Epithelioid schwannoma of the skin displaying unique histopathological features: a teaching case giving rise to diagnostic difficulties on a morphological examination of a resected specimen, with a brief literature review
Identifieur interne : 000586 ( Main/Exploration ); précédent : 000585; suivant : 000587Epithelioid schwannoma of the skin displaying unique histopathological features: a teaching case giving rise to diagnostic difficulties on a morphological examination of a resected specimen, with a brief literature review
Auteurs : Sohsuke Yamada [Japon] ; Mari Kirishima [Japon] ; Tsubasa Hiraki [Japon] ; Michiyo Higashi [Japon] ; Kazuhito Hatanaka [Japon] ; Akihide Tanimoto [Japon]Source :
- Diagnostic Pathology [ 1746-1596 ] ; 2017.
Abstract
Epithelioid schwannoma as a rare variant poses a challenge to all pathologists, as this uncommon entity is extremely difficult to conclusively diagnose by morphological analyses on a resected sample alone owing to its unique histopathological features. However, few papers have described the detailed clinicopathological characteristics of epithelioid schwannoma.
A 65-year-old female presented with a history of a flat and slightly elevated firm and tan plaque accompanied by occasional tenderness, measuring 10 × 8 mm, in the right joint of her hand 1 year before resection. A gross examination of a locally resected specimen revealed an encapsulated nodular lesion, yellow-whitish in color, partly filled with blood. A microscopic examination showed that the tumor predominantly consisted of a solid proliferation of epithelioid cells having mildly enlarged and round to partially spindled nuclei and abundant vacuolated or clear cytoplasm with very few mitotic figures and modest nuclear size variation, associated with focal hyalinized, cystic and hemorrhagic degeneration. This well-demarcated tumor was surrounded by dense, hyalinized and layered fibrocollagenous stroma. Immunohistochemically, these tumor cells were diffusely positive for S-100 protein and had a very low MIB-1 labeling index, and type IV collagen was strongly reactive with reduplicated basal lamina of them. We ultimately made a diagnosis of cutaneous epithelioid schwannoma.
We should be aware that, since pathologists might misinterpret epithelioid schwannoma as other soft tissue tumors, including its malignant counterpart, a wide panel of immunohistochemical antibodies can be powerful supplementary tools for identifying a very rare entity of conventional schwannoma.
Url:
DOI: 10.1186/s13000-017-0604-9
PubMed: 28103910
PubMed Central: 5248503
Affiliations:
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specimen, with a brief literature review</title><author><name sortKey="Yamada, Sohsuke" sort="Yamada, Sohsuke" uniqKey="Yamada S" first="Sohsuke" last="Yamada">Sohsuke Yamada</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1167 1801</institution-id><institution-id institution-id-type="GRID">grid.258333.c</institution-id><institution>Department of Pathology, Field of Oncology, Graduate School of Medical and Dental Sciences,</institution><institution>Kagoshima University,</institution></institution-wrap>8-35-1 Sakuragaoka, Kagoshima, 890-8544 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>8-35-1 Sakuragaoka, Kagoshima</wicri:regionArea><wicri:noRegion>Kagoshima</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="ISNI">0000 0004 0377 8088</institution-id><institution-id 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8088</institution-id><institution-id institution-id-type="GRID">grid.411988.d</institution-id><institution>Department of Pathology,</institution><institution>Kagoshima University Hospital,</institution></institution-wrap>Kagoshima, 890-8544 Japan</nlm:aff><country xml:lang="fr">Japon</country><wicri:regionArea>Kagoshima</wicri:regionArea></affiliation></author><author><name sortKey="Hatanaka, Kazuhito" sort="Hatanaka, Kazuhito" uniqKey="Hatanaka K" first="Kazuhito" last="Hatanaka">Kazuhito Hatanaka</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="ISNI">0000 0001 1167 1801</institution-id><institution-id institution-id-type="GRID">grid.258333.c</institution-id><institution>Department of Pathology, Field of Oncology, Graduate School of Medical and Dental Sciences,</institution><institution>Kagoshima University,</institution></institution-wrap>8-35-1 Sakuragaoka, Kagoshima, 890-8544 Japan</nlm:aff><country 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unique histopathological features. However, few papers have described the detailed clinicopathological characteristics of epithelioid schwannoma.</p></sec><sec><title>Case presentation</title><p>A 65-year-old female presented with a history of a flat and slightly elevated firm and tan plaque accompanied by occasional tenderness, measuring 10 × 8 mm, in the right joint of her hand 1 year before resection. A gross examination of a locally resected specimen revealed an encapsulated nodular lesion, yellow-whitish in color, partly filled with blood. A microscopic examination showed that the tumor predominantly consisted of a solid proliferation of epithelioid cells having mildly enlarged and round to partially spindled nuclei and abundant vacuolated or clear cytoplasm with very few mitotic figures and modest nuclear size variation, associated with focal hyalinized, cystic and hemorrhagic degeneration. This well-demarcated tumor was surrounded by dense, hyalinized and layered fibrocollagenous stroma. Immunohistochemically, these tumor cells were diffusely positive for S-100 protein and had a very low MIB-1 labeling index, and type IV collagen was strongly reactive with reduplicated basal lamina of them. We ultimately made a diagnosis of cutaneous epithelioid schwannoma.