Reticular perineurioma: A distinctive variant of soft tissue perineurioma

J. Frans Graadt Van Roggen, Mairin E. McMenamin, Deborah A. Belchis, G. Petur Nielsen, Andrew Rosenberg, Christopher D M Fletcher

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Soft tissue perineurioma is a relatively recently characterized, uncommon tumor composed of perineurial cells exhibiting immunoreactivity for epithelial membrane antigen (EMA). These lesions occur preferentially in adults and may arise in a wide variety of anatomic sites. We report the clinicopathologic, immunohistochemical, and ultrastructural features of six cases of a poorly recognized morphologic variant of soft tissue perineurioma, characterized by a highly distinctive reticular growth pattern. Four of the patients were women, two were men (age range, 34-61 yrs; median, 43 yrs). Four of the cases arose in the subcutis of the upper extremity; three were located distally (thumb, finger, palm), whereas one was situated more proximally near the elbow region. One case each was located in the gingiva and subcutaneous tissue of the inguinal region, respectively. In those cases in which clinical information was available (n = 5), the lesions were asymptomatic and had been present from 4 months to 10 years before resection. Tumor size ranged from 1.5 cm to 10 cm (median size, 4.25 cm). Microscopically the lesions demonstrated a predominantly lace-like or reticular growth pattern composed of anastomosing cords of fusiform cells with bipolar cytoplasmic processes and palely eosinophilic cytoplasm. Nuclei were centrally placed, ovoid to fusiform in shape, and no mitoses were seen. Transition to more cellular areas was focally present in all cases. The stroma was variably collagenous to myxoid. Immunohistochemically all six cases stained positively for EMA but not for S-100 protein. Two cases demonstrated focal positive cytoplasmic staining for cytokeratin, whereas one case was focally desmin positive. Ultrastructural examination of two tumors showed typical features of perineurial cells. Follow up (available in only two cases) showed no evidence of recurrence. Reticular perineurioma of soft tissue represents an unusual morphologic variant within the perineurioma group, which should be distinguished from myoepithelial tumors, extraskeletal myxoid chondrosarcoma, and myxoid synovial sarcoma.

Original languageEnglish
Pages (from-to)485-493
Number of pages9
JournalAmerican Journal of Surgical Pathology
Volume25
Issue number4
DOIs
StatePublished - Apr 5 2001
Externally publishedYes

Fingerprint

Nerve Sheath Neoplasms
Mucin-1
S100 Proteins
Myoepithelioma
Synovial Sarcoma
Neoplasms
Desmin
Groin
Thumb
Subcutaneous Tissue
Gingiva
Growth
Elbow
Keratins
Mitosis
Upper Extremity
Fingers
Cytoplasm
Staining and Labeling
Recurrence

Keywords

  • Perineurioma
  • Peripheral nerve
  • Soft tissue
  • Tumor

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine

Cite this

Graadt Van Roggen, J. F., McMenamin, M. E., Belchis, D. A., Nielsen, G. P., Rosenberg, A., & Fletcher, C. D. M. (2001). Reticular perineurioma: A distinctive variant of soft tissue perineurioma. American Journal of Surgical Pathology, 25(4), 485-493. https://doi.org/10.1097/00000478-200104000-00008

Reticular perineurioma : A distinctive variant of soft tissue perineurioma. / Graadt Van Roggen, J. Frans; McMenamin, Mairin E.; Belchis, Deborah A.; Nielsen, G. Petur; Rosenberg, Andrew; Fletcher, Christopher D M.

In: American Journal of Surgical Pathology, Vol. 25, No. 4, 05.04.2001, p. 485-493.

Research output: Contribution to journalArticle

Graadt Van Roggen, JF, McMenamin, ME, Belchis, DA, Nielsen, GP, Rosenberg, A & Fletcher, CDM 2001, 'Reticular perineurioma: A distinctive variant of soft tissue perineurioma', American Journal of Surgical Pathology, vol. 25, no. 4, pp. 485-493. https://doi.org/10.1097/00000478-200104000-00008
Graadt Van Roggen, J. Frans ; McMenamin, Mairin E. ; Belchis, Deborah A. ; Nielsen, G. Petur ; Rosenberg, Andrew ; Fletcher, Christopher D M. / Reticular perineurioma : A distinctive variant of soft tissue perineurioma. In: American Journal of Surgical Pathology. 2001 ; Vol. 25, No. 4. pp. 485-493.
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