 Site created by Dr Sampurna Roy MD
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| Normal Anatomy of the Nerve |
Surgical-Pathology.com
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Classification of Cutaneous Meningeal Lesion:
1. Ectopic
meningothelial hamartoma :
Site:
Scalp (occipital region) and spinal cord
Clinical
presentation:
Congenital
lesion. Presents as cutaneous lump in children. No true defect of skull or
spinal column is present.
Microscopic
features:
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- Lesion is characterized by narrow ectatic pseudovascular spaces lined by epithelioid
meningothelial cells present in the dermis and subcutis. Immunohistochemically
, these cells were negative for factor VIII-related antigen and Ulex
europaeus lectin but were strongly positive with vimentin and epithelial
membrane antigen antibodies, this latter being in keeping with the
immunohistochemical profile of meningothelial cells.
- Abnormally dense collagen is present in the backround.
- Irregular strands and clusters of meningothelial cells and variable numbers of psammoma bodies may be present in the collagenous stroma.
- Scattered
multinucleate cells may be present.
2. Cutaneous
meningioma :
Site:
Around sensory
organs of the head -Eg. paranasal, orbital and aural.
Clinical
presentation:
Presents as a discrete nodule in adults.
Microscopic
features:
The tumour is well circumscribed and more cellular. It is composed of
meningothelial cells together with spindle cell areas. Psammoma bodies
and meningeal whorls may be present.
3.
Type III lesion :
This lesion
represents direct extension or distant metastasis of central nervous system
meningioma. The tumour spreads into the skin and subcutaneous tissue usually
at the site of previous surgery.
Immunohistochemistry: S100 protein, EMA and Vimentin are positive.
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Reactive and hamartomatous lesions:
Fibrolipomatous hamartoma of nerve
Schwannoma (neurilemmoma)
Dermal nerve sheath myxoma
Malignant peripheral nerve sheath tumour Merkel cell (neuroendocrine) carcinoma Malignant primitive neuroectodermal tumour Miscellaneous neuroectodermal tumours presenting in soft tissue |
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