A nonfunctioning paraganglioma of vagus nerve:An ultrastructural study

Abstract

The clinical, histological, and ultrastructural aspects of a cervical paraganglioma of the vagus nerve, in a 66-year-old white man, have been discussed in detail. Ultrastructurally, the tumor chief cells contained characteristic membrane-bound and dense-cored neurosecretory granules which ranged in size from 85 millimicron to 190 millimicron. Unlike earlier ultrastructural reports, the present study showed the presence of sustentacular or supporting cells. These cells were smaller, darker, polymorphic, and were commonly located at the periphery of a single or group of chief cells. Furthermore, unlike earlier reports on vagal paragangliomas, nonmyelinated nerve fibers and an occasional axon were identified in the present fine structure study.

Malignant vagal paraganglioma

“…However, not all tumours accumulate MIBG and so a negative scan cannot exclude other lesions. Twenty-four hour urinary VMA levels should be measured in all suspected cases of paraganglioma (Chaudry et al, 1979), however, there have been only five reported cases of functional VP in the literature (Levit et al, 1969;Sundaram and Cope, 1976;Bogdasarian and Lotz, 1979;Tannir et al, 1985;Karusseit and Lodder, 1987). Open biopsy of these tumours is no longer recommended.…”

Paragangliomas of the Neck

“…Resection is usually curative, although sacrifice of the vagus nerve is nearly always required.16 The rate of met¬ astatic spread is approximately 18%. 22 Laryngeal paragangliomas are rare neoplasms, with a malignancy rate of 25% to 37%.19 They usually originate within or near the superior laryngeal nerve just above the anterior portion of the vocal cord in the plica ventricularis.4 The inferior laryngeal paraganglion is located at the divi¬ sion of the recurrent laryngeal nerve into adductor and abductor branches. Hoarseness, dysphagia, and pain are the usual presenting symptoms.…”

Vagal paragangliomas: a clinical, pathological, and DNA assessment

“…Using the Fisher exact test, the P value for aneuploidy in our series was 0.2. 16 Heinrich etal. in 1985 reviewed the English language literature and found only 15 cases that were malignant.'…”