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plexiform fibromyxoma:Review of rare mesenchymal gastric neoplasm and its differential diagnosis

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World Journal of Gastrointestinal Oncology 2021年第5期13卷 409-423页

作者： Mustafa Erdem Arslan Hua Li Zhiyan Fu Timothy A Jennings Hwajeong Lee Pathology and Laboratory Medicine Albany Medical CenterAlbanyNY 12208United States

plexiform fibromyxoma(PF)is a very rare mesenchymal neoplasm of the stomach that was first described in 2007 and was officially recognized as a subtype of gastric mesenchymal neoplasm by World Health Organization(WHO)in 2010.Histologically,PF is characterized by a plexiform growth of bland spindle to ovoid cells embedded in a myxoid stroma that is rich in small vessels.The lesion is usually paucicellular.While mucosal and vascular invasion have been documented,no metastasis or malignant transformation has been reported.Its pathogenesis is largely unknown and defining molecular alterations are not currently available.There are other mesenchymal tumors arising in the gastrointestinal tract that need to be differentiated from PF given their differing biologic behaviors and malignant potential.Histologic mimics with spindle cells include gastrointestinal stromal tumor,smooth muscle tumor,and nerve sheath tumor.Histologic mimics with myxoid stroma include myxoma and aggressive angiomyxoma.Molecular alterations that have been described in a subset of PF may be seen in gastroblastoma and malignant epithelioid tumor with gliomaassociated oncogene homologue 1(GLI1)rearrangement.The recent increase in publications on PF reflects growing recognition of this entity with expansion of clinical and pathologic findings in these cases.Herein we provide a review of PF in comparison to other mesenchymal tumors with histologic and molecular resemblance to raise the awareness of this enigmatic neoplasm.Also,we highlight the challenges pathologists face when the sample is small,or such rare entity is encountered intraoperatively.

关键词： plexiform Fibromyxoma Gastrointestinal Mesenchymal Neoplasm Stomach

Discriminating performance of macular ganglion cellinner plexiform layer thicknesses at different stages of glaucoma

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International Journal of Ophthalmology(English edition) 2019年第3期12卷 464-471页

作者： Melih Ustaoglu Nilgun Solmaz Feyza Onder Glaucoma Research Center Wills Eye Hospital Ophthalmology Clinic Sisli Hamidiye Etfal Training and Research Hospital Ophthalmology Clinic Haseki Training and Research Hospital

AIM: To determine the discriminating performance of the macular ganglion cell-inner plexiform layer(GCIPL) parameters between all the consecutive stages of glaucoma(from healthy to moderate-to-severe glaucoma), and to compare it with the discriminating performances of the peripapillary retinal nerve fiber layer(RNFL) parameters and optic nerve head(ONH) parameters.METHODS: Totally 147 eyes(40 healthy, 40 glaucoma suspects, 40 early glaucoma, and 27 moderate-to-severe glaucoma) of 133 subjects were included. Optical coherence tomography(OCT) was obtained using Cirrus HD-OCT 5000. The diagnostic performances of GC-IPL, RNFL, and ONH parameters were evaluated by determining the area under the curve(AUC) of the receiver operating characteristics. RESULTS: All GC-IPL parameters discriminated glaucoma suspect patients from subjects with healthy eyes and moderate-to-severe glaucoma from early glaucoma patients(P<0.017, for all). Also, minimum, inferotemporal and inferonasal GC-IPL parameters discriminated early glaucoma patients from glaucoma suspects, whereas no RNFL or ONH parameter could discriminate between the two. The best parameters to discriminate glaucoma suspects from subjects with healthy eyes were superonasal GC-IPL, superior RNFL and average c/d ratio(AUC=0.746, 0.810 and 0.746, respectively). Discriminating performances of all the parameters for early glaucoma vs glaucoma suspect comparison were lower than that of the other consecutive group comparisons, with the bestGC-IPL parameters being minimum and inferotemporal(AUC=0.669 and 0.662, respectively). Moreover, minimum GC-IPL, average RNFL, and rim area(AUC=0.900, 0.858, 0.768, respectively) were the best parameters for discriminating moderate-to-severe glaucoma patients from early glaucoma patients.CONCLUSION: GC-IPL parameters can discriminate glaucoma suspect patients from subjects with healthy eyes, and also all the consecutive stages of glaucoma from each other(from glaucoma suspect to moderate-tosevere glaucoma). Further, the discriminating performa

关键词： retinal nerve fiber layer optic nerve head cirrus HD-OCT ganglion cell-inner plexiform layer glaucoma suspect

