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Bezerra HKF, Nakamura GP, Mariz BALA, Lopes RN, Prado JD, Roza ALOC, Vargas PA. Atypical cellular neurothekeoma of the oral mucosa: A rare case report and literature review. J Cutan Pathol 2024. [PMID: 39021336 DOI: 10.1111/cup.14693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/26/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024]
Abstract
Cellular neurothekeoma (CN) is a benign dermal neoplasm that most often affects the head and neck region and rarely occurs in the oral mucosa. We report a rare case of CN with atypical features on the floor of the mouth and summarize the reported cases of oral CN in English-language literature. A 62-year-old woman presented with a 6-month history of a painless mass on the floor of the mouth. Histopathological analysis of the excised specimen revealed a proliferation of neoplastic cells with oval to spindle morphology arranged in a vaguely nested and multinodular architecture separated by scarce hyaline collagen within a predominantly myxoid-rich stroma. The tumor cells were positive for NSE, and CD63 (NKI/C3), and negative for S100 protein, CD34, and SMA. Thus, the final diagnosis was CN. In addition, we summarized all clinicopathological data on oral CNs reported in the English-language literature. Nineteen cases were reviewed. Among them, only one case affected the floor of the mouth of a young girl, in contrast to the present case that occurred in an elderly woman. CN is particularly rare in this location and may be a diagnostic challenge for oral pathologists due to its rarity and morphological similarity with other lesions.
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Affiliation(s)
| | | | | | | | - José Divaldo Prado
- A. C. Camargo Cancer Center, Department of Stomatology, São Paulo, Brazil
| | | | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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2
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Aru MG, Davis JL, Stacy GS, Mills MK, Yablon CM, Hanrahan CJ, McCallum R, Nomura EC, Hansford BG. Beyond schwannomas and neurofibromas: a radiological and histopathological review of lesser-known benign lesions that arise in association with peripheral nerves. Skeletal Radiol 2023; 52:649-669. [PMID: 36280619 DOI: 10.1007/s00256-022-04207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 02/02/2023]
Abstract
Peripheral nerve sheath tumors comprise a significant percentage of both benign and malignant soft tissue tumors. The vast majority of these lesions are schwannomas and neurofibromas, which most radiologists are familiar with including the well-described multimodality imaging features. However, numerous additional often under-recognized benign entities associated with nerves exist. These rarer entities are becoming increasingly encountered with the proliferation of cross-sectional imaging, particularly magnetic resonance imaging (MRI). It is important for the radiologist to have a basic understanding of these entities as many have near-pathognomonic MR imaging features as well as specific clinical presentations that when interpreted in concert, often allows for a limited differential or single best diagnosis. The ability to provide a prospective, pre-intervention diagnosis based solely on imaging and clinical presentation is crucial as several of these entities are "do not touch" lesions, for which even a biopsy may have deleterious consequences. To our knowledge, the majority of these benign entities associated with nerves have only been described in scattered case reports or small case series. Therefore, the aim of this article is to provide a radiopathologic comprehensive review of these benign entities that arise in association with nerves with a focus on characteristic MRI features, unique histopathologic findings, and entity specific clinical exam findings/presentation.
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Affiliation(s)
- Marco G Aru
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA.
| | - Jessica L Davis
- Department of Pathology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L-471, Portland, OR, 97239, USA
| | - Gregory S Stacy
- Department of Diagnostic Radiology, University of Chicago, 5841 South Maryland Avenue, MC2026, Chicago, IL, 60637, USA
| | - Megan K Mills
- Department of Radiology and Imaging Sciences, University of Utah, 30 N 1900 E, Rm #1A71, Salt Lake City, UT, 84132, USA
| | - Corrie M Yablon
- Department of Diagnostic Radiology, University of Michigan Health System, 1500 E. Medical Center Dr, TC2910Q, Ann Arbor, MI, 48109, USA
| | - Christopher J Hanrahan
- Department of Diagnostic Radiology, University of Utah School of Medicine, Intermountain Healthcare, Salt Lake City, UT, 84132, USA
| | - Raluca McCallum
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
| | - Eric C Nomura
- Department of Pathology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L-471, Portland, OR, 97239, USA
| | - Barry G Hansford
- Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA
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3
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Cheng Y, Zhang N, Deng Z, Guan X, Xu J, Qu L, He L. Expression of TFE3 in Cellular and Myxoid Type of Neurothekeoma: Four Cases in Young Children and Adolescents. Fetal Pediatr Pathol 2023:1-6. [PMID: 36802993 DOI: 10.1080/15513815.2023.2181626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Introduction: Cellular neurothekeoma is a benign tumor that mainly occurs in young children and adolescents. The aberrant expression of transcription factor E3 (TFE3) has not been reported in cellular neurothekeoma previously. Case report: We report four cellular neurothekeoma with aberrant immunohistochemical expression of TFE3 protein. The fluorescence in situ hybridization (FISH) showed no TFE3 gene rearrangement or amplification. Discussion/Conclusion: TEF3 protein expression may not be related to TFE3 gene translocation in cellular neurothekeoma. TFE3 may be a potential pitfall in diagnosis, for several malignant tumors in children also express TFE3. The aberrant expression of TFE3 may offer insights into cellular neurothekeoma etiology, and associated molecular mechanisms.
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Affiliation(s)
- Yin Cheng
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Nan Zhang
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Zhijuan Deng
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Xiaoxing Guan
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jiaosheng Xu
- Department of Dermatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Linlin Qu
- Department of Pathology, Peking University People's Hospital, Beijing, China
| | - Lejian He
- Department of Pathology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
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4
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Ortega M, Sparks J, Nava VE, Smith SDB. Neurothekeoma With PI3K w552*, ALK P1469S, SMO G461S, and ERBB3 L77M Genetic Alterations. Am J Dermatopathol 2022; 44:958-960. [PMID: 36075574 DOI: 10.1097/dad.0000000000002292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Neurothekeoma, a lesion of possible fibrohistiocytic origin, is a rare, benign, superficial soft tissue tumor, histologically subclassified in 3 types: myxoid, cellular, or mixed. It clinically presents as a solitary, pink to brown nodule, ranging from 0.3 to 2.0 cm. Four point mutations (PI3K w552*, ALK P1469S, SMO G461S, and ERBB3 L77M) were identified by next-generation sequencing of a neurothekeoma presenting in the left inner thigh of a 53-year-old man. We highlight novel genetic alterations (SMO G461S and ERBB3 L77M) and previously known mutations (PI3KCA w552* and ALK P1469S) that play a role in other pathogenic pathways, but to the best of our knowledge, these have not yet been reported in neurothekeoma.
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Affiliation(s)
- Mahatma Ortega
- Department of Pathology, Veterans Affairs Medical Center, Washington, DC
| | - Jessica Sparks
- University of Louisville School of Medicine, Louisville, KY; and
| | - Victor E Nava
- Department of Pathology, Veterans Affairs Medical Center, Washington, DC
- Department of Pathology, The George Washington University, Washington, DC
| | - Shane D B Smith
- Department of Pathology, The George Washington University, Washington, DC
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5
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Xu F, Jin Y, Li Q, Dong F, Lu L, Cui Q, Wang C. Intradural Extramedullary Nerve Sheath Myxoma of the Cervical Spine: A Case Report and Review of Literature. Front Surg 2022; 8:722254. [PMID: 35071307 PMCID: PMC8776648 DOI: 10.3389/fsurg.2021.722254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Nerve sheath myxoma is a rare benign soft tissue tumor. Intraspinal nerve sheath myxomas are rare. Only 8 cases of intraspinal nerve sheath myxoma have been reported to date, and no case of nerve sheath myxoma has been reported in the cervical spinal canal. Herein, we reported the first case of intradural extramedullary nerve sheath myxoma in the cervical spinal canal of a 57-year-old man, including its complete clinical course and radiological findings. Case Presentation: A 57-year-old male patient presented with numbness in his left finger without any obvious inducement for 3 years. CT and contrast-enhanced magnetic resonance imaging (MRI) of the spine were performed. Based on the radiological examinations, a diagnosis of schwannoma was initially made. However, nerve sheath myxoma was finally confirmed by histopathological and immunohistochemical examinations. Complete tumor excision at the C1-2 level was performed. Then, the patient recovered well, and the numbness of his left finger disappeared during the later follow-up after the surgery. Conclusion: Nerve sheath myxoma should receive diagnostic consideration for an extramedullary subdural lesion that is a clear boundary mass characterized by isointensity on T1-weighted images, heterogeneous intensity on T2-weighted images, obvious peripheral enhancement, and a growing tendency toward the intervertebral foramen.