</p></sec><sec><title>Conclusion</title><p>We should be aware that, since pathologists might misinterpret epithelioid schwannoma as other soft tissue tumors, including its malignant counterpart, a wide panel of immunohistochemical antibodies can be powerful supplementary tools for identifying a very rare entity of conventional schwannoma.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Laskin, Wb" uniqKey="Laskin W">WB Laskin</name></author><author><name sortKey="Fetsch, Jf" uniqKey="Fetsch J">JF Fetsch</name></author><author><name sortKey="Lasota, J" uniqKey="Lasota J">J Lasota</name></author><author><name sortKey="Miettinen, M" uniqKey="Miettinen M">M Miettinen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hart, J" uniqKey="Hart J">J Hart</name></author><author><name sortKey="Gardner, Jm" uniqKey="Gardner J">JM Gardner</name></author><author><name sortKey="Edgar, M" uniqKey="Edgar M">M Edgar</name></author><author><name sortKey="Weiss, Sw" uniqKey="Weiss S">SW Weiss</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Orosz, Z" uniqKey="Orosz Z">Z Orosz</name></author><author><name sortKey="Sapi, Z" uniqKey="Sapi Z">Z Sápi</name></author><author><name sortKey="Szentirmay, Z" uniqKey="Szentirmay Z">Z Szentirmay</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kindblom, Lg" uniqKey="Kindblom L">LG Kindblom</name></author><author><name sortKey="Meis Kindblom, Jm" uniqKey="Meis Kindblom J">JM Meis-Kindblom</name></author><author><name sortKey="Havel, G" uniqKey="Havel G">G Havel</name></author><author><name sortKey="Busch, C" uniqKey="Busch C">C Busch</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamada, S" uniqKey="Yamada S">S Yamada</name></author><author><name sortKey="Guo, X" uniqKey="Guo X">X Guo</name></author><author><name sortKey="Yoshizawa, M" uniqKey="Yoshizawa M">M Yoshizawa</name></author><author><name sortKey="Li, Z" uniqKey="Li Z">Z Li</name></author><author><name sortKey="Matsuyama, A" uniqKey="Matsuyama A">A Matsuyama</name></author><author><name sortKey="Hashimoto, H" uniqKey="Hashimoto H">H Hashimoto</name></author><author><name sortKey="Sasaguri, Y" uniqKey="Sasaguri Y">Y Sasaguri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamada, S" uniqKey="Yamada S">S Yamada</name></author><author><name sortKey="Noguchi, H" uniqKey="Noguchi H">H Noguchi</name></author><author><name sortKey="Nabeshima, A" uniqKey="Nabeshima A">A Nabeshima</name></author><author><name sortKey="Tasaki, T" uniqKey="Tasaki T">T Tasaki</name></author><author><name sortKey="Kitada, S" uniqKey="Kitada S">S Kitada</name></author><author><name sortKey="Guo, X" uniqKey="Guo X">X Guo</name></author><author><name sortKey="Takama, T" uniqKey="Takama T">T Takama</name></author><author><name sortKey="So, K" uniqKey="So K">K So</name></author><author><name sortKey="Sasaguri, Y" uniqKey="Sasaguri Y">Y Sasaguri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamada, S" uniqKey="Yamada S">S Yamada</name></author><author><name sortKey="Yamada, Y" uniqKey="Yamada Y">Y Yamada</name></author><author><name sortKey="Kobayashi, M" uniqKey="Kobayashi M">M Kobayashi</name></author><author><name sortKey="Hino, R" uniqKey="Hino R">R Hino</name></author><author><name sortKey="Nawata, A" uniqKey="Nawata A">A Nawata</name></author><author><name sortKey="Noguchi, H" uniqKey="Noguchi H">H Noguchi</name></author><author><name sortKey="Nakamura, M" uniqKey="Nakamura M">M Nakamura</name></author><author><name sortKey="Nakayama, T" uniqKey="Nakayama T">T Nakayama</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Yamada, S" uniqKey="Yamada S">S Yamada</name></author><author><name sortKey="Harada, Y" uniqKey="Harada Y">Y Harada</name></author><author><name sortKey="Noguchi, H" uniqKey="Noguchi H">H Noguchi</name></author><author><name sortKey="Satoh, N" uniqKey="Satoh N">N Satoh</name></author><author><name sortKey="Kimura, S" uniqKey="Kimura S">S Kimura</name></author><author><name sortKey="Nakayama, T" uniqKey="Nakayama T">T Nakayama</name></author><author><name sortKey="Tanimoto, A" uniqKey="Tanimoto A">A Tanimoto</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Japon</li></country></list><tree><country name="Japon"><noRegion><name sortKey="Yamada, Sohsuke" sort="Yamada, Sohsuke" uniqKey="Yamada S" first="Sohsuke" last="Yamada">Sohsuke Yamada</name></noRegion><name sortKey="Hatanaka, Kazuhito" sort="Hatanaka, Kazuhito" uniqKey="Hatanaka K" first="Kazuhito" last="Hatanaka">Kazuhito Hatanaka</name><name sortKey="Higashi, Michiyo" sort="Higashi, Michiyo" uniqKey="Higashi M" first="Michiyo" last="Higashi">Michiyo Higashi</name><name sortKey="Hiraki, Tsubasa" sort="Hiraki, Tsubasa" uniqKey="Hiraki T" first="Tsubasa" last="Hiraki">Tsubasa Hiraki</name><name sortKey="Kirishima, Mari" sort="Kirishima, Mari" uniqKey="Kirishima M" first="Mari" last="Kirishima">Mari Kirishima</name><name sortKey="Tanimoto, Akihide" sort="Tanimoto, Akihide" uniqKey="Tanimoto A" first="Akihide" last="Tanimoto">Akihide Tanimoto</name><name sortKey="Tanimoto, Akihide" sort="Tanimoto, Akihide" uniqKey="Tanimoto A" first="Akihide" last="Tanimoto">Akihide Tanimoto</name><name sortKey="Yamada, Sohsuke" sort="Yamada, Sohsuke" uniqKey="Yamada S" first="Sohsuke" last="Yamada">Sohsuke Yamada</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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