This case was presented at the 102nd Annual Meeting of the Japanese Society of Pathology.
Hybrid schwannoma/perineurioma of the spinal nerve: Multifocal occurrence, and recurrence as an intraneural perineurioma
Article first published online: 18 JUL 2013
© 2013 The Authors. Pathology International © 2013 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd
Volume 63, Issue 7, pages 368–373, July 2013
How to Cite
Hayashi, T., Hirose, T., Nishimura, Y., Fukuoka, J. and Kishikawa, M. (2013), Hybrid schwannoma/perineurioma of the spinal nerve: Multifocal occurrence, and recurrence as an intraneural perineurioma. Pathology International, 63: 368–373. doi: 10.1111/pin.12073
Conflict of interest: The manuscript was prepared so as not to be identified by the patient's personal information. This case report was approved by the Institutional Review Board of Nagasaki University Hospital (Approval # 13022538).
Disclosures: None declared.
- Issue published online: 18 JUL 2013
- Article first published online: 18 JUL 2013
- Manuscript Accepted: 28 MAY 2013
- Manuscript Received: 2 MAR 2013
- Institutional Review Board of Nagasaki University Hospital. Grant Number: 13022538
- spinal nerve
A 63-year-old Japanese man complained of lower back pain and numbness and was diagnosed as intradural tumors at the T11/12 and L1 level. The thoracic tumor originated from the posterior nerve root, and the lumbar tumor originated from the cauda equina. Five months after surgical resection, the patient developed recurrent tumor consisting of enlargement of multiple caudal nerves. Pathologically, the primary tumors showed a nodular and lobular pattern, including spindle cells in a fascicular, whorl and storiform pattern, with variable cellularity, nuclear palisading and frequent small onion bulb structures. Mild pleomorphism was present, and there were four mitoses per 10 high power fields. Many cells showed immunoreactivity for S-100 and Sox10. There were also claudin-1-positive spindle cells, but no epithelial membrane antigen (EMA)-positive cells. The cells in onion bulb structures were positive for claudin-1 and glucose transporter 1 (GLUT-1). These findings led to a diagnosis of hybrid schwannoma/perineurioma. The features of high cellularity, pleomorphism and a Ki-67 index over 10% suggested a low-malignant nature. The recurrent tumor also showed high proliferative activity, as reflected by mitotic figures and a Ki-67 index of 20%. This is the first case of spinal nerve hybrid schwannoma/perineurioma with low malignant potential and peculiar intraneural perineurioma component.