Brooks J J, Draffen R M
Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical School, Philadelphia.
Arch Pathol Lab Med. 1992 Feb;116(2):192-5.
The vast majority of reported glandular schwannomas, the rarest type of divergent differentiation in nerve sheath neoplasms, have been malignant tumors. We describe a benign glandular schwannoma, less than 1 cm in diameter, that developed in the deep subcutaneous region of the left flank of a 36-year-old woman. The glandular component occurred as a single large cyst with an undulating lining occupying the central one third of the lesion and was lined in large part by a well-oriented, flattened, single cell layer of cuboidal to low columnar cells with a basement membrane. This extremely unusual lesion, apparently the fourth benign instance reported, is important for several reasons: (1) it does not appear to be a result of inclusion of previously postulated dermal adnexal glands; (2) it further establishes the existence of a true benign counterpart of the glandular schwannoma, of which pathologists should be aware; (3) it can be distinguished from the recently reported pseudoglandular schwannoma; and (4) it lends additional support to the concept of a direct metaplastic origin of the epithelial element from the schwannian component because of the focal presence of a maloriented pseudoglandular element.
在已报道的腺性神经鞘瘤(神经鞘肿瘤中最罕见的一种分化类型)中,绝大多数都是恶性肿瘤。我们描述了一例直径小于1厘米的良性腺性神经鞘瘤,它发生在一名36岁女性左侧腰部的皮下深部区域。腺性成分表现为单个大囊肿,其起伏的内衬占据病变中央三分之一,大部分内衬为排列良好、扁平的单层立方至低柱状细胞,并伴有基底膜。这个极其罕见的病变显然是第四例被报道的良性病例,因其以下几个原因而具有重要意义:(1)它似乎并非如先前推测的那样是由于皮肤附属器腺体包埋所致;(2)它进一步证实了腺性神经鞘瘤存在真正的良性对应物,病理学家应予以关注;(3)它可与最近报道的假腺性神经鞘瘤相鉴别;(4)由于存在局部排列紊乱的假腺性成分,它为上皮成分直接由雪旺氏成分化生而来这一概念提供了额外支持。