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Mediastinum

Other benign / low grade tumors

Neurofibroma


Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 2 March 2013, last major update December 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Usually in posterior mediastinum, asymptomatic
● May be multiple
● Plexiform tumors are specific for neurofibromatosis
● Benign

Epidemiology
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● Young adults

Treatment
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● Excision is usually curative (Chirurgia (Bucur) 2011;106:199)

Gross description
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● Often encapsulated in mediastinum (not at other sites)
● Usually centered on or grow within a large spinal nerve root
● May have intradural and extradural components and protrude through neural foramina of vertebral column
● Plexiform tumors resemble a neural plexus
● Degenerative changes are common (fat, hemorrhage, cysts)

Gross images
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Well circumscribed myxomatous tumor surrounded by thin pseudocapsule

Micro description
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● Uniform growth pattern of bland spindle cells in fascicles, storiform arrays or tactoids (“elongated particles that appears as spindle-shaped bodies under polarizing microscope”)
● Myxoid stroma, frequent mast cells, no distinct biphasic pattern
● No thick walled blood vessels

Micro images
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Fascicular proliferation of spindle tumor cells

Electron microscopy description
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● Fibroblast-like tumor cells with abundant rough endoplasmic reticulum, rudimentary cytoplasmic processes, sparse pericellular basal lamina
● May lack evidence of schwannian differentiation

End of Mediastinum > Other benign / low grade tumors > Neurofibroma


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