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Affiliation(s)
- Fangfang Xu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ying Jin
- Department of Rehabilitation in Traditional Chinese Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Fei Dong
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Liangji Lu
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qingfeng Cui
- Department of Rehabilitation in Traditional Chinese Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chao Wang
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Chao Wang
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Lau SK, Cassarino DS, Koh SS. Multiple myxoid cellular neurothekeomas in a patient with systemic lupus erythematosus. J Cutan Pathol 2021; 48:980-985. [PMID: 33844324 DOI: 10.1111/cup.14025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/24/2021] [Accepted: 04/06/2021] [Indexed: 12/28/2022]
Abstract
Cellular neurothekeoma is a cutaneous tumor with a distinctive histopathologic appearance characterized by a dermal-based multinodular proliferation of epithelioid to spindled cells. Although the tumor may show varying amounts of myxoid stroma, extensive myxoid change is uncommon. The tumor typically presents as a solitary nodule with a predilection for the head and neck and upper limbs; examples of multiple cellular neurothekeomas are decidedly rare. The present report describes a unique case of multiple myxoid cellular neurothekeomas arising in a 60-year-old female with systemic lupus erythematosus. Two papular lesions were identified involving the skin inferior to the umbilicus and the left inguinal crease. Both lesions were histopathologically similar, forming a nodular mass composed of epithelioid cells in a prominent myxoid stroma. By immunohistochemistry the lesional cells expressed NKI/C3, microphthalmia transcription factor (MiTF), and CD68, with focal staining for PGP9.5, factor XIIIa, and CD10 also observed. The tumors were negative for S-100, SOX-10, epithelial membrane antigen, desmin, smooth muscle actin, glial fibrillary acid protein, and CD34. The present case confirms that cellular neurothekeoma can present clinically as multiple lesions and can have a predominantly myxoid appearance, potentially mimicking other cutaneous myxoid lesions.
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Affiliation(s)
- Sean K Lau
- Southern California Permanente Medical Group, Department of Pathology, Orange County-Anaheim Medical Center, Anaheim, California, USA
| | - David S Cassarino
- Southern California Permanente Medical Group, Department of Pathology, Los Angeles Medical Center, Los Angeles, California, USA
| | - Stephen S Koh
- Southern California Permanente Medical Group, Department of Pathology, Orange County-Anaheim Medical Center, Anaheim, California, USA
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7
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Nerve Sheath Myxoma Involving the Medial Rectus Muscle: A Case Report. Ophthalmic Plast Reconstr Surg 2021; 37:e60-e62. [PMID: 32618824 DOI: 10.1097/iop.0000000000001766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 63-year-old man reported a 2-year history of painless OS proptosis. The first MRI, performed in the institution of origin, resulted in a diagnosis of hemangioma versus orbital pseudotumor. Examination revealed proptosis and mild chemosis. Ancillary tests were normal, and oral prednisone was initiated without remarkable changes. Later, an incisional biopsy identified the lesion as an intramuscular myxoma of the left rectus, and a new MRI was ordered. It described a fusiform thickening of the medial rectus with and exophytic growth below the inferior rectus and upward toward the superior oblique. Due to the localization of the lesion, a combined transcaruncular and swinging eyelid approach with a lateral orbitotomy was performed. Histopathological examination revealed a proliferation of stromal origin composed of myxoid matrix with fusocellular and stellate-shaped cells. Cells were S-100, CD34, and CD56 positive and negative for epithelial membrane antigen, CD68, CD10, actin, and desmin. Results were consistent with a left medial rectus nerve sheath myxoma.
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8
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Tafti DA, Dearborn MC, Ornoff A, Moeck AR, Cecava ND. Nerve Sheath Myxoma in the Lower Extremity: A Rare Case with Description of Magnetic Resonance Imaging and Sonographic Findings. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e927922. [PMID: 33814549 PMCID: PMC8040932 DOI: 10.12659/ajcr.927922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND This report is of a nerve sheath myxoma presenting as a slow-growing mass in the back of the left ankle of a 36-year-old man that was investigated by ultrasound and magnetic resonance imaging (MRI) before the diagnosis was confirmed by histopathology. CASE REPORT We report a nerve sheath myxoma of the ankle in a 36-year-old man. The palpable abnormality was falsely assumed to be a ganglion cyst prior to advanced imaging. Magnetic resonance imaging demonstrated a lobular mass with high T2 and intermediate T1 signal as well as moderate enhancement. T2 sequences also demonstrated distinctive internal septae. These internal septae were also noted on sonographic evaluation prior to biopsy. The patient was treated with surgical excision, and pathologic analysis showed myxoid nodules with loose arrangements of spindled cells separated by fibrous septae. S-100 protein and glial fibrillary acidic protein positivity by immunohistochemistry staining was demonstrated. Follow-up imaging at 12 months showed no evidence of tumor recurrence. CONCLUSIONS This case highlights that while nerve sheath myxomas are rare tumors, they should be considered in cases of cutaneous soft-tissue masses with myxoid imaging features. Ultrasound and magnetic resonance imaging features of thin internal septae may be present and correspond well with the unique histopathological characteristics of these lesions. This report shows the importance of imaging of peripheral soft-tissue masses, including ultrasound and MRI, which can identify localized and benign features and the solid, cystic, and myxoid areas, which were characteristic in this case of benign nerve sheath myxoma.
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Affiliation(s)
- Dawood A Tafti
- Department of Radiology, San Antonio Military Medical Center, San Antonio, TX, USA
| | - Micheal C Dearborn
- Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX, USA
| | - Ashley Ornoff
- Department of Pathology, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX, USA
| | - Adam R Moeck
- Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX, USA
| | - Nathan D Cecava
- Department of Radiology, Brooke Army Medical Center, Fort Sam Houston, San Antonio, TX, USA.,Uniformed Services University of Health Sciences, Bethesda, MD, USA.,Texas A&M School of Medicine, Bryan, TX, USA
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9
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Silva CMM, Fontenele JPU, Lopes JR, de Brito GCC, Teixeira MJD, Rocha FAC. Neurothekeoma in the Axilla Causing Persistent Shoulder Pain: Case Report. Rev Bras Ortop 2020; 55:804-807. [PMID: 33364664 PMCID: PMC7748936 DOI: 10.1055/s-0040-1712135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/02/2020] [Indexed: 12/17/2022] Open
Abstract
Neurothekeomas, also known as neural sheath myxomas, are rare benign tumors of the neural sheath affecting most commonly the head, arms and shoulder of women in their 2
nd
and 3
rd
decades of life. Due to the low prevalence and undefined clinical picture, they are hardly considered in the initial differential diagnosis of skin tumors. We report the case of a 24 year-old woman who was seen in 2016 reporting > 1 year of moderate pain and limited mobility of her left shoulder. Clinical evaluation revealed restricted mobility of the affected shoulder and nuclear magnetic resonance imaging showed a T2-weighted contrast-enhanced multilobular mass in the quadrilateral area apparently invading the adjacent humeral cortical region. Histopathology of a needle sample material revealed loose fibroconnective tissue with no signs of invasion, mitosis or atypical figures. Successful surgical excision was performed and the diagnosis of neurothekeoma was confirmed after detailed histopathology, including immunohistochemistry. The patient was asymptomatic at 18 months of follow-up, with full recovery of shoulder movement and no signs of relapse.
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Positive MITF and NKI/C3 Expression in Cellular Neurothekeoma and Dermatofibroma. Appl Immunohistochem Mol Morphol 2020; 29:440-445. [PMID: 33264109 DOI: 10.1097/pai.0000000000000889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cellular neurothekeoma (CNT) is a benign mesenchymal tumor with uncertain cellular differentiation. Studies have found evidence of myofibroblastic differentiation and possible relation to dermatofibromas (DFs). As microphthalmia transcription factor (MITF) and NKI/C3 stains are routinely positive in CNT, we compared expression patterns of both markers in CNT and DF to assess their relationship. MATERIALS AND METHODS We assessed cases of CNT (n=25) and DFs (n=35) for histopathologic characteristics and MITF and NKI/C3 expression. Immunostaining results were classified as negative, focally positive (<50%), and diffusely positive (>50%). At least 1 additional melanocytic marker was assessed in each case of CNT. RESULTS Both DFs and CNTs showed a female predilection and a wide age range. Immunostaining in CNTs for MITF was positive in the vast majority (focal 68%, diffuse 24%), as was NKI/C3 (focal 72%, diffuse 24%). All DFs were MITF positive (diffuse 74%, focal 26%), and most DFs were NKI/C3 positive (focal 57%, diffuse 3%). CONCLUSION CNT and DF share demographic, histopathologic, and immunohistochemical features, including shared expression of MITF and NKI/C3, especially cellular DF.
