PMID: 6402292Apr 15, 1983Paper

Electron microscopy in the diagnosis of malignant schwannomas. A report of six cases

Cancer
A R Chitale, G R Dickersin

Abstract

The diagnosis of malignant schwannoma may be difficult or impossible by light microscopy alone, if the neoplasm is poorly differentiated and if there is no clinical evidence for its arising from a nerve-trunk. Six cases of malignant schwannoma in which electron microscopy confirmed or established the diagnosis are reported. In four cases, the anatomic origin of the neoplasm arising from a large nerve was demonstrated at the time of operation, and in one of these the patient had von Recklinghausen's disease. In three of the four cases, as well as in the fifth case, in which the tumor was associated with an overlying malignant melanoma, the distinctive schwannoma patterns of Antoni types A and B tissue were absent. In the sixth case, there were no clinical clues as to nerve sheath origin, but both the light and electron microscopic features of the neoplasm were very characteristic of Schwann cell derivation. The most consistently present, ultrastructural features of malignant schwannoma are the spindle shape of the cells and the terminal cytoplasmic processes. If the processes show intertwining and if lateral cell borders are interdigitated, the diagnosis is more readily confirmed. Likewise, basal lamina is an important diagnosti...Continue Reading

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