Ferro de Beça Francisco, Lopes Joanne, Maçoas Fernanda, Carneiro Fátima, Lopes José Manuel
IPATIMUP, Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal Faculty of Medicine, University of Porto, Porto, Portugal Centro Hospitalar de São João, Porto, Portugal.
Centro Hospitalar de São João, Porto, Portugal.
Int J Surg Pathol. 2014 Aug;22(5):438-41. doi: 10.1177/1066896913501384. Epub 2013 Aug 30.
Mesenchymal colorectal polyps are uncommon lesions, particularly those of neurogenic origin. We describe a mucosal Schwann cell hamartoma of the colon with tactoid features, so far reported in peripheral nerve sheath tumours, and address its differential diagnosis and clinical implications.
A 72-year-old man underwent screening colonoscopy that presented a 5-mm polyp on distal sigmoid. Histologically, it displayed a lesion in the lamina propria comprising oval structures with tactoid features and bland spindle cells, entrapping adjacent crypts. No ganglion cells were seen. Spindle cells expressed only S-100 protein and vimentin.
Mucosal Schwann cell hamartoma was recently recognized as distinct from common (submucosal) colorectal Schwannomas and so far not associated to inherited syndromes. Thus, it should be considered in the differential diagnosis of look-alike lesions (eg, ganglioneuroma, neuroma, and neurofibroma) that may occur in the setting of inherited syndromes such as Cowden syndrome, multiple endocrine neoplasia-2B, and type 1 neurofibromatosis.
间质性结直肠息肉是罕见病变，尤其是神经源性起源的。我们描述了一例具有触觉小体特征的结肠黏膜施万细胞错构瘤，这种特征迄今仅在外周神经鞘瘤中报道过，并探讨其鉴别诊断及临床意义。
一名72岁男性接受结肠镜筛查，在乙状结肠远端发现一个5毫米的息肉。组织学检查显示，固有层有一病变，由具有触觉小体特征的椭圆形结构和温和的梭形细胞组成，包绕相邻隐窝。未见神经节细胞。梭形细胞仅表达S-100蛋白和波形蛋白。
黏膜施万细胞错构瘤最近被认为不同于常见的（黏膜下）结直肠施万瘤，且迄今未发现与遗传性综合征相关。因此，在鉴别诊断可能发生于考登综合征、多发性内分泌肿瘤2B型和1型神经纤维瘤病等遗传性综合征背景下的相似病变（如神经节瘤、神经瘤和神经纤维瘤）时，应考虑到该病。