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11
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Nerve Sheath Myxoma: A rare tumor, a case report and literature review. Int J Surg Case Rep 2020; 73:183-186. [PMID: 32693231 PMCID: PMC7533628 DOI: 10.1016/j.ijscr.2020.07.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Nerve Sheath Myxoma is a rare benign nerve sheath tumor, commonly seen in young adults. Patients usually present with a small nodule commonly affecting upper and lower limbs. Nerve Sheath Myxoma has not been reported in children below the age of 1 year. CASE PRESENTATION AND METHODS We present the first reported case of Nerve Sheath Myxoma (NSM) in the hand in a 4-month old child in line with the SCARE 2018 criteria. DISCUSSION NSM is difficult to diagnose using standard imaging technique; Magnetic Resonance Imaging (MRI) and Ultrasonography (USS) cannot differentiate it from vascular anomalies. CONCLUSION Soft tissue tumors in the hand of pediatric population are difficult to diagnose. Formal excision of the tumor by a specialized pediatric hand surgeon and histopathological analysis were the only avenue to correctly diagnose the NSM.
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12
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Murphrey M, Huy Nguyen A, White KP, Krol A, Bernert R, Yarbrough K. Pediatric cellular neurothekeoma: Seven cases and systematic review of the literature. Pediatr Dermatol 2020; 37:320-325. [PMID: 31930561 DOI: 10.1111/pde.14043] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND/OBJECTIVES Neurothekeoma is a rare, benign, cutaneous neoplasm consisting of Schwann cells and perineural cells in myxoid stroma. Cellular neurothekeoma (CNT) was previously thought to represent a morphologic variant of neurothekeoma, but recent studies have shown that CNTs are unrelated to neurothekeomas and are more likely of histiocytic lineage. METHODS Herein, we describe seven cases of CNT in pediatric patients. A comprehensive search of PubMed was performed, and 71 cases of cellular neurothekeoma in pediatric patients were reviewed. RESULTS The clinical differential diagnosis for these lesions included Spitz nevi, keloid, juvenile xanthogranuloma, cutaneous lymphoid hyperplasia, and lymphomatoid papulosis. All cases were treated by excision or excisional biopsy. Histopathologically, all demonstrated multilobular, primarily intradermal neoplasms composed of plump spindled or epithelioid mononuclear cells with abundant eosinophilic pale-staining cytoplasm. Immunophenotypic findings included CD68 and NKI/C3 positivity, and negative staining with cytokeratin, S-100, Melan-A, and SOX-10. CONCLUSION Cellular neurothekeoma is distinguished from conventional neurothekeoma by increased cellularity, a lack of myxoid stroma, and a lack of neural expression with immunohistochemical stains. These uncommon neoplasms should be included in the differential diagnosis of dermal nodules in children. Accurate diagnosis of these lesions is essential, as they can be mistaken for malignancy leading to unnecessary treatment.
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Affiliation(s)
- Morgan Murphrey
- Creighton University School of Medicine Regional Campus, Phoenix, Arizona
| | - Austin Huy Nguyen
- Creighton University School of Medicine Regional Campus, Phoenix, Arizona
| | - Kevin P White
- Oregon Health & Science University, Portland, Oregon
| | - Alfons Krol
- Oregon Health & Science University, Portland, Oregon
| | - Richard Bernert
- Aurora Diagnostics Arizona Dermatopathology, Scottsdale, Arizona
| | - Kevin Yarbrough
- Dermatology Department, Phoenix Children's Hospital, Phoenix, Arizona.,Kaiser Permanente Pediatric Dermatology, Clackamas, Oregon
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13
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Srinivasamurthy B, Bhat R. Subungual myxoid neurothekeoma of the toe: A rare entity. INDIAN JOURNAL OF DERMATOPATHOLOGY AND DIAGNOSTIC DERMATOLOGY 2020. [DOI: 10.4103/ijdpdd.ijdpdd_17_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Abstract
Benign peripheral nerve tumors encompass a wide range of neoplasms and non-neoplastic tumor like lesions. Some of these lesions if not encountered in the setting of genetic syndromes, are occurring sporadically. The principles of oncology should be respectfully followed in every step of diagnostic approach and surgical management. Albeit, classified as benign, some of them do have different level of malignant potential, thus the treating physicians should be aware of that to avoid possible pitfalls with devastating outcomes. This article reviews the most common benign peripheral nerve tumors discussing the clinicopathological findings, imaging appearance and the current trend in their approach.
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Affiliation(s)
- Zinon T Kokkalis
- University of Patras, School of Medicine, University Hospital of Patras, Department of Orthopaedics, Rio-Patras, Greece.
| | - Nikolaos A Stavropoulos
- Second Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Konstantopouleio General Hospital, Athens, Greece
| | - Andreas F Mavrogenis
- First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
| | - Andreas Panagopoulos
- University of Patras, School of Medicine, University Hospital of Patras, Department of Orthopaedics, Rio-Patras, Greece
| | - Panayotis N Soucacos
- "Panayotis N. Soucacos" Orthopaedic Research & Education Center (OREC), National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
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15
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Cohen JN, Yeh I, Jordan RC, Wolsky RJ, Horvai AE, McCalmont TH, LeBoit PE. Cutaneous Non-Neural Granular Cell Tumors Harbor Recurrent ALK Gene Fusions. Am J Surg Pathol 2019; 42:1133-1142. [PMID: 30001233 DOI: 10.1097/pas.0000000000001122] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Non-neural granular cell tumor (NNGCT; also known as primitive polypoid granular cell tumor) is a rare neoplasm composed of large ovoid cells with abundant granular cytoplasm, variable nuclear pleomorphism, and the potential for regional lymph node spread. In contrast to conventional granular cell tumor (GCT), NNGCT lacks S100 expression and can exhibit greater nuclear atypia and mitotic activity. Therefore, we investigated clinicopathologic features of 12 NNGCT, and also used next-generation sequencing to identify potential driver events in a subset of NNGCT and 6 GCT. NNGCT demonstrated mild-to-moderate nuclear pleomorphism, variable mitotic activity (0 to 10/10 high-power fields), and were S100. Genetic analysis of 5 cutaneous NNGCT revealed gene fusions involving the anaplastic lymphoma kinase gene (ALK) in 3 cases (60%). Specifically, an interstitial deletion of chromosome 2 resulting in an in-frame fusion of dyanactin 1 (DCTN1) to ALK was identified in 2 cases, and a translocation resulting in a fusion between sequestosome 1 (SQSTM1) on chromosome 5 and ALK was identified in one case. Two of 6 GCT (33%) showed gains of chromosome 7. No other molecular or chromosomal alterations were detected in NNGCT and GCT. ALK immunohistochemistry revealed weak-to-moderate positivity in 4/9 cutaneous NNCGT (44%) including all 3 tumors with ALK fusions. Three oral NNGCT lacked ALK expression. NNGCT with ALK immunostaining did not have morphologic features distinguishing them from those without ALK staining. Our results demonstrate that a subset of NNGCT harbor ALK fusions, suggest that NNGCT are molecularly diverse, and further substantiate NNGCT as distinct from GCT.
