Font R L, Truong L D
Am J Surg Pathol. 1984 Feb;8(2):129-38. doi: 10.1097/00000478-198402000-00007.
This is a report of an unusual case of melanotic schwannoma located in the soft tissue of the shoulder. By light microscopy, the partially pigmented, encapsulated mass showed tumor lobules displaying an organoid pattern and benign cytologic features. By electron microscopy, the tumor cells disclosed numerous interdigitating blunt cytoplasmic processes invested by a thin, continuous basal lamina with formation of mesaxons and moderate amount of glycogen as well as immature and mature melanosomes. The patient was reported to be alive and well 7 years after local excision of the mass. We also reviewed 21 additional cases from the literature. The most frequent sites of involvement were: the spinal nerve roots and adjacent structures (12 cases), soft tissues (five cases), heart (one case), esophageal wall (one case), acoustic nerve (one case), and mandible (one case). Twelve patients were alive and well (follow-up periods ranging from 9 months to 13 years after surgical resection), and one died of surgical complications. Eight patients were lost to follow-up. Three patients had local recurrences due to incomplete excision of the mass. Ten tumors were studied electron microscopically and displayed characteristic features of both Schwann cells and melanocytes. This unique dual differentiation probably reflects their common ancestry from neural crest cells.
这是一篇关于肩部软组织黑色素性施万瘤罕见病例的报告。光镜下，部分色素沉着的包膜肿块显示出呈器官样结构和良性细胞学特征的肿瘤小叶。电镜下，肿瘤细胞可见许多相互交错的钝圆细胞质突起，被一层薄的连续基膜包绕，形成轴索，还有适量糖原以及未成熟和成熟的黑素小体。据报道，该患者在肿块局部切除7年后仍存活且状况良好。我们还复习了文献中另外21例病例。最常受累的部位有：脊神经根及相邻结构（12例）、软组织（5例）、心脏（1例）、食管壁（1例）、听神经（1例）和下颌骨（1例）。12例患者存活且状况良好（手术切除后随访时间为9个月至13年），1例死于手术并发症。8例患者失访。3例患者因肿块切除不完全出现局部复发。对10个肿瘤进行了电镜研究，显示出施万细胞和黑素细胞的特征。这种独特的双重分化可能反映了它们源自神经嵴细胞的共同起源。
