Connective Tissue Lesion Neural Flashcards
Part of a neuron
Receive signals from other neuron cells
Dendrites
Part of a neuron
Contains the cell nucleus
Cell body
Part of a neuron
Conducts electrical impulses along the neuron cell
Axon
Part of a neuron
Insulates the axon to help protect the neuron cell and speed up transmission of electrical impulses
Myelin sheath
Part of a neuron
Transmits electrical and chemical signals to other neuron cells and effector cells
Axon terminal
Etiology of traumatic neuromas
From tooth extraction, local anesthesia injection, from accident
Most common location of traumatic neuroma
Mental foramen
Palate - if soft tissue location
Microscopically, bundles of nerves in a haphazard or tortuous arrangement are found admixed with dense collagenous fibrous tissue
Traumatic neuroma
Treatment for traumatic neuroma
Surgical excision
No recurrence
Clinical features of traumatic lesion
50% cases are associated with pain
Radiating facial pain
Wide age range, mostly seen in adults
Is traumatic neuroma encapsulated?
Yes = good prognosis
Benign neoplasm that is derived from a proliferation of Schwann cells of the neurilemma or nerve sheath
Schwannoma
Capable of regeneration
Prerequisite for regenrating neurons of the PNS
The nerve is pushed aside (does not entangle within the tumor)
Schwannoma (neurilemmoma)
Encapsulated mass, asymptomatic lump in any age
Tongue = favored location
40S% occur in head and neck
Schwannoma
Well defined radiolucent pattern with a corticated periphery and may cause pain or pasthesia
Schwannoma
Encapsulated tumor, spindle cells with two different pattern. Antoni A and Antoni B
Schwannoma
IHC immunoprofile of schwannoma
S-100
Negative for actin and desmin
Consists of spindle cell organized in palisaded whorls and waves
Often surround an acellular eosinophilic zone (verocay body)
Representing reduplicated basement membrane and cytoplasmic cellular processes
Antoni A of schwannoma
Consists of spindle cells haphazardly distributed in a delicate fibrillar microcystic matrix
Antoni B Of schwannoma
Hypercellular
Nuclear palisading
Whorls and waves
Verocay bodies
Antoni A
Hypocelular
Loosely arranged
Haphazard
Myxoid background
Antoni B
Essential diagnostic criteria of schwannoma (neurilemmoma)
Hypecellular spindled areas and loose hypocellular myxoid bodies
Spindle cells with buckled, elongated, fusiform nuclei, palisaded
S-100, SOX10 positive
Treatment for schwannoma
Surgical excision
Good prognosis - encapsulated
May appear as solitary lesion or as multiple lesions as part of the neurofibromatosis (von recklinghausen’s disease of skin)
Neurofibroma
An inherited autosomal-dominant trait that has two subsets: one associated with NF1 gene and the other with the NF2 gene
Neurfibroma
Cell of origin of:
Schwannoma
Neurofibroma
Mucosal neuroma
PEN
Schwann cell
Schwann cell and perineural fibroblast
Nerve tissue, hamartoma
Schwann cell
Age
Schwannoma
Neurofibroma
Mucosal neuroma
PEN
Any
Any
Children, young adults
Adults
Site
Schwannoma
Neurofibroma
Mucosal neuroma
PEN
Any, especially tongue
Any, especially tongue, buccal mucosa
Tongue, lip, buccal mucosa
Palate, lip
Number
Schwannoma
Neurofibroma
Mucosal neuroma
PEN
Solitary
Solitary to multiple
Multiple
Solitary
Bone lesions
Schwannoma
Neurofibroma
Mucosal neuroma
PEN
Occasionally
Frequently
No
No
Syndrome associated
Schwannoma
Neurofibroma
Mucosal neuroma
PEN
Neurofibromatosis
Neurofibromatosis
MEN III
None
Malignant potential
Schwannoma
Neurofibroma
Mucosal neuroma
PEN
Rarely with sydrome
Infrequently with syndrome
No
No
clinical features of neurofibroma
Asymptomatic submucosal mass (neoplastic)
Unencapsulated
Tongue, buccal mucosa and vestibule - most commonly affected
NF1: multiple neurofibroma. Cafe-au-lait, bone abnormalities, CNS changes
Histopath
Non-encapsulatd
Random distribution o spindle cells in myxoid to collagenous stroma
Nuclei are wavy and tapered
Neurofibroma
IHC of neurofibroma
S-100, SOX10, CD34
Contains the genetic material of the neuron cell
Nucleus