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Affiliation(s)
| | - Iwei Yeh
- Dermatopathology.,Clinical Cancer Genomics Laboratory.,Helen Diller Cancer Center, University of California, San Francisco
| | - Richard C Jordan
- Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco.,Orofacial Sciences, Pathology & Radiation Oncology
| | - Rebecca J Wolsky
- Departments of Pathology.,Department of Pathology, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | | | - Timothy H McCalmont
- Departments of Pathology.,Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco
| | - Philip E LeBoit
- Departments of Pathology.,Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco
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16
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Tamiolakis P, Chrysomali E, Sklavounou-Andrikopoulou A, Nikitakis NG. Oral neural tumors: Clinicopathologic analysis of 157 cases and review of the literature. J Clin Exp Dent 2019; 11:e721-e731. [PMID: 31598201 PMCID: PMC6776406 DOI: 10.4317/jced.55944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background Oral neural tumors (ONTs) are rare lesions and represent reactive or neoplastic proliferations of nerve sheath cells. The purpose of the present study is to report the clinical, demographic and histopathologic features of 157 ONTs diagnosed in a single Oral Pathology Department and review the pertinent literature. Material and Methods 157 cases of ONTs diagnosed during a 44-year period were retrospectively collected and the diagnosis was reconfirmed by studying representative haematoxylin and eosin stained tissue sections. The patients’ gender and age, as well as the main clinical features of the lesions, were retrieved from the biopsy submission forms. Results The 157 ONTs represented approximately 0.4% of 35,590 biopsies accessioned during the study period. They affected 71 male and 86 female patients with a mean age of 38.4±18.8 years. They mainly appeared as asymptomatic nodules of normal or white colour on the tongue, lip mucosa and hard palate. The most common ONT was granular cell tumour (38.9%) followed by neurofibroma (19.7%), schwannoma (15.9%), traumatic neuroma (15.9%), palisaded encapsulated neuroma (8.3%) and nerve sheath myxoma (1.3%). Conclusions This study confirmed the rarity of ONTs. Their clinical characteristics mimic other oral lesions; thus, microscopic examination is the only mean to arrive at a definitive diagnosis. Key words:Oral neural tumors; oral neural neoplasms; neurofibroma; oral neurofibroma; schwannoma; oral schwannoma; neurilemmoma; oral neurilemmoma; granular cell tumor; oral granular cell tumor; traumatic neuroma; oral traumatic neuroma; palisaded encapsulated neuroma; oral palisaded encapsulated neuroma.
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Affiliation(s)
- Paris Tamiolakis
- DDS, MSc, Department of Oral Medicine and Pathology, Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Evanthia Chrysomali
- DDS, PhD, Associate Professor, Department of Oral Medicine and Pathology, Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Alexandra Sklavounou-Andrikopoulou
- DDS, MSc, PhD, Professor, Department of Oral Medicine and Pathology, Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, Greece
| | - Nikolaos G Nikitakis
- MD, DDS, PhD, Professor, Head of Department of Oral Medicine and Pathology, Department of Dentistry, School of Health Sciences, National and Kapodistrian University of Athens, Greece
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17
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Yadav SK, Singh S, Sarin N, Naeem R, Pruthi SK. Nerve Sheath Myxoma of Scalp: A Rare Site of Presentation. Int J Trichology 2019; 11:34-37. [PMID: 30820132 PMCID: PMC6385516 DOI: 10.4103/ijt.ijt_45_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Nerve sheath myxoma, a superficial myxoid tumor, was first described in 1969 by Harkin and Reed. Tumor has cytological and histological resemblance with neurothekeoma, another cutaneous myxoid lesion. Nerve sheath myxoma affects individuals of all age groups and equal predilection for both genders with most favored sites being the fingers and knee. Here, we present a case report of nerve sheath myxoma of the scalp, diagnosed and confirmed with histopathology and immunohistochemistry.
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Affiliation(s)
- Shakti Kumar Yadav
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Sompal Singh
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Namrata Sarin
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Roshina Naeem
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Sonam Kumar Pruthi
- Department of Pathology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
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18
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Graf SA, Heppt MV, Wessely A, Krebs S, Kammerbauer C, Hornig E, Strieder A, Blum H, Bosserhoff AK, Berking C. The myelin protein PMP2 is regulated by SOX10 and drives melanoma cell invasion. Pigment Cell Melanoma Res 2018; 32:424-434. [PMID: 30506895 DOI: 10.1111/pcmr.12760] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 10/05/2018] [Accepted: 11/20/2018] [Indexed: 12/22/2022]
Abstract
The transcription factor sex determining region Y-box 10 (SOX10) plays a key role in the development of melanocytes and glial cells from neural crest precursors. SOX10 is involved in melanoma initiation, proliferation, invasion, and survival. However, specific mediators which impart its oncogenic properties remain widely unknown. To identify target genes of SOX10, we performed RNA sequencing after ectopic expression of SOX10 in human melanoma cells. Among nine differentially regulated genes, peripheral myelin protein 2 (PMP2) was consistently upregulated in several cell lines. Direct regulation of PMP2 by SOX10 was shown by chromatin immunoprecipitation, electrophoretic mobility shift, and luciferase reporter assays. Moreover, a coregulation of PMP2 by SOX10 and early growth response 2 in melanoma cells was found. Phenotypical investigation demonstrated that PMP2 expression can increase melanoma cell invasion. As PMP2 protein was detected only in a subset of melanoma cell lines, it might contribute to melanoma heterogeneity.
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Affiliation(s)
- Saskia Anna Graf
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Markus Vincent Heppt
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Anja Wessely
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Krebs
- Gene Center, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Claudia Kammerbauer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Eva Hornig
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Annamarie Strieder
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Helmut Blum
- Gene Center, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Anja-Katrin Bosserhoff
- Department of Biochemistry and Molecular Medicine, Institute of Biochemistry, Emil Fischer Center, University of Erlangen-Nürnberg, Erlangen, Germany.,Comprehensive Cancer Center (CCC) Erlangen-EMN, Erlangen, Germany
| | - Carola Berking
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
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19
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Choi JH, Ro JY. Cutaneous Spindle Cell Neoplasms: Pattern-Based Diagnostic Approach. Arch Pathol Lab Med 2018; 142:958-972. [DOI: 10.5858/arpa.2018-0112-ra] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Spindle cell neoplasms arising in the skin comprise a heterogeneous group of tumors with divergent lineages. Cutaneous spindle cell neoplasms are relatively common and present surgical pathologists with diagnostic challenges. Recognition of their histopathologies is important for correct diagnosis and management. The current review presents a pattern-based diagnostic approach to common cutaneous spindle cell neoplasms that often cause diagnostic difficulties.
Objective.—
To provide a useful guide for diagnosis of cutaneous spindle cell neoplasms.
Data Sources.—
PubMed (US National Library of Medicine) reports and the authors' personal experiences are reviewed.
Conclusions.—
The authors briefly summarize the histologic features and differential diagnoses of common cutaneous spindle cell neoplasms.
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Affiliation(s)
| | - Jae Y. Ro
- From the Department of Pathology, Yeungnam University College of Medicine, Daegu City, Korea (Dr Choi); and the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, Texas (Dr Ro)
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20
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Behera B, Mathews I, Kumari R, Thappa DM, Toi PC, Patel B, Govindarajalou R. Clinical, dermoscopic and histopathological features of a rare cutaneous neural tumour. Clin Exp Dermatol 2018; 44:206-209. [PMID: 29978583 DOI: 10.1111/ced.13690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2018] [Indexed: 11/29/2022]
Affiliation(s)
- B Behera
- Department of Dermatology, Venereology and Leprology, JIPMER, Puducherry, India
| | - I Mathews
- Department of Dermatology, Venereology and Leprology, JIPMER, Puducherry, India
| | - R Kumari
- Department of Dermatology, Venereology and Leprology, JIPMER, Puducherry, India
| | - D M Thappa
- Department of Dermatology, Venereology and Leprology, JIPMER, Puducherry, India
| | - P C Toi
- Department of Pathology, JIPMER, Puducherry, India
| | - B Patel
- Department of Radiodiagnosis, JIPMER, Puducherry, India
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21
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Abstract
This overview of mesenchymal tumors presenting in the skin and/or subcutis in children brings together the range of neoplasms and hamartomas which are seen in this age-group. It is not surprising from the perspective of the pediatric or general surgical pathologist that vascular anomalies, including true neoplasms and vascular malformations, are the common phenotypic category. Since there is considerable morphologic overlap among these lesions, clinicopathologic correlation may be more important than for many of the other mesenchymal tumors. The skin and subcutis are the most common sites of clinical presentation for the infantile myofibroma which is the most common of fibrous mesenchymal tumors in children. Several of the other mesenchymal tumors are more common adults-like dermatofibrosarcoma protuberans, but nonetheless have an important presence in children, even as a congenital neoplasm. A lipomatous tumor in a young child should be considered as a possible manifestation of an overgrowth syndrome.
