry but this is of no help.
PAX5I'm sorry but this is of no help.
PAX8I'm sorry but this is of no help.
PCNA I'm sorry but this is of no help.
PDGFRI'm sorry but this is of no help.
PLAP to WT1
Test Result
PLAP I'm sorry but this is of no help.
PNL-2C I'm sorry but this is of no help.
Prolactin I'm sorry but this is of no help.
PSA I'm sorry but this is of no help.
PSAPI'm sorry but this is of no help.
RCCI'm sorry but this is of no help.
S-100
Neuropathology case I-Gomorri 07.jpg
SALL4I'm sorry but this is of no help.
Smooth muscle actin I'm sorry but this is of no help.
Somatostatin I'm sorry but this is of no help.
STAT6 I'm sorry but this is of no help.
Synaptophysin I'm sorry but this is of no help.
TdT I'm sorry but this is of no help.
TFE3I'm sorry but this is of no help.
TFEBI'm sorry but this is of no help.
Thyroglobulin I'm sorry but this is of no help.
Toxoplasma I'm sorry but this is of no help.
TSH I'm sorry but this is of no help.
TTF-1 I'm sorry but this is of no help.
Ubiquitin I'm sorry but this is of no help.
UCHL1 (PGP9.5)I'm sorry but this is of no help.
Ulex Europaeus I'm sorry but this is of no help.
VimentinI'm sorry but this is of no help.
VIP I'm sorry but this is of no help.
VZV I'm sorry but this is of no help.
WT-1I'm sorry but this is of no help.


Diagnosis

Diagnosis 
Schwannoma, WHO grade I.


Comment:
This is the most frequent tumor of the cerebellopontine angle. Positive S-100 Immunostain and reticulin around individual tumor cells confirm the diagnosis and rule out a potential meningioma.


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