Neurofibroma differential diagnosis: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 195: Line 195:
* CD34 (strongly)
* CD34 (strongly)
* [[S-100]](stains only fat cells)
* [[S-100]](stains only fat cells)
|
|
|
|-
|'''Ganglioneuroma'''
|
|
|
|
|
|-
|
|
|
|
|
|
|-
|
|
|
|
|
|
|-
|
|
|
|
|
|
|-
|
|
|
|
|
|
|

Revision as of 15:41, 22 April 2019

Neurofibroma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Neurofibroma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

Staging

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Neurofibroma differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Neurofibroma differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Neurofibroma differential diagnosis

CDC on Neurofibroma differential diagnosis

Neurofibroma differential diagnosis in the news

Blogs on Neurofibroma differential diagnosis

Directions to Hospitals Treating Neurofibroma

Risk calculators and risk factors for Neurofibroma differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2] Shanshan Cen, M.D. [3]

Overview

Neurofibroma must be differentiated from schwannoma, dermatofibrosarcoma protuberans (DFSP), ganglioneuroma, and melanocytic nevus.

Differential Diagnosis

Neurofibroma must be differentiated from:[1][2][3]

Differentiating neurofibroma from other diseases
Disease entity Histopathological findings Immunohistochemical staining Risk factors Common site of involvement Other associated features
Neurofibroma
  • Uniphasic, low to moderate cellularity
  • Non-encapsulated
  • Random pattern, only rare palisading
  • No well formed verocy bodies
  • Cells separated by collagen bundles
  • Hypocellular with abundant mucinous matrix
  • No peripheral perineural capsule
  • Frequent mast cells
  • Contains neural fibroblasts and fibrillary collagen
  • Random proliferation of Schwann cells and scattered admixed axons
  • No nevoid cells
  • No epithelial component
  • Diffuse growth pattern
  • Scant cytoplasm
  • Wavy cells with buckled nuclei
  • Pseudomeissnerian bodies representing specific differentiation may be present
  • Lacks storiform pattern

Neurofibroma with degenerative atypia ("ancient change") has following microscopic features:

  • Localized cells with large pleomorphic nuclei, cytoplasmic nuclear inclusions, smudgy chromatin, and inconspicuous nuclei
  • Absent or very low mitotic activity
  • Low to moderate cellularity
Positive for:
  • NF-1 associated
  • Can occur anywhere
  • Nerve often not identified, incorporates nerve, axons often present in lesion
  • Seldom cystic
  • Frequently multiple
  • Widespread soft tissue infiltration
  • Tends to displace adnexa
  • <2cm in diameter
  • Lacks distinct lobulation
  • Lacks fat
Schwannoma
  • Encapsulated
  • Biphasic (majority entirely hypercellular Antoni A & hypocellular Antoni B)
  • Palisading
  • Verocay bodies
  • Infrequent extracellular collagen
Positive for:
  • NF-2 associated
  • Nerve often identifiable
  • Eccentric to nerve, axons generally absent within lesion
  • Occasionally cystic
Palisaded encapsulated neuroma Positive for:
  • EMA

Negative for:

  • 90% lesions affect the face
  • No known familial association
Traumatic neuroma
  • Numerous well formed small nerve twigs
  • Limited soft tissue infiltration
  • Contains axons in haphazardly arranged nerves
  • History of trauma or surgery
Neurotized Melanocytic Nevus
  • Superficial classic nevoid melanocytes
  • Congenital and nested growth patterns
  • More abundant cytoplasm
  • Tends to surround adnexa
Positive for:

Negative for:

  • Factor XIIIa
Cutaneous Myxoma (Superficial angiomyxoma)
  • Spindle to stellate cells with oval nuclei
  • 1-5cm in diameter
Positive for:
  • Associated with Carney complex
Nerve sheath myxoma Positive for:
Malignant peripheral nerve sheath tumor
  • Generalized atypia
  • Increased mitotic activity
  • Diffuse hypercellularity
Positive for:
Dermatofibrosarcoma protuberans (DFSP)
  • More cellular
  • Distinct storiform pattern
  • Usually forms a mass
Strongly positive for:

Negative for:

  • Deep soft tissue of posterior neck
Spindle cell lipoma
  • Delicate encapsulation
  • Mostly cases contain fat
  • Floret cell formation
  • No degenerative atypia
Positive for:
  • CD34 (strongly)
  • S-100(stains only fat cells)
Ganglioneuroma

References


Template:WikiDoc Sources