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Affiliation(s)
- Louis P Dehner
- 1 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital, Washington University Medical Center, St. Louis, Missouri.,2 Dermatopathology Center and Division of Dermatology, Washington University Medical Center, St. Louis, Missouri
| | - Alejandro A Gru
- 3 Department of Pathology, University of Virginia, Charlottesville, Virginia.,4 Department of Dermatology, University of Virginia, Charlottesville, Virginia
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22
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Frydrych AM, Firth NA. Oral nerve sheath myxoma: a rare and unusual intraoral neoplasm. Clin Case Rep 2018; 6:302-305. [PMID: 29445466 PMCID: PMC5799657 DOI: 10.1002/ccr3.1341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 11/29/2017] [Accepted: 12/01/2017] [Indexed: 12/18/2022] Open
Abstract
We present a rare case of intraoral nerve sheath myxoma. Clinically, the neoplasm mimics many other oral mucosal pathosis, underscoring the importance of histopathology in ensuring accurate diagnosis of oral mucosal lesions. Reports of intraoral nerve sheath myxomas are essential to enhance our understanding of this rare intraoral entity.
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Affiliation(s)
- Agnieszka M Frydrych
- Oral Medicine UWA Dental School The University of Western Australia M512, 17 Monash Avenue Nedlands Western Australia 6009 Australia.,Oral Medicine WA Suite 3, 42-44 Parliament Place West Perth Western Australia 6005 Australia
| | - Norman A Firth
- Oral Medicine and Oral Pathology UWA Dental School The University of Western Australia M512, 17 Monash Avenue Nedlands Western Australia 6009 Australia
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23
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24
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Bartake A, Palaskar SJ, Narang B, Kathuriya P. Nerve sheath myxoma of the oral cavity: a distinct entity. Br J Neurosurg 2017; 33:213-214. [DOI: 10.1080/02688697.2017.1301379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Anirudha Bartake
- Department of Oral Pathology & Microbiology, Sinhgad Dental College & Hospital, Pune, India
| | - Sangeeta J Palaskar
- Department of Oral Pathology & Microbiology, Sinhgad Dental College & Hospital, Pune, India
| | - Bindiya Narang
- Department of Oral Pathology & Microbiology, Sinhgad Dental College & Hospital, Pune, India
| | - Pargatsingh Kathuriya
- Department of Oral Pathology & Microbiology, Sinhgad Dental College & Hospital, Pune, India
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25
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Zou Y, Billings SD. Myxoid cutaneous tumors: a review. J Cutan Pathol 2016; 43:903-18. [DOI: 10.1111/cup.12749] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 02/16/2016] [Accepted: 04/05/2016] [Indexed: 01/16/2023]
Affiliation(s)
- Youran Zou
- Department of PathologyCleveland Clinic Cleveland OH USA
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26
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Abstract
This article presents an overview of soft tissue tumors that have a plexiform histomorphology. The more commonly encountered entities, including plexiform fibrohistiocytic tumor, cellular neurothekeoma, dermal nerve sheath myxoma, plexiform schwannoma, and plexiform neurofibroma, are discussed in detail, and other tumors are noted. Information on clinical features, microscopic findings, ancillary studies, differential diagnosis, and prognosis is provided for each entity.
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Affiliation(s)
- Hillary Elwood
- Department of Pathology, The Johns Hopkins Hospital, Path 401, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - Janis Taube
- Departments of Dermatology and Pathology, The Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA
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27
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Ding YI, Zou F, Peng W, Dai M, Gu H, Zhang B, Nie T. A giant neurothekeoma of the left shoulder blade: A case report. Oncol Lett 2015; 11:1130-1134. [PMID: 26893705 DOI: 10.3892/ol.2015.4028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 09/17/2015] [Indexed: 01/29/2023] Open
Abstract
Neurothekeoma is a rare myxoma of the peripheral nerve sheath. The current report presents a case of a giant neurothekeoma with a partially-formed capsule, scapula erosion and unclear biological behavior, which originated in the intermuscular space between the left trapezius muscle and scapula. The patient was initially misdiagnosed with a fibromatosis using computed tomography and magnetic resonance image scanning. Diagnosis of the neoplasm was confirmed by pathological and immunohistochemical examination, revealing a neurothekeoma with unclear biological behavior. The patient underwent a wide and complete local resection. Using a comprehensive postoperative follow-up strategy, it was determined that the patient recovered well. The tumor was ~17×16×10 cm in size and was in contact with the scapula. The purpose of the present study was to describe a rare giant neurothekeoma and review the diagnostic techniques utilized to reach a definitive diagnosis. Histopathological and immunohistochemical analyses were recommended for the diagnosis of neurothekeoma. There have been no previous reports regarding neurothekeomas exhibiting malignant transformation. Early and complete surgical resection is considered to be an effective method of treating this type of neurothekeoma.
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Affiliation(s)
- Y I Ding
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Fan Zou
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Weixia Peng
- Department of Administration, The Fourth Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330003, P.R. China
| | - Min Dai
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Houyun Gu
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Bin Zhang
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Tao Nie
- Department of Orthopedics, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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28
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Schneider N, Fisher C, Thway K. Ossifying fibromyxoid tumor: morphology, genetics, and differential diagnosis. Ann Diagn Pathol 2015; 20:52-8. [PMID: 26732302 DOI: 10.1016/j.anndiagpath.2015.11.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 11/30/2015] [Indexed: 01/17/2023]
Abstract
Ossifying fibromyxoid tumor (OFMT) is a soft tissue neoplasm of uncertain differentiation and intermediate (rarely metastasizing) biologic potential, with typical morphologic features, of an encapsulated, lobulated tumor comprising uniform polygonal cells within fibromyxoid stroma, which is surrounded by or contains metaplastic bone, classically as a peripheral rim of lamellar bone. Ossifying fibromyxoid tumor can arise at almost any site, although most frequently occurs within the extremities and trunk. Although most behave in a benign fashion, tumors can rarely show atypical or malignant features. It is now established that OFMTs represent translocation-associated tumors, with up to 85% associated with recurrent gene rearrangements, mostly involving the PHF1 gene (including in typical, atypical, and malignant neoplasms), with EP400-PHF1 in approximately 40% of tumors, and ZC3H7B-BCOR, MEAF6-PHF1, and EPC1-PHF1 fusions also described. Correct diagnosis is clinically important to ensure correct treatment and prognostication, both to avoid overdiagnosing OFMT as a malignant neoplasm such as osteosarcoma and also because of the propensity for aggressive behavior in a small number of OFMT. We review OFMT, with emphasis on the morphologic spectrum, recent molecular genetic findings, and the differential diagnosis.
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Affiliation(s)
- Nina Schneider
- Sarcoma Unit, Royal Marsden Hospital, London, United Kingdom
| | - Cyril Fisher
- Sarcoma Unit, Royal Marsden Hospital, London, United Kingdom
| | - Khin Thway
- Sarcoma Unit, Royal Marsden Hospital, London, United Kingdom.
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29
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Benign Cutaneous Biphasic Hybrid Tumor of Perineurioma and Cellular Neurothekeoma. Am J Dermatopathol 2015; 37:319-22. [DOI: 10.1097/dad.0000000000000105] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Bhat A, Narasimha A, C V, VK S. Nerve sheath myxoma: report of a rare case. J Clin Diagn Res 2015; 9:ED07-9. [PMID: 26023558 PMCID: PMC4437072 DOI: 10.7860/jcdr/2015/10911.5810] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 02/20/2015] [Indexed: 12/11/2022]
Abstract
Nerve sheath myxoma defined by Harkin and Reed is an uncommon benign neoplasm with nerve sheath like features. It has several cytological and histological differential diagnoses. One such lesion is neurothekeoma, which can be differentiated using immunohistochemistry. In most of the previous reports nerve sheath myxoma and neurothekeoma were considered synonymous and were often confused for one another. This case report separates the two using immunohistochemistry. Also, the cytological features of nerve sheath myxoma are not well documented in the past. This case report attempts to display the cyto-morphology of nerve sheath myxoma. We report a rare case of nerve sheath myxoma diagnosed on cytological features confirmed by histopathology and immunohistochemistry in a 32-year-old lady who presented with an asymptomatic nodule over the left cervical area and discuss its cyto-histological mimics.
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Affiliation(s)
- Amoolya Bhat
- Assistant Professor, Department of Pathology, Sapthagiri Institute of Medical Sciences and Research Centre, #15,Chikkasandra, Hesarghatta Main Road, Bangalore, India.
| | - Aparna Narasimha
- Professor, Department of Pathology, Sapthagiri Institute of Medical Sciences and Research Centre, #15,Chikkasandra, Hesarghatta Main Road, Bangalore, India.
| | - Vijaya C
- Professor and HOD, Department of Pathology, Sapthagiri Institute of Medical Sciences and Research Centre, #15,Chikkasandra, Hesarghatta Main Road, Bangalore, India.
| | - Sundeep VK
- Assistant Professor, Department of Surgery, Sapthagiri Institute of Medical Sciences and Research Centre, #15,Chikkasandra, Hesarghatta Main Road, Bangalore, India.
