Download Surgical Pathology of the Head and Neck, Volume 2, 3rd by Leon Barnes PDF
By Leon Barnes
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Extra resources for Surgical Pathology of the Head and Neck, Volume 2, 3rd Edition
Sample text
And it is important to perform imaging studies (CT and MRI scans) to demonstrate the communication with the intracranial contents through a bony defect in NE. When long-standing NE results in excessive fibrous tissue relative to the amount of glial cells and is associated with an absence of neurons, the histological distinction between NG and NE may be impossible (1,2,36). Nasal dermoid cysts may also show an intracranial connection, and are often associated with a sinus tract. Histologically, the dermoid cyst lacks glial tissue and is lined by epidermis with dermal appendages.
Unlike neurofibromas, schwannomas do not contain axons and are typically separated form the nerve fibers by a capsule. Several morphological variants of schwannoma have been described, including cellular (43–46), epithelioid (47,48), glandular (49–51), plexiform (multin o d u l a r ) ( 5 2 –5 9 ) , m e l a n o c y t i c ( 6 0 –7 0 ) , a n d neuroblastoma-like (71,72). These variants may cause diagnostic difficulty; however, no prognostic association has been identified. Cellular schwannomas are often located in the paravertebral region of the pelvis, retroperitoneum, and posterior mediastinum and are associated with a major nerve.
Small unmyelinated axons predominate. The endoneurial fibroblasts are seen at the periphery of the Schwann cells, and dense collagen fibers are observed adjacent to these fibroblasts. F. Immunohistochemistry The same immunoreactivities of the normal nerve elements are seen in traumatic neuroma. Axons are positive for neurofilament protein, Schwann cells express S-100 protein, fibroblasts show vimentin reaction, and perineurial cells stain for EMA (16). G. Differential Diagnosis Traumatic neuromas can mimic palisaded encapsulated neuromas and neurofibromas.