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Presented by Pedram Argani, M.D. and prepared by Shiyama Mudali, M.D.
Case 6: This is a 60 year old female with an abdominal tumor.
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Question 1 of 1
1. Question
Week 443: Case 6
This is a 60 year old female with an abdominal tumor.images/1alex/07192010case6image1.jpg
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images/1alex/07192010case6image5.jpgCorrect
Answer: Schwannoma
Histology: This is well defined, encapsulated lesion characterized by spindle cells which have pale cytoplasm and somewhat bent, club shaped nuclei. In many areas the nuclei line up and palisade, forming “Verocay bodies”. The nuclei are hyperchromatic, but significant mitotic activity is not appreciated. Neoplastic cells are diffusely immunoreactive for S100 protein, but negative for CD117 and desmin. These are the typical features of schwannoma.
Discussion: Gastrointestinal stromal tumor would label for CD117, and not diffusely label for S100 protein. Leiomyoma would label diffusely for desmin, but not for S100 protein. Fibromatosis would not label for S100 protein, and would feature a more infiltrative pattern. Verocay bodies would not be expected in a fibromatosis.
Incorrect
Answer: Schwannoma
Histology: This is well defined, encapsulated lesion characterized by spindle cells which have pale cytoplasm and somewhat bent, club shaped nuclei. In many areas the nuclei line up and palisade, forming “Verocay bodies”. The nuclei are hyperchromatic, but significant mitotic activity is not appreciated. Neoplastic cells are diffusely immunoreactive for S100 protein, but negative for CD117 and desmin. These are the typical features of schwannoma.
Discussion: Gastrointestinal stromal tumor would label for CD117, and not diffusely label for S100 protein. Leiomyoma would label diffusely for desmin, but not for S100 protein. Fibromatosis would not label for S100 protein, and would feature a more infiltrative pattern. Verocay bodies would not be expected in a fibromatosis.
