Hamazaki Shuji, Fujiwara Kazuo, Okada Shigeru
Department of Pathology, Okayama University Hospital, Okayama, Japan.
Pathol Int. 2004 May;54(5):371-5. doi: 10.1111/j.1440-1827.2004.01634.x.
Intraneural perineurioma is a rare peripheral nerve sheath tumor consisting of intraneural proliferation of neoplastic perineurial cells. Clinical and pathological findings of a perineurioma involving the ulnar nerve is presented. A 7-year-old girl presented with a 2 year history of weakness and atrophy of the right hand muscles. Physical examination and imaging study revealed a pea-sized tumor in the ulnar side of the right forearm. At surgery, a fusiform swelling of the ulnar nerve was found and an excisional biopsy of the lesion was performed. Light microscopy revealed numerous whorls consisting of concentric layers of spindle cells encircling the nerve fibers. The proliferating cells were immunoreactive for vimentin, epithelial membrane antigen and glucose transporter protein 1 (Glut1), but negative for S-100 protein and CD34. Ultrastructural examination revealed features of perineurial cell differentiation. The current study suggests that Glut1 is a useful marker of intraneural perineurioma.
神经内神经束膜瘤是一种罕见的周围神经鞘瘤,由肿瘤性神经束膜细胞在神经内增殖形成。本文报告了一例累及尺神经的神经束膜瘤的临床及病理表现。一名7岁女孩,有右手肌肉无力和萎缩2年的病史。体格检查和影像学检查发现右前臂尺侧有一个豌豆大小的肿瘤。手术中,发现尺神经呈梭形肿胀,并对病变进行了切除活检。光镜检查显示有许多由围绕神经纤维的同心层梭形细胞组成的漩涡。增殖细胞波形蛋白、上皮膜抗原和葡萄糖转运蛋白1(Glut1)免疫反应阳性,但S-100蛋白和CD34免疫反应阴性。超微结构检查显示神经束膜细胞分化的特征。本研究提示Glut1是神经内神经束膜瘤的一个有用标志物。