Atypical Reexcision Perineural Invasion

Wu, Mark Li-cheng; William, A.; Richards, Kristen A.; Guitart, Joan

doi:10.1097/00000478-200006000-00019

Cited by 20 publications

(20 citation statements)

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“…They termed the lesion reexcision perineural invasion and proposed the following guidelines for its diagnosis: absence of perineural spread beyond the immediate previous biopsy site, benign appearance of the perineural epithelial cells different from the appearance of the original tumor, and absence of residual epithelial tumor in the vicinity of the involved perineurium. Recently Wu et al [23] reported a similar but not identical case in which a focus of perineural invasion by a nest of atypical squamous epithelium was observed in a reexcision specimen in which an earlier biopsy showed a scar. Because of the epithelial atypia, Stern and Haupt [24] felt that a diagnosis of reexcision perineural invasion was not reliable in that case.…”

Section: Discussionmentioning

confidence: 86%

Reactive Neuroepithelial Aggregates of the Skin

Chen

2003

Int J Surg Pathol

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A peculiar, apparently reactive, microscopic structure of the skin was observed in 5 patients. It is characterized histologically by a bundle of nerve fibers partially or completely ensheathed by bland nonkeratinizing squamous epithelium. In 2 patients, the specimens were reexcision specimens, in which this structure was found amid active postbiopsy repair. In the remaining 3 patients, there was no history of previous excision or trauma at the lesional sites, and the background changes were consistent with either folliculitis or prurigo nodularis. This structure, when viewed in isolation, resembles carcinomatous perineural invasion. This structure and comparable structures observed in extracutaneous sites have often been referred to as "perineural invasion" in the literature, but the author proposes the term reactive neuroepithelial aggregate (RNEA) to denote its reactive nature.

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Section: Discussionmentioning

confidence: 86%

Reactive Neuroepithelial Aggregates of the Skin

Chen

2003

Int J Surg Pathol

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“…For the diagnosis of RPI, they recommended specific criteria: perineural involvement should be limited to the immediate previous biopsy site, perineural epithelial cells should reveal well‐differentiated tissue different from the appearance of the original neoplasm and no residual neoplastic epithelial cells should be present adjacent to the neuroepithelial lesion 12 . According to these criteria, Stern and Haupt 13 rejected the suggestion of Wu et al that cytological atypia may be seen in RPI 14 . ESN can be differentiated from RPI by the absence of history of local excision and the lack of any evidence of scarring in histological sections.…”

Section: Discussionmentioning

confidence: 99%

Epithelial sheath neuroma: be aware of benign perineural invasion!

Husain

Al-Daraji

2009

J Cutan Pathol

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Perineural involvement by epithelial cells is usually considered as a sign of malignancy and is seen in a variety of malignant skin neoplasms. However, there are other benign conditions characterized by the presence of perineural involvement by epithelial cells. We present a case of epithelial sheath neuroma in a 43-year-old male. The clinicopathological features of this newly described entity are discussed together with the differential diagnosis and the different hypotheses of pathogenesis. Both pathologists and dermatologists should be aware of this entity to avoid misdiagnosis of malignancy.

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“…Bei perineural liegenden epithelialen Zellen in einem Nachexzidat muss auch an das Vorliegen von artifiziell um Nerven angeordnete Adnexstrukturen gedacht werden ("reexcision perineural invasion") [52]. Beschrieben wurden dabei 2 Fälle mit vorausgegangener Exzision von melanozytären Neoplasien.Es fanden sich S100-negative neurotrope epitheliale Zellen, die vermutlich von den in der Nähe liegenden Schweißdrüsen stammten [52,61].Die regelrechte Zytologie der Epithelien ließ einen malignen Prozess ausschließen.Eine weitere histologische Differenzialdiagnose ist das seltene "epithelial sheath neuroma",das aus hyperplastischen,in der oberen Dermis liegenden Nervenbündeln aufgebaut ist,die eine epitheliale Hülle aufweisen [30,48,62].…”

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