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Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature

Summary Schwannoma is a rare gastrointestinal mesenchymal tumor, as the vast majority of gastric mesenchymal tumors are gastrointestinal stromal tumors. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female p... Full description

Journal Title: Human pathology 2012, Vol.43 (5), p.650-659
Main Author: Voltaggio, Lysandra, MD
Other Authors: Murray, Rebecca, MD , Lasota, Jerzy, MD , Miettinen, Markku, MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0046-8177
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3305846
title: Gastric schwannoma: a clinicopathologic study of 51 cases and critical review of the literature
format: Article
creator:
  • Voltaggio, Lysandra, MD
  • Murray, Rebecca, MD
  • Lasota, Jerzy, MD
  • Miettinen, Markku, MD
subjects:
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis
  • Article
  • Biological and medical sciences
  • Biomarkers, Tumor - metabolism
  • Cancer
  • Chromosome 22
  • Chromosomes
  • Cloning
  • Colon
  • Colorectal cancer
  • Female
  • Gastrointestinal system
  • GFAP
  • Humans
  • Intermediate filament proteins
  • Investigative techniques, diagnostic techniques (general aspects)
  • Male
  • Medical sciences
  • Melanoma
  • Middle Aged
  • Muscle proteins
  • Nerve sheath tumor
  • Neurilemmoma - metabolism
  • Neurilemmoma - pathology
  • Neurology
  • Older people
  • Oncology, Experimental
  • Pathology
  • Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
  • Polymerase chain reaction
  • Polyploidy
  • Prognosis
  • Proteins
  • Proto-Oncogene Proteins c-kit - metabolism
  • S100 protein
  • S100 Proteins - metabolism
  • Sarcoma
  • Schwannoma
  • Sex Factors
  • Smooth muscle
  • Stem cells
  • Stomach
  • Stomach - metabolism
  • Stomach - pathology
  • Stomach Neoplasms - metabolism
  • Stomach Neoplasms - pathology
  • Studies
  • Tomography
  • Tumors
  • Tumors of the nervous system. Phacomatoses
ispartof: Human pathology, 2012, Vol.43 (5), p.650-659
description: Summary Schwannoma is a rare gastrointestinal mesenchymal tumor, as the vast majority of gastric mesenchymal tumors are gastrointestinal stromal tumors. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female predominance (40 women and 11 men; median and mean ages, 60 and 58 years). They variably presented with gastric discomfort, bleeding, or rarely gastric outlet obstruction; and many were incidental findings during other medical procedures. The tumors ranged from 1 to 10.5 cm (median, 4.5 cm). The typical histologic features included spindle cells usually with microtrabecular architecture and focal nuclear atypia, and peritumoral lymphoid cuff, whereas features of soft tissue schwannomas, such as encapsulation, nuclear palisading, vascular hyalinization, and dilatation, were absent or infrequent. Median mitotic count was 2/50 high-power fields, with the highest count being 13/50 high-power fields. No malignant variants were recognized, and long-term follow-up did not reveal recurrences or metastases. Immunohistochemically, all examined tumors were S100 protein positive and most were also GFAP positive, whereas CD34 and NF68 were encountered rarely and all tumors were negative for HMB45, KIT , DOG1/Ano 1, smooth muscle actin, desmin, and synaptophysin. None of the 9 tumors studied contained gastrointestinal stromal tumor–specific KIT or PDGFRA mutations. Fluorescence in situ hybridization studies revealed multiple signals with BCR probe (chromosome 22) and centromeric probes for chromosomes 2 and 18 suggesting polyploidy. These findings indicate that gastric schwannoma is a distinctive form of peripheral nerve sheath tumor that in many ways differs from soft tissue schwannoma. It should be distinguished from gastrointestinal stromal tumor and other mesenchymal tumors of the gastrointestinal tract, such as the S100 protein–positive gastrointestinal clear cell sarcoma and metastatic melanoma.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0046-8177
fulltext: fulltext
issn:
  • 0046-8177
  • 1532-8392
url: Link


