Perineurial Cells and Nerve Axons inGastrointestinal Schwannomas: a Similaritywith Neurofibromas.An Immunohistochemical Study of Eight Cases
Perineuriálne bunky a nervové axóny v gastrointestinálnych schwannómoch:podobnost s neurofibrómom. Imunohistochemická štúdia 8 prípadov
Schwannóm gastrointestinálneho traktu je osobitná jednotka s odlišnostami od konvenčnéhoschwannómu a s niekoľkými rysmi podobnými neurofibrómu. Neurofibróm a schwannómmäkkých tkanív sa líšia obsahom rôznych typov „nerve sheath“ buniek (Schwannove bunky,perineuriálne bunky, CD34+ bunky). Za účelom porovnania s týmito léziami mäkkých tkanív bolaštudovaná zostava 8 gastrointestinálnych schwannómov. Ako perineuriálne markery boli použitéprotilátky proti epitelovému membránovému antigénu (EMA) a klaudínu-1. Na znázornenie intratumorálnychaxónov sa použila protilátka proti neurofilamentovému proteinu. Dalšie použitéprotilátky boli: S100-protein, CD34, pancytokeratín, špecifický hladkosvalový aktín a CD117 (CKIT).Bunky pozitívne na EMA a klaudín-1 boli nájdené v 2 (25%) respektíve 1 tumore. Axóny bolizretelné v 4 (50%) léziach. CD34+ bunky boli v 6 tumoroch (75%) a casto boli rozložené difúzne (niezonálne ako v schwannómoch mäkkých tkanív). Uvedené nálezy ukazujú, že gastrointestinálnyschwannóm má často celulárnu kompozíciu bližšiu neurofibrómu ako konvenčnému schwannómu.V bioptickej praxi pozitivity EMA, klaudínu-1 a nález axónov nevylučujú diagnózu gastrointestinálnehoschwannómu.
Klíčová slova:
gastrointestinálny schwannóm – neurofibróm – perineurálna bunka – axón – imunohistochémia
Authors:
M. Zámečník 1; P. Mukenšnabl 1; L. Sokol 2; M. Michal 1
Authors place of work:
Šikl’s Department of Pathology, Charles University, Pilsen, Czech Republic 2Department of Pathology, Faculty Hospital, Šafárik University, Košice, Slovak Republic
1
Published in the journal:
Čes.-slov. Patol., , 2004, No. 4, p. 150-153
Category:
Summary
Gastrointestinal schwannoma (GIS) is a distinctive and extremely rare lesion showing some differencesfrom conventional soft tissue schwannoma and some similarities with common soft tissueneurofibroma. Soft tissue neurofibromas and schwannomas differ by contents of specific types ofnerve sheath cells, such as Schwann cells, perineurial cells and CD34+ cells. To compare GIS withthese soft tissue lesions, eight cases of typical GIS were studied immunohistochemically to evaluatetheir nerve sheath cell types. Epithelial membrane antigen (EMA) and claudin-1 as perineurialcell markers, and neurofilament protein as a marker for intratumoral axons were used. In addition,the tumors were stained for cytokeratin, CD117 (C-KIT), alpha-muscle specific actin, S100protein and CD34. EMA- and claudin-positive cells were seen in 2 (25%) and one lesion, respectively,thus resembling cellular composition of neurofibroma. Intratumoral neurofilament proteinpositive axons otherwise typical of neurofibroma were found inside 4 tumors (50%). CD34 positivitywas found in 6 tumors (75%) and often revealed a diffuse pattern as seen in neurofibroma andnot a zonal pattern as described in schwannomas. These results show that GIS has some featuresthat are more typical for neurofibroma than for conventional schwannoma. In surgical pathologypractice, a finding of intratumoral axons and positivity for claudin-1 and especially for EMAshould not preclude diagnosis of GIS.
Key words:
gastrointestinal schwannoma – neurofibroma – perineurial cell – nerve axon – immunohistochemistry
Štítky
Anatomical pathology Forensic medical examiner ToxicologyČlánok vyšiel v časopise
Czecho-Slovak Pathology
2004 Číslo 4
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