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31
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Abstract
Peripheral nerve sheath tumors are common neoplasms in daily practice. Diagnosis and classification of most conventional peripheral nerve sheath tumors are relatively straightforward for the experienced observer; but on occasion, they are diagnostically challenging (especially with locally aggressive and malignant tumors). This article aims to provide an update of the data (clinical, histological, immunohistochemistry and genomic) of benign, intermediate and malignant peripheral nerve sheath tumors, thanks to the latest WHO "Classification of Tumors of Soft Tissue and Bone", published in 2013, which includes a new chapter on "Nerve Sheath Tumors". 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.
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Affiliation(s)
- Sophie Le Guellec
- Département de pathologie, institut universitaire du cancer Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
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32
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Jiang N, Li H, Sun Y, Yin D, Zhao Q, Cui S, Yao D. Differential gene expression in proximal and distal nerve segments of rats with sciatic nerve injury during Wallerian degeneration. Neural Regen Res 2014; 9:1186-94. [PMID: 25206781 PMCID: PMC4146292 DOI: 10.4103/1673-5374.135325] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2014] [Indexed: 11/09/2022] Open
Abstract
Wallerian degeneration is a subject of major interest in neuroscience. A large number of genes are differentially regulated during the distinct stages of Wallerian degeneration: transcription factor activation, immune response, myelin cell differentiation and dedifferentiation. Although gene expression responses in the distal segment of the sciatic nerve after peripheral nerve injury are known, differences in gene expression between the proximal and distal segments remain unclear. In the present study in rats, we used microarrays to analyze changes in gene expression, biological processes and signaling pathways in the proximal and distal segments of sciatic nerves undergoing Wallerian degeneration. More than 6,000 genes were differentially expressed and 20 types of expression tendencies were identified, mainly between proximal and distal segments at 7–14 days after injury. The differentially expressed genes were those involved in cell differentiation, cytokinesis, neuron differentiation, nerve development and axon regeneration. Furthermore, 11 biological processes were represented, related to responses to stimuli, cell apoptosis, inflammatory response, immune response, signal transduction, protein kinase activity, and cell proliferation. Using real-time quantitative PCR, western blot analysis and immunohistochemistry, microarray data were verified for four genes: aquaporin-4, interleukin 1 receptor-like 1, matrix metalloproteinase-12 and periaxin. Our study identifies differential gene expression in the proximal and distal segments of a nerve during Wallerian degeneration, analyzes dynamic biological changes of these genes, and provides a useful platform for the detailed study of nerve injury and repair during Wallerian degeneration.
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Affiliation(s)
- Nan Jiang
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China ; China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Huaiqin Li
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
| | - Yi Sun
- China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Dexin Yin
- China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Qin Zhao
- Key Laboratory of People's Liberation Army, Institute of Orthopedics, Chinese PLA General Hospital, Beijing, China
| | - Shusen Cui
- China-Japan Union Hospital of Jilin University, Changchun, Jilin Province, China
| | - Dengbing Yao
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, Jiangsu Province, China
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33
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Areolar Dermal Nodule. Am J Dermatopathol 2014. [DOI: 10.1097/dad.0000000000000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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34
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Sachdev D, Barnhill RL, Taylor E, Worswick S. Cellular Neurothekeoma in a Female with Guillain-Barré Syndrome: A Case Report and Review of the Literature. Dermatopathology (Basel) 2014; 1:91-7. [PMID: 27047928 PMCID: PMC4772922 DOI: 10.1159/000369162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cellular neurothekeoma is a rare cutaneous tumor that occurs more frequently in women. A 68-year-old female with a history of left nasal alar basal cell carcinoma and Guillain-Barré syndrome presented to the clinic with a 3-mm firm skin-colored papule with scattered telangiectasias. Histopathologic examination with immunochemistry of the lesion was consistent with cellular neurothekeoma. It stained positive for microphthalmia transcription factor and NKI-C3 and negative for HMB-45 and S-100. The lesion was excised with 3-mm margins, and no recurrence was noted within 1 year of follow-up. We present a case of cellular neurothekeoma in a patient with a history of Guillain-Barré syndrome as well as a review of the literature. Our case report is unique in that no prior association has been found in the literature between cellular neurothekeoma and Guillain-Barré syndrome.
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Affiliation(s)
- Divya Sachdev
- University of California Los Angeles, Los Angeles, Calif., USA
| | | | - Emma Taylor
- University of California Los Angeles, Los Angeles, Calif., USA
| | - Scott Worswick
- University of California Los Angeles, Los Angeles, Calif., USA
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35
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Stratton J, Billings SD. Cellular neurothekeoma: analysis of 37 cases emphasizing atypical histologic features. Mod Pathol 2014; 27:701-10. [PMID: 24186141 DOI: 10.1038/modpathol.2013.190] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 08/30/2013] [Accepted: 09/01/2013] [Indexed: 11/09/2022]
Abstract
Cellular neurothekeoma is a frequent source of diagnostic difficulty. In order to gain more insight into the range of histologic features of cellular neurothekeoma, we examined all cases from our institution, with a focus on describing atypical histologic features. Cases with sufficient histologic material for evaluation were retrieved. Cases were analyzed for demographics, growth pattern, myxoid stroma, cytologic atypia, mitotic rate, perineural invasion, and other histologic features. The 37 patients (16 M; 21 F) had a mean age of 31.0 years (range: 4-89). Tumors involved the head and neck (n=16), arms (n=11), trunk and shoulders (n=8), and foot (n=2). All cases had at least focal nesting of epithelioid to spindled tumors cells characteristic of cellular neurothekeoma. In many, alternate growth patterns were present and represented the dominant pattern in some. These patterns included fascicular (n=9), sheet-like (n=6), and corded (n=4). Myxoid stroma was present in 14 and was prominent in 5. Cytologic atypia was present in 19 patients, with 3 having severe atypia. Mean mitotic rate was 2.0/mm(2) (range 0-10 per mm(2)). Neurotropism was seen in four cases. Other unusual features included collagen trapping, giant cells, hemorrhage, lymphocytic cuffing, chondroid stroma, and cellular vacuolization. Cellular neurothekeoma has a wider range of features than is commonly recognized. The presence of nests of epithelioid tumor cells with characteristic cytologic features, no matter how focal, is a clue to the diagnosis.
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Affiliation(s)
- Jason Stratton
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Steven D Billings
- 1] Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA [2] Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA
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Pan HY, Tseng SH, Weng CC, Chen Y. Cellular neurothekeoma of the upper lip in an infant. Pediatr Neonatol 2014; 55:71-4. [PMID: 23597544 DOI: 10.1016/j.pedneo.2012.12.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 02/16/2012] [Accepted: 11/07/2012] [Indexed: 11/29/2022] Open
Abstract
Cellular neurothekeoma is an uncommon benign skin neoplasm and also a variant of neurothekeoma. Cellular neurothekeomas usually occur in the skin of the upper trunk, head, or neck of children and young adults; however, they rarely occur in infants or involve the lip. A 6-month-old male infant was incidentally found to have a tumor in the upper lip. The tumor was elastic, nontender, and movable, and the overlying mucosa and skin were normal without discoloration. The tumor was excised from the mucosal side of the upper lip, and a pathological examination revealed cellular neurothekeoma. Cellular neurothekeoma in the lip of an infant without overlying skin discoloration might delay the diagnosis and lead to wrong preoperative diagnosis. No similar case has been reported in the literature.
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Affiliation(s)
- Hsin-Yen Pan
- Division of Pediatric Surgery, Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei City, Taiwan
| | - Sheng-Hong Tseng
- Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chia-Chi Weng
- Division of Pediatric Surgery, Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei City, Taiwan
| | - Yun Chen
- Division of Pediatric Surgery, Department of Surgery, Far Eastern Memorial Hospital, Pan-Chiao, New Taipei City, Taiwan; Department of Chemical Engineering and Materials Science, Yuan Ze University, Taoyuan, Taiwan.
