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Reticular and plexiform perineurioma: clinicopathological and immunohistochemical analysis of two cases and review of perineurial neoplasms of skin and soft tissues

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Abstract

Perineurioma represents a recently described and relatively rare neoplasm in the spectrum of benign peripheral nerve sheath tumours composed of perineurial cells staining immunohistochemically positive for epithelial membrane antigen (EMA). In addition to intraneural, extraneural and sclerosing perineurioma, rare variants of perineurioma may occur, and their knowledge is important in the differential diagnosis of mesenchymal tumours of different lines of differentiation and clinically more aggressive neoplasms. We present a case of deep-seated reticular perineurioma arising on the upper arm of a 34-year-old female and a case of a dermal plexiform perineurioma arising on the lower lip of a 60-year-old female. The diagnosis was confirmed in both cases immunohistochemically; neoplastic cells stained positively for EMA and for the newly described perineurial markers, claudin-1 and glut-1. The morphological spectrum and the differential diagnosis of perineurial neoplasms of skin and soft tissues are discussed.

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References

  1. Argenyi ZB, Cooper PH, Santa Cruz D (1993) Plexiform and other unusual variants of palisaded encapsulated neuroma. J Cutan Pathol 20:34–39

    Article  PubMed  CAS  Google Scholar 

  2. Balarezo FS, Muller RC, Weiss RG, Brown T, Knibbs D, Joshi VV (2003) Soft tissue perineurioma in children: report of three cases and review of the literature. Pediatr Dev Pathol 6:137–141

    Article  PubMed  Google Scholar 

  3. Bilbao JM, Khoury NJ, Hudson AR, Briggs SJ (1984) Perineurioma (localized hypertrophic neuropathy). Arch Pathol Lab Med 108:557–560

    PubMed  CAS  Google Scholar 

  4. Burgues O, Monteagudo C, Noguera R, Revert A, Molina I, Llombart-Bosch A (2001) Cutaneous sclerosing pacinian-like perineurioma. Histopathology 39:498–502

    Article  PubMed  CAS  Google Scholar 

  5. de La Jarte-Thirouard AS, Jacquier I, de Saint-Maur PP (2003) Intraneural reticular perineurioma of the neck. Ann Diagn Pathol 7:120–123

    Article  PubMed  Google Scholar 

  6. Diaz-Flores L, Alvarez-Argüelles H, Madrid JF, Varela H, Gonzalez MP, Guitierrez R (1997) Perineurial cell tumor (perineurioma) with granular cells. J Cutan Pathol 24:575–579

    Article  PubMed  CAS  Google Scholar 

  7. Emory TS, Scheithauer BW, Hirose T, Wood M, Onofrio BM, Jenkins RB (1995) Intraneural perineurioma. A clonal neoplasm associated with abnormalities of chromosome 22. Am J Clin Pathol 103:696–704

    PubMed  CAS  Google Scholar 

  8. Erlandson RA (1991) The enigmatic perineurial cell and its participation in tumors and tumor-like entities. Ultrastruct Pathol 15:335–351

    Article  PubMed  CAS  Google Scholar 

  9. Fetsch JF, Miettinen M (1997) Sclerosing perineurioma. A clinicopathologic study of 19 cases of a distinctive soft tissue lesion with a predilection for the fingers and palms of young adults. Am J Surg Pathol 21:1433–1442

    Article  PubMed  CAS  Google Scholar 

  10. Folpe AL, Billings SD, McKenney JK, Walsh SV, Nusrat A, Weiss SW (2002) Expression of claudin-1, a recently described tight junction-associated protein, distinguishes soft tissue perineurioma from potential mimics. Am J Surg Pathol 26:1620–1626

    Article  PubMed  Google Scholar 

  11. Giannini C, Scheithauer BW, Jenkins RB, Erlandson RA, Perry A, Borell TJ, Hoda RS, Woodruff JM (1997) Soft-tissue perineurioma. Evidence for an abnormality of chromosome 22, criteria for diagnosis, and review of the literature. Am J Surg Pathol 21:164–173

    Article  PubMed  CAS  Google Scholar 

  12. Giannini C, Scheithauer BW, Stenberg J, Cosgrove TJ (1998) Intraventricular perineurioma: case report. Neurosurgery 43:1478–1481

    Article  PubMed  CAS  Google Scholar 

  13. Graadt van Roggen JF, McMenamin ME, Belchis DA, Nielsen GP, Rosenberg AE, Fletcher CDM (2001) Reticular perineurioma. A distinctive variant of soft tissue perineurioma. Am J Surg Pathol 25:485–493

    Article  PubMed  CAS  Google Scholar 

  14. Hirose T, Scheithauer BW, Sano T (1998) Perineurial malignant peripheral nerve sheath tumor (MPNST). A clinicopathologic, immunohistochemical, and ultrastructural study of seven cases. Am J Surg Pathol 22:1368–1378

    Article  PubMed  CAS  Google Scholar 

  15. Hornick JL, Fletcher CDM (2003) Myoepithelial tumors of soft tissue: a clinicopathologic and immunohistochemical study of 101 cases with evaluation of prognostic parameters. Am J Surg Pathol 27:1183–1196

    Article  PubMed  Google Scholar 

  16. Hornick JL, Fletcher CDM (2005) Soft tissue perineurioma: clinicopathologic analysis of 81 cases including those with atypical histologic features. Am J Surg Pathol 29:845–858

