Ohata Chika, Imai Naho, Hinogami Haruna, Akamatsu Kana, Sumimura Yukiko
Department of Dermatology, Ikeda Municipal Hospital, Jonan, Ikeda, Osaka, Japan.
J Cutan Pathol. 2012 Jan;39(1):56-62. doi: 10.1111/j.1600-0560.2011.01805.x. Epub 2011 Nov 12.
Hybrid schwannoma/perineurioma represents a recently characterized dermal or subdermal tumor showing schwannian cytomorphology and a perineurioma-like architecture composed of an admixture of both cell types. We report two additional cases of hybrid schwannoma/ perineurioma, one of which occurred after irradiation. Patient 1 was that of a 33-year-old man presented with a 2.8-cm dermal tumor on his left lower leg. Patient 2 was that of an 89-year-old woman with a history of uterine carcinoma treated by surgery and radiation therapy at the age of 35. She presented with a 1.2 × 1.0 cm dermal tumor on her left mons pubis with multiple coincidental basal-cell carcinomas around it. Both tumors were microscopically well circumscribed but unencapsulated and situated in the dermis and adipose tissue and showed a vague storiform and lamellar pattern. Cytologically, both tumors contained two-cell populations, i.e. spindled cells with plump nuclei, which were positive for S-100 protein and negative for epithelial membrane antigen (EMA), claudin-1 and CD34, as well as cells with very slender nuclei and elongated cytoplasmic processes, which were negative for S-100 protein yet expressed EMA, claudin-1 and CD34. Claudin-1 was a better marker to highlight cells with very slender nuclei than EMA. Both tumors lacked expression of neurofilament.
混合型神经鞘瘤/神经束膜瘤是一种最近才被描述的真皮或皮下肿瘤，具有神经鞘细胞的细胞形态学特征，以及由两种细胞类型混合组成的神经束膜瘤样结构。我们报告另外两例混合型神经鞘瘤/神经束膜瘤，其中一例发生于放疗后。病例1为一名33岁男性，左小腿出现一个2.8厘米的真皮肿瘤。病例2为一名89岁女性，35岁时因子宫癌接受手术及放疗。她左耻骨结节处出现一个1.2×1.0厘米的真皮肿瘤，周围伴有多个基底细胞癌。两个肿瘤在显微镜下边界清晰，但无包膜，位于真皮和脂肪组织中，呈现模糊的束状和层状结构。细胞学上，两个肿瘤均包含两种细胞群，即核饱满的梭形细胞，S-100蛋白阳性，上皮膜抗原（EMA）、claudin-1和CD34阴性；以及核非常细长、胞质突起细长的细胞，S-100蛋白阴性，但表达EMA、claudin-1和CD34。与EMA相比，claudin-1是突出核非常细长细胞的更好标记物。两个肿瘤均缺乏神经丝表达。
