Erlandson R A, Woodruff J M
Cancer. 1982 Jan 15;49(2):273-87. doi: 10.1002/1097-0142(19820115)49:2<273::aid-cncr2820490213>3.0.co;2-r.
To obtain data concerning their histogenesis, 23 benign solitary schwannomas (including five cellular variants), 10 neurofibromas, and 10 malignant peripheral nerve sheath tumors were studied by electron microscopy. The results confirm previous findings that solitary schwannomas (so-called neurilemomas) are composed principally of cells showing features of differentiated Schwann cells. The principal cells of neurofibromas on the other hand did not resemble differentiated Schwann cells. The predominant cell type in six cases was indistinguishable from normal perineurial cells. Schwann cell-axon complexes seen in three cases may have represented entrapped normal structures or perhaps one component of a hamartomatous tumor. In contrast to the benign neoplasms the cells of the ten malignant peripheral nerve sheath tumors were in general poorly differentiated. When differentiated, they shared some features with Schwann and perineurial cells. Cell forms intermediate between them and fibroblastic cells were also identified. These findings indicate that schwannoma and neurofibroma are distinct entities. In the authors' experience schwannomas rarely undergo malignant change. For this reason and because it is unclear whether malignant tumors of peripheral nerves arise from more than one sheath cell, the designation of malignant peripheral nerve sheath tumor (PNST) is preferable to malignant schwannoma.
为获取有关其组织发生的数据，我们通过电子显微镜研究了23例良性孤立性神经鞘瘤（包括5例细胞型变体）、10例神经纤维瘤和10例恶性外周神经鞘瘤。结果证实了先前的发现，即孤立性神经鞘瘤（所谓的神经鞘瘤）主要由表现出分化型施万细胞特征的细胞组成。另一方面，神经纤维瘤的主要细胞与分化型施万细胞不同。6例中的主要细胞类型与正常神经束膜细胞难以区分。3例中见到的施万细胞 - 轴突复合体可能代表被困的正常结构，或者可能是错构瘤的一个组成部分。与良性肿瘤相反，10例恶性外周神经鞘瘤的细胞总体上分化较差。当分化时，它们与施万细胞和神经束膜细胞有一些共同特征。还鉴定出了介于它们和成纤维细胞之间的细胞形态。这些发现表明神经鞘瘤和神经纤维瘤是不同的实体。根据作者的经验，神经鞘瘤很少发生恶变。出于这个原因，并且由于尚不清楚外周神经的恶性肿瘤是否起源于不止一种鞘细胞，因此恶性外周神经鞘瘤（PNST）的命名比恶性神经鞘瘤更可取。