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Fried I, Sitthinamsuwan P, Muangsomboon S, Kaddu S, Cerroni L, McCalmont TH. SOX-10 and MiTF expression in cellular and 'mixed' neurothekeoma. J Cutan Pathol 2014; 41:640-5. [PMID: 24475873 DOI: 10.1111/cup.12301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 01/12/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Neurothekeoma and nerve sheath myxoma have long been interpreted as related tumors that share nerve sheath linage. Lack of S100 expression in neurothekeoma and similarities of gene expression profiles between neurothekeoma and fibrohistiocytic tumors have created reasonable doubt about this concept. SOX-10 represents a marker for schwannian and melanocytic differentiation, and is expressed in other tumors of nerve sheath linage. Microphthalmia transcription factor (MiTF) expression has been repeatedly reported in cellular neurothekeoma in the recent literature and was proposed as a helpful marker in this entity. METHODS We investigated 25 cases of cellular neurothekeoma, 8 cases of mixed neurothekeoma and 1 case of nerve sheath myxoma for the expression of SOX-10, MiTF, S100, NKI/C3, Melan-A and smooth muscle actin (SMA) using immunohistochemistry. RESULTS A lack of SOX-10 expression was demonstrated in 100% of cellular and mixed neurothekeomas, but was present in the case of nerve sheath myxoma. More than two thirds of neurothekeomas showed very focal or no reactivity with MiTF. CONCLUSIONS Our data suggest that neurothekeoma and nerve sheath myxoma are unrelated, and that cellular and mixed neurothekeoma may not be of nerve sheath lineage. In addition, MiTF should not be regarded as a useful marker in neurothekeoma.
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Affiliation(s)
- Isabella Fried
- Research Unit Dermatopathology, Department of Dermatology and Venerology, Medical University of Graz, Graz, Austria
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38
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Affiliation(s)
- Byung Wook Kim
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. E-mail:
| | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. E-mail:
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. E-mail:
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. E-mail:
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Rodríguez-Uña I, Troyano-Rivas JA, González-García C, Chícharo-de-Freitas R, Ortiz-Zapata JJ, Ortega-Medina L, Toledano-Fernández N, García-Feijoo J. Orbital nerve seath myxoma with extraocular muscle involvement: a rare case. Semin Ophthalmol 2014; 30:316-20. [PMID: 24475917 DOI: 10.3109/08820538.2013.874471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A 66-year-old woman with breast cancer presented with a painless mass in the left orbit. MRI revealed a well-defined intraconal mass in the temporal quadrant of the orbit. Fifteen months later, a further MRI indicated the mass had grown, displacing the left optic nerve and making contact with the lateral rectus muscle, suggesting its possible intramuscular origin. Despite the clinical and radiological characteristics of the lesion and its slow growth, a PET/CT study was developed because of the history of malignant disease. No metabolic activity of the mass or malignant lesion in other locations was observed. After surgical excision, histopathological examination revealed an abundant myxoid matrix with few spindle-shaped cells and no signs of malignancy. The cells were immunopositive for CD34, positive for S-100 protein, and negative for EMA, actin, and CD57. A diagnosis was made of a nerve sheath myxoma. The orbital location of these tumors is extremely rare.
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Affiliation(s)
- Ignacio Rodríguez-Uña
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC) , Madrid , Spain
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40
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Cribier B, Baran R, Varini JP. [Nerve sheath myxoma of the hyponychium]. Ann Dermatol Venereol 2013; 140:535-9. [PMID: 24034639 DOI: 10.1016/j.annder.2013.04.074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2012] [Revised: 03/04/2013] [Accepted: 04/08/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Nerve sheath myxoma is a rare benign tumour of the extremities that was long confounded with neurothekeoma. Herein, we describe a rare case of interest because of its site on the hyponychium. PATIENTS AND METHODS A 31-year-old woman presented with a painless distal tumour on the right ring finger that had been present for 3 to 4 years. It consisted of a firm, round nodule under the nail and spreading to the fingertip. Complete excision was carried out after cutting away the distal nail plate. Histological examination revealed a myxoid tumour comprising very clearly delineated lobules containing pale fusiform cells with small nuclear inclusions. These cells expressed S100 protein but no CD34 or epithelial membrane antigen (EMA). Complete excision was performed and a full recovery was made. DISCUSSION This type of tumour is characteristic of nerve sheath myxoma, and is almost certainly of Schwannian origin, although distinct from Schwannoma. It is rare, occurs after the age of 35 years and is preferentially located in the extremities of the limbs. There has only been one other description of its occurrence under the fingernail, in which it was described as neurothekeoma. However, neurothekeoma is entirely different, being more cellular, with no expression of protein S100, and marked by the NKIC3 antibody; it occurs in children or young adults, and is frequently found on the face. These two tumours were confused for some time, but today they must be completely distinguished from one another. These myxomas must be completely excised because of the risk of relapse. Finally, they should be distinguished from other myxoid tumours of the digits, certain of which can be malignant.
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Affiliation(s)
- B Cribier
- Clinique dermatologique, faculté de médecine, université de Strasbourg, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67084 Strasbourg cedex, France.
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41
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Akhtar K, Zaheer S, Ray PS, Sherwani RK. Myxoid neurothekeoma: a rare soft tissue tumor of hand in a male toddler. Niger J Surg 2013; 19:32-4. [PMID: 24027416 PMCID: PMC3762041 DOI: 10.4103/1117-6806.111508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Neurothekeomas are rare benign neoplasms, typically occurring in young patients with a remarkable predilection for the female population. Patients usually present with a small nodule in different anatomical sites, commonly involving the face and the upper limb. We report a case of a three-year-old boy, who presented with a nontender nodule on the left thumb. Surgical biopsy and immunostaining confirmed the diagnosis as myxoid neurothekeoma. The rarity of this unusual skin tumor in a toddler prompted the following report.
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Affiliation(s)
- Kafil Akhtar
- Department of Pathology, J. N. Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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42
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A Benign Cutaneous Plexiform Hybrid Tumor of Perineurioma and Cellular Neurothekeoma. Am J Surg Pathol 2013; 37:845-52. [DOI: 10.1097/pas.0b013e31827edfda] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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43
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Rozza-de-Menezes RE, Andrade RM, Israel MS, Gonçalves Cunha KS. Intraoral nerve sheath myxoma: case report and systematic review of the literature. Head Neck 2013; 35:E397-404. [PMID: 23616426 DOI: 10.1002/hed.23361] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 04/10/2013] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Oral nerve sheath myxoma (NSM) is an uncommon benign neoplasm with Schwann-cell origin, which is frequently mistaken for neurothekeoma. We report a case of NSM on the buccal mucosa in a 42-year-old woman. This case is compared with previously reported cases and a systematic review is performed. METHODS AND RESULTS We conducted a case report and systematic review of oral cases considered true NSMs. A literature search was performed using PubMed, Lilacs, Scielo, Cochrane, SciVerse Scopus, Web of Science, and Embase electronic database. Twenty-five cases of oral NSM were included in the systematic review. CONCLUSION Oral NSM is rare and may represent a diagnostic challenge for pathologists. To confirm the diagnosis of NSM, the evaluation of S-100 protein expression or other neural marker is essential. The use of the terms NSM and neurothekeoma as synonymous or as variants of the same tumor should be avoided, because they are clearly distinct lesions.
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Li S, Liu Q, Wang Y, Gu Y, Liu D, Wang C, Ding G, Chen J, Liu J, Gu X. Differential gene expression profiling and biological process analysis in proximal nerve segments after sciatic nerve transection. PLoS One 2013; 8:e57000. [PMID: 23437294 PMCID: PMC3578805 DOI: 10.1371/journal.pone.0057000] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 01/16/2013] [Indexed: 01/28/2023] Open
Abstract
After traumatic injury, peripheral nerves can spontaneously regenerate through highly sophisticated and dynamic processes that are regulated by multiple cellular elements and molecular factors. Despite evidence of morphological changes and of expression changes of a few regulatory genes, global knowledge of gene expression changes and related biological processes during peripheral nerve injury and regeneration is still lacking. Here we aimed to profile global mRNA expression changes in proximal nerve segments of adult rats after sciatic nerve transection. According to DNA microarray analysis, the huge number of genes was differentially expressed at different time points (0.5 h–14 d) post nerve transection, exhibiting multiple distinct temporal expression patterns. The expression changes of several genes were further validated by quantitative real-time RT-PCR analysis. The gene ontology enrichment analysis was performed to decipher the biological processes involving the differentially expressed genes. Collectively, our results highlighted the dynamic change of the important biological processes and the time-dependent expression of key regulatory genes after peripheral nerve injury. Interestingly, we, for the first time, reported the presence of olfactory receptors in sciatic nerves. Hopefully, this study may provide a useful platform for deeply studying peripheral nerve injury and regeneration from a molecular-level perspective.