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descriptionSummary Schwannoma is a rare gastrointestinal mesenchymal tumor, as the vast majority of gastric mesenchymal tumors are gastrointestinal stromal tumors. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female predominance (40 women and 11 men; median and mean ages, 60 and 58 years). They variably presented with gastric discomfort, bleeding, or rarely gastric outlet obstruction; and many were incidental findings during other medical procedures. The tumors ranged from 1 to 10.5 cm (median, 4.5 cm). The typical histologic features included spindle cells usually with microtrabecular architecture and focal nuclear atypia, and peritumoral lymphoid cuff, whereas features of soft tissue schwannomas, such as encapsulation, nuclear palisading, vascular hyalinization, and dilatation, were absent or infrequent. Median mitotic count was 2/50 high-power fields, with the highest count being 13/50 high-power fields. No malignant variants were recognized, and long-term follow-up did not reveal recurrences or metastases. Immunohistochemically, all examined tumors were S100 protein positive and most were also GFAP positive, whereas CD34 and NF68 were encountered rarely and all tumors were negative for HMB45, KIT , DOG1/Ano 1, smooth muscle actin, desmin, and synaptophysin. None of the 9 tumors studied contained gastrointestinal stromal tumor–specific KIT or PDGFRA mutations. Fluorescence in situ hybridization studies revealed multiple signals with BCR probe (chromosome 22) and centromeric probes for chromosomes 2 and 18 suggesting polyploidy. These findings indicate that gastric schwannoma is a distinctive form of peripheral nerve sheath tumor that in many ways differs from soft tissue schwannoma. It should be distinguished from gastrointestinal stromal tumor and other mesenchymal tumors of the gastrointestinal tract, such as the S100 protein–positive gastrointestinal clear cell sarcoma and metastatic melanoma.
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subjectAdult ; Aged ; Aged, 80 and over ; Analysis ; Article ; Biological and medical sciences ; Biomarkers, Tumor - metabolism ; Cancer ; Chromosome 22 ; Chromosomes ; Cloning ; Colon ; Colorectal cancer ; Female ; Gastrointestinal system ; GFAP ; Humans ; Intermediate filament proteins ; Investigative techniques, diagnostic techniques (general aspects) ; Male ; Medical sciences ; Melanoma ; Middle Aged ; Muscle proteins ; Nerve sheath tumor ; Neurilemmoma - metabolism ; Neurilemmoma - pathology ; Neurology ; Older people ; Oncology, Experimental ; Pathology ; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques ; Polymerase chain reaction ; Polyploidy ; Prognosis ; Proteins ; Proto-Oncogene Proteins c-kit - metabolism ; S100 protein ; S100 Proteins - metabolism ; Sarcoma ; Schwannoma ; Sex Factors ; Smooth muscle ; Stem cells ; Stomach ; Stomach - metabolism ; Stomach - pathology ; Stomach Neoplasms - metabolism ; Stomach Neoplasms - pathology ; Studies ; Tomography ; Tumors ; Tumors of the nervous system. Phacomatoses
ispartofHuman pathology, 2012, Vol.43 (5), p.650-659
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descriptionSummary Schwannoma is a rare gastrointestinal mesenchymal tumor, as the vast majority of gastric mesenchymal tumors are gastrointestinal stromal tumors. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female predominance (40 women and 11 men; median and mean ages, 60 and 58 years). They variably presented with gastric discomfort, bleeding, or rarely gastric outlet obstruction; and many were incidental findings during other medical procedures. The tumors ranged from 1 to 10.5 cm (median, 4.5 cm). The typical histologic features included spindle cells usually with microtrabecular architecture and focal nuclear atypia, and peritumoral lymphoid cuff, whereas features of soft tissue schwannomas, such as encapsulation, nuclear palisading, vascular hyalinization, and dilatation, were absent or infrequent. Median mitotic count was 2/50 high-power fields, with the highest count being 13/50 high-power fields. No malignant variants were recognized, and long-term follow-up did not reveal recurrences or metastases. Immunohistochemically, all examined tumors were S100 protein positive and most were also GFAP positive, whereas CD34 and NF68 were encountered rarely and all tumors were negative for HMB45, KIT , DOG1/Ano 1, smooth muscle actin, desmin, and synaptophysin. None of the 9 tumors studied contained gastrointestinal stromal tumor–specific KIT or PDGFRA mutations. Fluorescence in situ hybridization studies revealed multiple signals with BCR probe (chromosome 22) and centromeric probes for chromosomes 2 and 18 suggesting polyploidy. These findings indicate that gastric schwannoma is a distinctive form of peripheral nerve sheath tumor that in many ways differs from soft tissue schwannoma. It should be distinguished from gastrointestinal stromal tumor and other mesenchymal tumors of the gastrointestinal tract, such as the S100 protein–positive gastrointestinal clear cell sarcoma and metastatic melanoma.
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24Nerve sheath tumor
25Neurilemmoma - metabolism
26Neurilemmoma - pathology
27Neurology
28Older people
29Oncology, Experimental
30Pathology
31Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
32Polymerase chain reaction
33Polyploidy
34Prognosis
35Proteins
36Proto-Oncogene Proteins c-kit - metabolism
37S100 protein
38S100 Proteins - metabolism
39Sarcoma
40Schwannoma
41Sex Factors
42Smooth muscle
43Stem cells
44Stomach
45Stomach - metabolism
46Stomach - pathology
47Stomach Neoplasms - metabolism
48Stomach Neoplasms - pathology
49Studies
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abstractSummary Schwannoma is a rare gastrointestinal mesenchymal tumor, as the vast majority of gastric mesenchymal tumors are gastrointestinal stromal tumors. In this study, we analyzed clinicopathologically 51 gastric schwannomas. These tumors predominantly occurred in older adults with a marked female predominance (40 women and 11 men; median and mean ages, 60 and 58 years). They variably presented with gastric discomfort, bleeding, or rarely gastric outlet obstruction; and many were incidental findings during other medical procedures. The tumors ranged from 1 to 10.5 cm (median, 4.5 cm). The typical histologic features included spindle cells usually with microtrabecular architecture and focal nuclear atypia, and peritumoral lymphoid cuff, whereas features of soft tissue schwannomas, such as encapsulation, nuclear palisading, vascular hyalinization, and dilatation, were absent or infrequent. Median mitotic count was 2/50 high-power fields, with the highest count being 13/50 high-power fields. No malignant variants were recognized, and long-term follow-up did not reveal recurrences or metastases. Immunohistochemically, all examined tumors were S100 protein positive and most were also GFAP positive, whereas CD34 and NF68 were encountered rarely and all tumors were negative for HMB45, KIT , DOG1/Ano 1, smooth muscle actin, desmin, and synaptophysin. None of the 9 tumors studied contained gastrointestinal stromal tumor–specific KIT or PDGFRA mutations. Fluorescence in situ hybridization studies revealed multiple signals with BCR probe (chromosome 22) and centromeric probes for chromosomes 2 and 18 suggesting polyploidy. These findings indicate that gastric schwannoma is a distinctive form of peripheral nerve sheath tumor that in many ways differs from soft tissue schwannoma. It should be distinguished from gastrointestinal stromal tumor and other mesenchymal tumors of the gastrointestinal tract, such as the S100 protein–positive gastrointestinal clear cell sarcoma and metastatic melanoma.
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