Chauvin P J, Wysocki G P, Daley T D, Pringle G A
Department of Pathology, University of Western Ontario, London, Canada.
Oral Surg Oral Med Oral Pathol. 1992 Jan;73(1):71-4. doi: 10.1016/0030-4220(92)90158-m.
The palisaded encapsulated neuroma is a solitary, small peripheral nerve lesion that occurs primarily on the facial skin of middle-aged adults. We report a series of 13 cases of palisaded encapsulated neuroma occurring on oral mucosa. The lesions presented as solitary, firm, sessile, partly or completely encapsulated, 2 to 3 mm nodules in adults with a mean age of 51 years (median 55 years). Nine of the neuromas occurred on the hard palate; the remainder were found on the soft palate, lower lip mucosa, upper lip mucosa, and maxillary anterior alveolar ridge. None of the cases was associated with neurofibromatosis or multiple endocrine neoplasia syndrome type III. Microscopically, the tumors were characterized by a moderately cellular, fascicular proliferation of spindle cells that showed some areas of nuclear palisading, suggestive of schwannoma. Immunohistochemical stains revealed that the lesions were composed largely of S-100 protein-positive Schwann cells and variable numbers of peripheral nerve axons, which were identified by their positive neurofilament staining. The fibrous capsule of the lesions showed positive staining for epithelial membrane antigen, indicative of perineurium.
栅栏状包膜神经瘤是一种孤立的、小的周围神经病变，主要发生于中年成年人的面部皮肤。我们报告了一系列13例发生于口腔黏膜的栅栏状包膜神经瘤。这些病变表现为孤立的、质地硬、无蒂、部分或完全包膜的2至3毫米结节，患者为成年人，平均年龄51岁（中位数55岁）。其中9例神经瘤发生于硬腭；其余的则见于软腭、下唇黏膜、上唇黏膜和上颌前牙槽嵴。所有病例均与神经纤维瘤病或III型多发性内分泌肿瘤综合征无关。显微镜下，肿瘤的特征为梭形细胞呈中等细胞密度的束状增生，部分区域可见核栅栏状排列，提示为神经鞘瘤。免疫组织化学染色显示，病变主要由S-100蛋白阳性的施万细胞和数量不等的周围神经轴突组成，后者通过神经丝染色阳性得以识别。病变的纤维包膜上皮膜抗原染色阳性，提示为神经束膜。
