neurilemoma (synonym: schwannoma) ICD-10: D36.1; ICD-O: 9560/0
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Frau, 43 J., schmerzhafter Knoten subkutan. Operationspräparat
- Keine Organdiagnose möglich
- Knoten
- Dicht gepackte, parallel und längs orientierte oder in Wirbeln
gelagerte Schwann'sche Zellen mit "zigarrenförmigen"
Kernen (Zigarrenkern)
- Oft palisadenförmige oder fischzugähnliche,
parallele Anordnung der Kerne (Kernpalisade)
- Zwischen den Kernreihen parallel angeordnete feine Fasern
- Vermehrung von Bindegewebszellen des Peri- und Epineurium
Generelles Vorkommen:
Hirnnerven (z.B. Akustikusneurinom), Nervenwurzeln des Rückenmarks,
periphere Nerven (multipel bei Neurofibromatose) und vegetatives Nervensystem
43-year-old female had a painful subcutaneous tumor (surgical resection specimen).
- Circumscribed tumor consisting of spindle cells with fusiform nuclei (Zigarrenkern).
- In some areas closely packed cells growing in a fasciculated or whorled pattern (Antoni A pattern). Some nuclei form orderly palisades (Kernpalisade, Verocay bodies).
- In other areas loosely packed, haphazardly arranged elongated cells in a myxoid stroma (Antoni B pattern).
- Between tumor cells fine fibers arranged in parallel are observed.
- Some vessels show a hyalinized wall and the stroma is focally hyalinized (so called ancient change)
Occurrence:
- Peripheral nerves
- Spinal nerve roots
- Cranial nerves: e.g. vestibular schwannoma.
- Autonomic nervous system.
Bilateral vestibular schwannomas are commonly found in patients with neurofibromatosis Type 2. In addition, these patients develop schwannomas of other cranial and
peripheral nerves and have a predisposition to develop meningeomas and gliomas.
Immunohistochemistry:
Tumors are diffusely positive for S-100.