Acoustic neuroma pathophysiology: Difference between revisions

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== Gross Pathology ==
== Gross Pathology ==
On gross pathology, following are the characteristic findings of acoustic neuroma:
On [[gross pathology]], following are the characteristic findings of acoustic neuroma:
* Rubbery-firm with a pale, gray color<ref>{{Cite journal
* Rubbery-firm with a pale, gray color<ref>{{Cite journal
  | author = [[Joshua Greene]] & [[Mohammed A.. Al-Dhahir]]
  | author = [[Joshua Greene]] & [[Mohammed A.. Al-Dhahir]]
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}}</ref>
}}</ref>
* Well-defined capsule
* Well-defined capsule
* Different degrees of vascularity
* Different degrees of [[vascularity]]


==== On Cut Section ====
==== On Cut Section ====
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}}</ref>
}}</ref>
* Fine trabeculated appearance
* Fine trabeculated appearance
* Cystic degeneration
* [[Cyst|Cystic]] degeneration
* Hemorrhage
* [[Bleeding|Hemorrhage]]
* Calcification
* [[Calcification]]
* Xanthomatous changes
* Xanthomatous changes



Revision as of 19:59, 22 April 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2] Mohsen Basiri M.D.

Overview

Acoustic neuroma arises from Schwann cells, which are the cells involved in the conduction of nervous impulses along axons, nerve development and regeneration. On microscopic histopathological analysis, acoustic neuroma may display two types of growth patterns: Antoni type A and Antoni type B. Antoni type A growth pattern is composed of elongated cells with cytoplasmic processes arranged in fascicles, little stromal matrix and verocay bodies. Antoni type B growth pattern is composed of loose meshwork of cells, less dense cellular matrix, microcysts and myxoid change.

Pathophysiology

Genetic

Associated Conditions

Gross Pathology

On gross pathology, following are the characteristic findings of acoustic neuroma:

  • Rubbery-firm with a pale, gray color[3]
  • Well-defined capsule
  • Different degrees of vascularity

On Cut Section

Microscopic Pathology

  • In 1920, Nils Ragnar Euge`ne Antoni (1887–1968), a Swedish neurologist and researcher, described 2 distinct patterns of cellular architecture in the peripheral nerve sheath tumors, based his observations on analysis of 30 cases and described a “fibrillary, intensely polar, elongated appearing tissue type” which he called “tissue type A.” [5]
  • These highly cellular regions were eventually referred to as Antoni A regions by later authors. [5]
  • Antoni also described seemingly distinct loose microcystic tissue adjacent to the Antoni A regions, and these came to be known as Antoni B regions.[5]

They can display two types of growth patterns:[5]

  • Antoni A
  • Antoni B
    • Loose meshwork of cells
    • Less densely cellular
    • Microcysts and myxoid change
  • Photomicrograph of Antoni A tissue and Antoni B tissue within a schwannoma. The highly cellular Antoni A region on the right of the field is contrasted with the loosely organized hypocellular Antoni B region on left of the field (hematoxylin-eosin, original magnification 400).
Photomicrograph of Antoni A tissue and Antoni B tissue within a schwannoma. The highly cellular Antoni A region on the right of the field is contrasted with the loosely organized hypocellular Antoni B region on left of the field (hematoxylin-eosin, original magnification 400).
Photomicrograph of Antoni A tissue and Antoni B tissue within a schwannoma. The highly cellular Antoni A region on the right of the field is contrasted with the loosely organized hypocellular Antoni B region on left of the field (hematoxylin-eosin, original magnification 400). 

References

  1. Acoustic Schwannoma. Radiopedia(2015) http://radiopaedia.org/articles/acoustic-schwannoma Accessed on October 2 2015
  2. M. M. Eibl, R. Ahmad, H. M. Wolf, Y. Linnau, E. Gotz & J. W. Mannhalter (1987). "A component of factor VIII preparations which can be separated from factor VIII activity down modulates human monocyte functions". Blood. 69 (4): 1153–1160. PMID 3030465. Unknown parameter |month= ignored (help)
  3. Joshua Greene & Mohammed A.. Al-Dhahir (2019). "Acoustic Neuroma (Vestibular Schwannoma)". PMID 29262098. Unknown parameter |month= ignored (help)
  4. Joshua Greene & Mohammed A.. Al-Dhahir (2019). "Acoustic Neuroma (Vestibular Schwannoma)". PMID 29262098. Unknown parameter |month= ignored (help)
  5. 5.0 5.1 5.2 5.3 Wippold II, F.J (2007). "Neuropathology for the Neuroradiologist: Antoni A and Antoni B Tissue Patterns". AJNR Am J Neuroradiol.


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