Neural Related Lesions Flashcards
Reversed
Antoni B is less cellular and less organized
What is the main difference between Antoni A and Antoni B neurilemoma?
What are the histopathologic features of Antoni A neurilemoma?
Streaming fascicles of spindle-shaped Schwann cells that form a palisaded arrangement around the central, acellular eosinophilic areas known as Verocay bodies
Tx for neurilemoma
Solitary neurilemoma is treated with surgical excision
What is recurrence rate for neurilemoma?
Recurence should not occur
What is a neurilemoma?
Benign neural neoplasm of Schwann cell origin (Schwannoma)
Tx for traumatic neuroma
Tx of choice = surgical excision, including a small portion of the involved nerve bundle
What are the histopahtologic features of Antoni B neurilemoma?
Spindle cells are randomly arranged within a loose myxomatous stroma
Tumor cells will show a diffuse, positive reaction for S-100 protein
Neurites cannot be demonstrated within the tumor mass
What is a traumatic neuroma?
Reactive proliferation of neural tissue after transaction or other damage of a nerve bundle
Not a true neoplasm
What is the main difference between Antoni A and Antoni B neurilemoma?
Antoni B is less cellular and less organized
What is the most common location of neurilemoma?
tongue
What are the clinical features of neurilemoma?
Slow growing encapsulated tumor
Typically arises in association with a nerve trunk
Usually asymptomatic, but tnederness may occur
Pushes nerve aside as it grows
What is hte histopathologic appearance of a traumatic neuroma?
Haphazard proliferation of mature, myelinated and unmyelinated nerve bundles within a fibrous CT stroma that ranges from densely collagenized to myxomatous in nature
Mild chronic inflammatory infiltrate can be present
What cell types does a neurofibroma arise from?
Arise from a mixture of cell types including Schwann cells and perineural fibroblasts
Recurrence rate of neurofibroma
Rare
Where in the oral cavity do neurofibroma usually arise?
Most often on the tongue and buccal mucosa
How do neurofibromas appear?
Can arise as solitary tumors or be a component of neurofibromatosis
What are the two histopathologic forms of neurilemoma?
Antoni A
Antoni B
What is the histopathologic presentation of neurofibromas?
Tumor composed of interlacing bundles of spindle-shaped cells that often exhibit wavy nuclei
Numerous mast cells
Recurrence rate for a removed traumatic neuroma?
Most lesions do not recur
Pain may persist or return at a later date
Tx for neurofibroma
Local surgical excision
Any patient diagnosed with neurofibroma should be evaluated for the possibility of neurofibromatosis
What sensations can arise from a traumatic neuroma?
Associated with altered nerve sensations that can range from anesthesia to dyesthesia to over pain
Only 1/4 to 1/3 of oral truamatic lesions are painful
Neuromas of the mental nerve are frequently painful
What are verocay bodies?
Verocay bodies consist of reduplicated BM and cytoplasmic processes
What is the pathiphysiologic process in which a traumatic neuroma occurs?
After a nerve has been damaged or severed, the proximal portion attempts to regenerate and reestablish innervations of the distal segment by growth of axons through rubes of prliferating Schwann cells.
If these regenerating elements encounter scar tissue or otherwise cannot reestablish innervations, then a tumor-like mass may develop at the site of injury
What is a neurofibroma?
Most common type of peripheral nerve neoplasm
What is the most common location of neurofibroma?
Skin is the most common location but can occur in the oral cavity
