Wilson Andrew D H, Rigby Howard, Orlando Antonio
Department of Plastic Surgery, Frenchay Hospital, Frenchay Park Road, Frenchay, Bristol BS16 1LE, UK.
J Plast Reconstr Aesthet Surg. 2008;61(2):186-8. doi: 10.1016/j.bjps.2007.01.078. Epub 2007 Aug 20.
We present a rare case of atypical cellular neurothekeoma arising in the area of a previous nose piercing on the ala of a 34-year-old female. Neurothekeoma is a benign tumour of probable nerve sheath origin. The cell of origin for neurothekeoma is still unknown but most ultrastructural and immunohistochemical studies have favoured the Schwann cell perineurium or fibroblasts. A similar but distinct, more cellular variant with a less prominent myxoid component, was termed cellular neurothekeoma and, unlike myxoid neurothekeoma, the cellular variety generally lacks immunoreactivity to most neuronal markers. Atypical cellular neurothekeoma is characterised by the following features: large size of up to 6 cm, penetration into subcutaneous fat and or muscle, diffusely infiltrating borders, vascular invasion, a high mitotic rate and marked cytological pleomorphism. In this report we provide a review of the relevant literature and describe the clinical, histological and immunohistochemical features of an atypical cellular neurothekeoma excised from the ala nasi of a 34-year-old female, a hitherto unreported lesion in the plastic surgery literature.
我们报告一例罕见的非典型细胞性神经鞘黏液瘤，发生于一名34岁女性鼻翼先前穿鼻环的部位。神经鞘黏液瘤是一种可能起源于神经鞘的良性肿瘤。神经鞘黏液瘤的起源细胞尚不清楚，但大多数超微结构和免疫组织化学研究支持其起源于雪旺细胞、神经束膜细胞或成纤维细胞。一种类似但不同的、细胞成分更多且黏液样成分不那么突出的变体被称为细胞性神经鞘黏液瘤，与黏液样神经鞘黏液瘤不同，细胞性变体通常对大多数神经元标志物缺乏免疫反应性。非典型细胞性神经鞘黏液瘤具有以下特征：大小可达6 cm，可侵犯皮下脂肪和/或肌肉，边界弥漫性浸润，血管侵犯，高有丝分裂率以及明显的细胞多形性。在本报告中，我们回顾了相关文献，并描述了从一名34岁女性鼻翼切除的非典型细胞性神经鞘黏液瘤的临床、组织学和免疫组织化学特征，这是整形外科学文献中迄今未报道的病变。