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Affiliation(s)
- Shiying Li
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, China
| | - Qianqian Liu
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, China
| | - Yongjun Wang
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, China
| | - Yun Gu
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, China
| | - Dong Liu
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, China
| | - Chunming Wang
- School of computer science and technology, Nantong University, Nantong, China
| | - Guohui Ding
- Key Lab of Systems Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Jianping Chen
- School of computer science and technology, Nantong University, Nantong, China
| | - Jie Liu
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, China
| | - Xiaosong Gu
- Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, China
- * E-mail:
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45
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Affiliation(s)
- José Luis Rodríguez-Peralto
- Department of Pathology, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense, Madrid, Spain.
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46
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Yamato M, Ikota H, Hanakita J, Iizuka Y, Nakazato Y. Intradural extramedullary spinal nerve sheath myxoma: a report of two cases. Brain Tumor Pathol 2013; 31:57-61. [DOI: 10.1007/s10014-012-0131-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 12/20/2012] [Indexed: 11/25/2022]
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Abstract
Important advances in fibroblastic and fibrohistiocytic tumors relevant to dermatologists and dermatopathologists include (1) recognition that myxofibrosarcoma is a distinct entity that frequently arises in skin; (2) CD10 is sensitive but not specific atypical fibroxanthoma; (3) neurothekeomas lacking S100 expression are probably fibrohistiocytic/fibroblastic tumors, whereas S100+ myxoid variants are better classified as nerve sheath myxomas; (4) the recognition of a primary cutaneous variant of solitary fibrous tumor; (5) thelimitations of b-catenin immunohistochemistry in desmoid tumors; and (6) the prognostic utility of clinical and histopathologic variables in dermatofibrosarcoma protuberans, and the effects of imatinib mesylate therapy.
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Affiliation(s)
- Loren E Clarke
- Department of Pathology, Penn State Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA.
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48
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Shin J, Vincent JG, Cuda JD, Xu H, Kang S, Kim J, Taube JM. Sox10 is expressed in primary melanocytic neoplasms of various histologies but not in fibrohistiocytic proliferations and histiocytoses. J Am Acad Dermatol 2012; 67:717-26. [PMID: 22325460 DOI: 10.1016/j.jaad.2011.12.035] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 12/20/2011] [Accepted: 12/29/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Sox10 is a transcription factor associated with neural crest development. Its expression has been reported in melanocytes and peripheral nerve sheath cells and their associated tumors. OBJECTIVE To assess Sox10 sensitivity in benign and malignant melanocytic neoplasms of various histologic subtypes and to discern the specificity of Sox10 in distinguishing between melanocytic neoplasms and fibrohistiocytic and histiocytic mimickers. METHODS Sox10 expression was examined by immunohistochemistry in 145 cases of formalin-fixed paraffin-embedded tissue, including benign and malignant melanocytic lesions of various histologies and stages (n = 83), fibrohistiocytic and histiocytic lesions (n = 33), and peripheral nerve sheath tumors (n = 19), among others (n = 10). RESULTS Immunoreactivity with Sox10 was observed in 100% (83/83) of benign and malignant melanocytic lesions of various subtypes, as well as in 100% (19/19) of benign and malignant peripheral nerve sheath lesions. Among the fibrohistiocytic proliferations and histiocytoses examined, Sox10 was negative in all cases (0/33). Sox10 expression did not vary by histologic subtype in nevi or melanoma; however, both the percentage of tumor nuclei demonstrating Sox10 expression and the intensity of expression were inversely correlated with malignant potential (nevi, melanoma in situ, invasive and metastatic melanoma) (P < .001, P = .016, respectively). Malignant peripheral nerve sheath tumors also showed decreased mean Sox10 expression and decreased intensity of expression when compared with benign counterparts (P < .001, P = .021, respectively). LIMITATIONS This is a retrospective study with 145 cases included. CONCLUSIONS Sox10 is a highly sensitive marker for melanocytic proliferations and may be useful diagnostically when the differential diagnosis includes fibrohistiocytic and histiocytic proliferations demonstrating S100 expression.
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MESH Headings
- Biological Specimen Banks
- Biomarkers, Tumor/metabolism
- Biopsy
- Carcinoma, Basal Cell/metabolism
- Carcinoma, Basal Cell/pathology
- Diagnosis, Differential
- Histiocytoma, Malignant Fibrous/metabolism
- Histiocytoma, Malignant Fibrous/pathology
- Histiocytosis/metabolism
- Histiocytosis/pathology
- Humans
- Immunohistochemistry
- Lichenoid Eruptions/metabolism
- Lichenoid Eruptions/pathology
- Melanocytes/metabolism
- Melanocytes/pathology
- Melanoma/metabolism
- Melanoma/pathology
- Neoplasms, Adnexal and Skin Appendage/metabolism
- Neoplasms, Adnexal and Skin Appendage/pathology
- Nerve Sheath Neoplasms/metabolism
- Nerve Sheath Neoplasms/pathology
- Nevus, Pigmented/metabolism
- Nevus, Pigmented/pathology
- Retrospective Studies
- SOXE Transcription Factors/metabolism
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
- Vitiligo/metabolism
- Vitiligo/pathology
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Affiliation(s)
- Jeonghyun Shin
- Department of Dermatology, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA
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Rawal YB, Mustiful-Martin D, Rosebush MS, Anderson KM, Mincer HH. Slow-growing gingival mass. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:161-7. [DOI: 10.1016/j.tripleo.2011.07.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 07/14/2011] [Accepted: 07/30/2011] [Indexed: 11/30/2022]
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Ossifying fibromyxoid tumor of soft parts: a clinicopathologic, proteomic, and genomic study. Am J Surg Pathol 2011; 35:1615-25. [PMID: 21997683 DOI: 10.1097/pas.0b013e3182284a3f] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Ossifying fibromyxoid tumor (OFMTs) of soft parts is a rare soft tissue and bone tumor of borderline malignancy displaying an uncertain line of differentiation. The existence of fully malignant OFMT is controversial. To better understand the natural history and line of differentiation taken by OFMT, we studied 46 cases by light microscopic, immunohistochemical (IHC), genomic, proteomic, and fluorescence in situ hybridization (FISH) methods. Cases were classified according to the 2003 Folpe and Weiss system. Clinical and follow-up information was obtained. IHC for S-100 protein, desmin, epithelial membrane antigen (EMA), cytokeratins, smooth muscle actin (SMA), INI-1, neurofilament protein (NFP), CD56d excitatory amino acid transporter-4 (EAAT4), and MUC4 was performed on formalin-fixed, paraffin-embedded (FFPE) tissues. Gene expression profiling and proteomic studies were conducted on FFPE tissues from 13 and 5 cases, respectively. FISH for INI-1 was performed on 10 cases. The 46 tumors arose in 29 men and 17 women (median age, 52 y; range 39 to 63 y) and involved the proximal (N=17) and distal extremities (N=13), head and neck (N=9), and trunk (N=5). Median tumor size was 5.4 cm (range, 1.0 to 21.0 cm). Cases were classified as typical OFMT (26 of 46, 57%), atypical OFMT (5 of 46, 11%), and malignant OFMT (15 of 46 cases, 32%). Clinical follow-up (27 cases, median 55 months' duration) showed all patients with typical and atypical OFMT to be alive without disease. Adverse events, including 3 local recurrences, 3 metastases, and 3 deaths, were seen only in malignant OFMT. IHC results were as follows: S-100 protein (30 of 41, 73%), desmin (15 of 39, 38%), cytokeratin (4 of 35, 11%), EMA (5 of 32, 16%), SMA (2 of 34, 6%), INI-1 (lost in mosaic pattern in 14 of 19, 74%), EAAT4 (31 of 39, 80%), MUC4 (3 of 14, 21%), NFP (8 of 10, 80%) and CD56 (6 of 14, 43%). Gene expression profiling showed typical and malignant OFMTs to cluster together, distinct from schwannian tumors. Proteomic study showed expression of various collagens, S-100 protein, and neuron-related proteins. FISH showed INI-1 deletion in 5 of 7 (71%) cases. We conclude that malignant OFMTs exist and may be recognized by the previously proposed criteria of Folpe and Weiss. Expression of neuron-related markers, in addition to Schwann cell and cartilage-associated markers, suggests a "scrambled" phenotype in OFMTs. Loss of INI-1 or other genes on 22q is likely important in the pathogenesis of these rare tumors.
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