Neural Related Lesions

Question 1

Reversed

Antoni B is less cellular and less organized

Answer 1

What is the main difference between Antoni A and Antoni B neurilemoma?

Question 2

What are the histopathologic features of Antoni A neurilemoma?

Answer 2

Streaming fascicles of spindle-shaped Schwann cells that form a palisaded arrangement around the central, acellular eosinophilic areas known as Verocay bodies

Question 3

Tx for neurilemoma

Answer 3

Solitary neurilemoma is treated with surgical excision

Question 4

What is recurrence rate for neurilemoma?

Answer 4

Recurence should not occur

Question 5

What is a neurilemoma?

Answer 5

Benign neural neoplasm of Schwann cell origin (Schwannoma)

Question 6

Tx for traumatic neuroma

Answer 6

Tx of choice = surgical excision, including a small portion of the involved nerve bundle

Question 7

What are the histopahtologic features of Antoni B neurilemoma?

Answer 7

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

Question 8

What is a traumatic neuroma?

Answer 8

Reactive proliferation of neural tissue after transaction or other damage of a nerve bundle

Not a true neoplasm

Question 9

What is the main difference between Antoni A and Antoni B neurilemoma?

Answer 9

Antoni B is less cellular and less organized

Question 10

What is the most common location of neurilemoma?

Answer 10

tongue

Question 11

What are the clinical features of neurilemoma?

Answer 11

Slow growing encapsulated tumor

Typically arises in association with a nerve trunk

Usually asymptomatic, but tnederness may occur

Pushes nerve aside as it grows

Question 12

What is hte histopathologic appearance of a traumatic neuroma?

Answer 12

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

Question 13

What cell types does a neurofibroma arise from?

Answer 13

Arise from a mixture of cell types including Schwann cells and perineural fibroblasts

Question 14

Recurrence rate of neurofibroma

Answer 14

Rare

Question 15

Where in the oral cavity do neurofibroma usually arise?

Answer 15

Most often on the tongue and buccal mucosa

Question 16

How do neurofibromas appear?

Answer 16

Can arise as solitary tumors or be a component of neurofibromatosis

Question 17

What are the two histopathologic forms of neurilemoma?

Answer 17

Antoni A

Antoni B

Question 18

What is the histopathologic presentation of neurofibromas?

Answer 18

Tumor composed of interlacing bundles of spindle-shaped cells that often exhibit wavy nuclei

Numerous mast cells

Question 19

Recurrence rate for a removed traumatic neuroma?

Answer 19

Most lesions do not recur

Pain may persist or return at a later date

Question 20

Tx for neurofibroma

Answer 20

Local surgical excision

Any patient diagnosed with neurofibroma should be evaluated for the possibility of neurofibromatosis

Question 21

What sensations can arise from a traumatic neuroma?

Answer 21

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

Question 22

What are verocay bodies?

Answer 22

Verocay bodies consist of reduplicated BM and cytoplasmic processes

Question 23

What is the pathiphysiologic process in which a traumatic neuroma occurs?

Answer 23

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

Question 24

What is a neurofibroma?

Answer 24

Most common type of peripheral nerve neoplasm

Question 25

What is the most common location of neurofibroma?

Answer 25

Skin is the most common location but can occur in the oral cavity