Comparison study of clinicopathological features of cellular schwannoma between retroperitoneum and other sites

Background Cellular schwannoma (CS) is a relatively rare neural tumor with few reports. This study aimed to compare the clinicopathological characteristics of CS in the retroperitoneum and other sites by analyzing the hematoxylin-eosin (HE) staining and immunohistochemical (IHC) staining results, to provide some help for pathological diagnosis. Methods A total of 79 CS cases from the Department of Pathology, Peking University International Hospital were collected, and the diagnosis was based on the 5th WHO classification of soft tissue tumors. The staining results of HE and IHC were judged and analyzed according to the instructions. The t-tests, Chi-square test and Fisher’s exact probability test were used for statistical analysis. Results Compared with other sites, the volume of retroperitoneal CS tumors were larger (t=4.265, P=0.001) and more likely to recur (χ2=4.223, P=0.04). Nerve sheath structures were rare around the tumors (χ2=60.096, P=0.000). Immunohistochemically, there was a difference in the expression of glial fibrillary acidic protein (GFAP), Cytokeratin (CK), and myelin basic protein (MBP) between the two groups (χ2=54.290, P=0.000; χ2=4.879, P=0.027; χ2=31.792, P=0.000). But there was no difference in expression between the two groups in the other indexes. Conclusions It founded that Retroperitoneal CS was often positive for GFAP and CK, suggesting it originated from unmyelinated Schwann cells. CS in other sites, the expression of GFAP and CK was often negative, indicating they derived from myelinated Schwann cells. The expression of MBP in the peripheral nerve sheath structure of CS can be used to determine whether the tumor originates from myelinated or unmyelinated Schwann cells. These findings may provide a reference for revealing pathogenesis, diagnosis and evaluating prognosis of CS.

[1]  S. Sugita,et al.  Assessment of H3K27me3 immunohistochemistry and combination of NF1 and p16 deletions by fluorescence in situ hybridization in the differential diagnosis of malignant peripheral nerve sheath tumor and its histological mimics , 2021, Diagnostic Pathology.

[2]  Y. Oda,et al.  Clinicopathological and prognostic significance of H3K27 methylation status in malignant peripheral nerve sheath tumor: correlation with skeletal muscle differentiation , 2021, Virchows Archiv.

[3]  G. Tang,et al.  Comparison of pathological, radiological, and prognostic features between cellular schwannoma and non-cellular schwannoma. , 2021, European journal of radiology.

[4]  M. Bronner,et al.  Schwann cell precursors: Where they come from and where they go. , 2021, Cells & development.

[5]  T. Gupta,et al.  Melanotic Schwannoma, a Deceptive Misnomer for a Tumor With Relative Aggressive Behavior: A Series of 7 Cranial and Spinal Cases , 2020, International journal of surgical pathology.

[6]  E. Montgomery,et al.  Intracranial cellular schwannomas: a clinicopathological study of 20 cases , 2020, Histopathology.

[7]  S. Raimondo,et al.  Peripheral Nerve Regeneration Is Independent From Schwann Cell p75NTR Expression , 2019, Front. Cell. Neurosci..

[8]  K. Okubo,et al.  Successful Excision of Endobronchial Cellular Schwannoma With Right Lower Sleeve Lobectomy. , 2019, The Annals of thoracic surgery.

[9]  Arie Perry,et al.  Histopathologic evaluation of atypical neurofibromatous tumors and their transformation into malignant peripheral nerve sheath tumor in patients with neurofibromatosis 1-a consensus overview. , 2017, Human pathology.

[10]  A. Kawai,et al.  Malignant Peripheral Nerve Sheath Tumor of the Femur: A Rare Diagnosis Supported by Complete Immunohistochemical Loss of H3K27me3 , 2017, International journal of surgical pathology.

[11]  R. Mirsky,et al.  The repair Schwann cell and its function in regenerating nerves , 2016, The Journal of physiology.

[12]  J. Salzer Schwann cell myelination. , 2015, Cold Spring Harbor perspectives in biology.

[13]  J. Hamming,et al.  New insights in the neuroanatomy of the human adult superior hypogastric plexus and hypogastric nerves , 2015, Autonomic Neuroscience.

[14]  J. Herden,et al.  Retroperitoneal Schwannomas of Renal and Pararenal Origin: Presentation of Two Case Reports , 2015, Rare tumors.

[15]  D. Gutmann,et al.  Morphologic and immunohistochemical features of malignant peripheral nerve sheath tumors and cellular schwannomas , 2015, Modern Pathology.

[16]  T. Hirose,et al.  Retroperitoneal schwannoma is characterized by a high incidence of cellular type and GFAP‐immunoreactivity , 2012, Pathology international.

[17]  A. Iwama,et al.  Nonmyelinating Schwann Cells Maintain Hematopoietic Stem Cell Hibernation in the Bone Marrow Niche , 2011, Cell.

[18]  A. Proia,et al.  Neurothekeoma palpebrae: A report of 3 cases. , 2010, The American Journal of dermatopathology.

[19]  W. Thompson,et al.  Biology and pathology of nonmyelinating Schwann cells , 2008, Glia.

[20]  C. Fletcher,et al.  Cellular Neurothekeoma: Detailed Characterization in a Series of 133 Cases , 2007, The American journal of surgical pathology.

[21]  V. Kapoor,et al.  Solitary Cellular Schwannoma (Neurilemmoma) Showing Malignant Changes: Evaluation through Magnetic Resonance Imaging (M.R.I.), Surgical Intervention, and Histopathology , 1999, The Journal of dermatology.

[22]  B. Scheithauer,et al.  CELLULAR SCHWANNOMA: A CLINICOPATHOLOGIC STUDY OF 56 CASES , 1993 .

[23]  C. Fletcher,et al.  Cellular schwannoma: a distinct pseudosarcomatous entity , 1987, Histopathology.

[24]  Shoufeng Wang,et al.  Malignant transformation of neurofibromatosis-1 into low-grade malignant peripheral nerve sheath tumor: a case report. , 2021, International journal of clinical and experimental pathology.

[25]  M. Miettinen,et al.  Keratin expression in schwannoma; a study of 115 retroperitoneal and 22 peripheral schwannomas , 2006, Modern Pathology.

[26]  C. Tomasini,et al.  Cellular neurothekeoma. , 1996, Dermatology.