    Article  PubMed  Google Scholar 

  17. Hornick JL, Fletcher CDM (2005) Intestinal perineurioma: clinicopathologic definition of a new anatomic subset in a series of 10 cases. Am J Surg Pathol 29:859–865

    Article  PubMed  Google Scholar 

  18. Kazakov DV, Pitha J, Sima R, Vanecek T, Shelekhova K, Mukensnabl P, Michal M (2005) Hybrid peripheral nerve sheath tumors: schwannoma–perineurioma and neurofibroma–perineurioma. A report of three cases in extradigital locations. Ann Diagn Pathol 9:16–23

    Article  PubMed  Google Scholar 

  19. Lazarus SS, Trombetta LD (1978) Ultrastructural identification of a benign perineurial cell tumor. Cancer 41:1823–1829

    Article  PubMed  CAS  Google Scholar 

  20. Meis-Kindblom JM, Bergh P, Gunterberg G, Kindblom LG (1999) Extraskeletal myxoid chondrosarcoma: a reappraisal of its morphologic spectrum and prognostic factors based on 117 cases. Am J Surg Pathol 23:636–650

    Article  PubMed  CAS  Google Scholar 

  21. Mentzel T, Dei Tos AP, Fletcher CDM (1994) Perineurioma (storiform perineurial fibroma): clinicopathological analysis of four cases. Histopathology 25:261–267

    Article  PubMed  CAS  Google Scholar 

  22. Michal M (1999) Extraneural retiform perineurioma. A report of four cases. Pathol Res Pract 195:759–763

    PubMed  CAS  Google Scholar 

  23. Michal M, Kazakov DV, Belousova I, Bisceglia M, Zamecnik M, Mukensnabl P (2004) A benign neoplasm with histopathological features of both schwannoma and retiform perineurioma (benign schwannoma–perineurioma): a report of six cases of a distinctive soft tissue tumor with a predilection for the fingers. Virchows Arch 445:347–353

    Article  PubMed  Google Scholar 

  24. Rank JP, Rostad SW (1998) Perineurioma with ossification. A case report with immunohistochemical and ultrastructural studies. Arch Pathol Lab Med 122:366–370

    PubMed  CAS  Google Scholar 

  25. Robson AM, Calonje E (2000) Cutaneous perineurioma: a poorly recognized tumour often misdiagnosed as epithelioid histiocytoma. Histopathology 37:332–339

    Article  PubMed  CAS  Google Scholar 

  26. Scheithauer BW, Giannini C, Woodruff JM (2000) Perineurioma. In: Kleihues P, Cavenee WK (eds) WHO-classification. Tumours of the nervous system. IARC Press, Lyon

    Google Scholar 

  27. Theaker JM, Gatter KC, Puddle J (1988) Epithelial membrane antigen expression by the perineurium of peripheral nerve and in peripheral nerve tumours. Histopathology 13:171–179

    Article  PubMed  CAS  Google Scholar 

  28. Theaker JM, Fletcher CDM (1989) Epithelial membrane antigen expression by the perineurial cell: further studies of peripheral nerve lesions. Histopathology 14:581–592

    Article  PubMed  CAS  Google Scholar 

  29. Val-Bernal JF, Hernando M, Gariji MF, Villa P (1997) Renal perineurioma in childhood. Gen Diagn Pathol 143:75–81

    PubMed  CAS  Google Scholar 

  30. Yamaguchi U, Hasegawa T, Hirose T, Fugo K, Mitsuhashi T, Shimizu M, Kawai A, Ito Y, Chuman H, Beppu Y (2003) Sclerosing perineurioma: a clinicopathological study of five cases and diagnostic utility of immunohistochemical staining for glut-1. Virchows Arch 443:159–163

    Article  PubMed  Google Scholar 

  31. Younes M, Lechago LV, Somoano JR, Mosharaf M, Lechago J (1996) Wide expression of the human erythrocyte glucose transporter Glut 1 in human cancers. Cancer Res 56:1164–1167

    PubMed  CAS  Google Scholar 

  32. Zamecnik M, Koys F, Gomolcak P (2002) Atypical cellular perineurioma. Histopathology 40:296–298

    Article  PubMed  CAS  Google Scholar 

  33. Zamecnik M (2003) Perineurioma with adipocytes (lipomatous perineurioma). Am J Dermatopathol 25:171–173

    Article  PubMed  Google Scholar 

  34. Zelger BG, Weinlich G, Zelger B (2000) Perineuroma. A frequently unrecognized entity with emphasis on a plexiform variant. Adv Clin Pathol 4:25–33

    CAS  Google Scholar 

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Acknowledgements

The authors are grateful to Dr. Outrata, Stuttgart, Germany, for kindly providing case material and clinical follow-up for case 1.

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  1. Dermatopathologische Gemeinschaftspraxis, Siemensstrasse 6/1, 88048, Friedrichshafen, Germany

    Thomas Mentzel & Heinz Kutzner

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  1. Thomas Mentzel
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  2. Heinz Kutzner
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Correspondence to Thomas Mentzel.

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Mentzel, T., Kutzner, H. Reticular and plexiform perineurioma: clinicopathological and immunohistochemical analysis of two cases and review of perineurial neoplasms of skin and soft tissues. Virchows Arch 447, 677–682 (2005). https://doi.org/10.1007/s00428-005-0057-5

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  • DOI: https://doi.org/10.1007/s00428-005-0057-5

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