Cytopathology competency assessment
Neurogenic tumors

Topic Completed: 1 September 2012

Revised: 4 January 2019, last major update September 2012

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Mediastinum cytopathology neurogenic tumors

Gordon H. Yu, M.D.
Page views in 2018: 176
Page views in 2019 to date: 127
Cite this page: Yu G. Cytopathology competency assessment - neurogenic tumors. website. Accessed August 21st, 2019.
Medical knowledge, practice based learning and systems based practice
  1. Identify the most frequent location of neurogenic tumors of the mediastinum and the tissues from which they are derived
  2. Recognize that benign neurogenic tumors may result in false negative FNAs based on their scant cellularity
    1. Sympathetic nervous system tumors
      1. Neuroblastoma
        • Become familiar with the classic FNA findings of this highly aggressive tumor, which occurs most frequently in children
        • Recognize the morphologic features of the Homer Wright rosette and other associated FNA findings of this tumor
      2. Ganglioneuroblastoma
        • Recognize the morphologic feature which differentiates this tumor from the more clinically aggressive neuroblastoma and its frequency in the mediastinum, as compared with neuroblastoma
      3. Ganglioneuroma
        • Recognize the morphologic features of this benign tumor, including the lack of background features seen in more aggressive lesions within this category
    2. Peripheral nervous system tumors
      1. Schwannoma (neurilemmoma)
        • Recognize schwannoma as the most common neurogenic tumor of the mediastinum
        • Recognize the classic histologic features of schwannoma and correlate this to the expected cytologic findings of FNA
        • Appreciate the likelihood of obtaining suboptimal material from FNA of schwannoma due to the frequency of myxoid, cystic and degenerative changes in this lesion
        • Appreciate the difficulty in excluding malignancy in the presence of "ancient" change in fine needle aspirates of schwannoma
      2. Neurofibroma
        • Identify expected FNA findings of neurofibroma and the typical clinical scenario (neurofibromatosis)
      3. Malignant peripheral nerve sheath tumor
        • Recognize FNA findings which may be seen in this tumor, with appreciation for the difficulty in making a definitive diagnosis in small biopsy samples
    3. Paraganglioma
      1. Identify the various compartments in which paraganglioma may occur and the typical clinical presentation for each location
      2. Recognize the cytologic findings of FNA of paraganglioma
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