Magnetic resonance imaging findings for differential diagnosis of perianal plexiform schwannoma: Case report and review of the literature

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World Journal of Clinical Cases 2018年第5期6卷 88-93页

作者： Xue-Liang Sun Ke Wen Zhi-Zhong Xu Xiao-Peng Wang Department of Colorectal Surgery the Suzhou Affiliated Hospital of Nanjing University of Chinese Medicine

plexiform schwannoma is an extremely rare variant of schwannoma, accounting for approximately 5% of cases. Due to the rarity and lack of typical symptoms, signs and radiological images, a definite diagnosis of plexiform schwannoma may not be made by clinicians prior to biopsy. In the present study, we report the first case(to our knowledge) of perianal plexiform schwannoma arising from the overlapped skin of the ischioanal fossa, and we propose an intratumorally nonenhanced circumferential capsule dividing the tumour into multiple homogeneously enhanced nodules as a magnetic resonance imaging feature to aid in the differential diagnosis of plexiform schwannoma from ancient schwannoma, cavernous haemangioma, liposarcoma and plexiform neurofibroma.

关键词： plexiform schwannoma Magnetic resonance imaging Perianal Bascom cleft lift Diagnosis

plexiform angiomyxoid myofibroblastic tumor of stomach:A rare case

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World Journal of Gastrointestinal Endoscopy 2016年第18期8卷 674-678页

作者： Laimas Jonaitis Mindaugas Kiudelis Paulius Slepavicius Lina Poskiene Limas Kupcinskas Department of Gastroenterology Medical Academy Lithuanian University of Health Sciences 50009 Kaunas Lithuania Department of Surgery Medical AcademyLithuanian University of Health Sciences 50009 Kaunas Lithuania Department of Pathological Anatomy Medical Academy Lithuanian University of Health Sciences 50009 Kaunas Lithuania

plexiform angiomyxoid myofibroblastic tumor(PAMT) is a rare benign mesenchymal tumor of stomach. Rarity of this kind of tumors and scarce review articles may cause underrecognition of this entity and pose a real diagnostic challenge to gastroenterologists, pathologists and surgeons when encountering such patients and differentiating PAMT from other gastric intramural tumors. We report a case of 28-year-old woman, who presented with epigastric pain after meals, iron-deficiency anaemia and weight loss. Upper gastrointestinal endoscopy revealed submucosal tumorlike elevated lesion in the anterior wall of the antrum with intact overlying mucosa. Endoscopic ultrasound showed a 3-cm hypoechoic homogenous mass, originating from the third layer of the gastric wall. Endoscopic ultrasound-guided fine needle aspiration was not informative. Endoscopic buttonhole biopsy was performed to obtain specimens. Following this, the unexpected prolapse of the tumor occurred into the lumen of the stomach, causing gastric outlet obstruction- the biopsy was obtained. Pathomorphological features suggested the diagnosis of PAMT. Gastric resection of the Billroth I type was performed. Diagnosis was confirmed by histological analysis of the surgical specimen.

关键词： plexiform angiomyxoid myofibroblastic tumor Intramural Mesenchymal Submucosal Antrum

Cutaneous plexiform schwannoma in the right thigh after trauma

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International Journal of Dermatology and Venereology 2019年第1期2卷 45-46页

作者： Ying Li Chao-Yang Miao Chen Wang Xiao-Yan Zhang Peking University China-Japan Friendship School of Clinical Medicine Beijing 100029China Department of Dermatology China-Japan Friendship HospitalBeijing 100029China

Introduction plexiform schwannoma accounts for approximately 2%-5% of schwannoma.It often afflicts young adults,affecting males and females at a similar rate,and is most commonly located in the head,neck,trunk,or upper extremities.plexiform schwannoma occasionally occur in the foot,but are rarely found in the lower limbs[1].The tumor usually presents as a solitary,slow-growing,asymptomatic nodule,and the maximum diameter of plexiform schwannomas is less than 2 cm[2].Trauma-related plexiform schwannoma is rare and needs to be differentiated in clinic.Herein,we report an unusual case of 28-year-old women with a reddish-brown plaque of her right thigh accompanying tenderness,the patient had been injured in the same location where the plaque later developed,and the histopathological results were consistent with plexiform schwannoma.

关键词： histopathological plexiform schwannoma tenderness

plexiform Neurofibroma of Nasal Tip

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第6期4卷 423-428页

作者： Rajanala Venkata Nataraj Mohan Jagade Kartik Parelkar Reshma Hanawte Arpita Singhal Dev Rengaraja Kiran Kulsange Kartik Rao Pallavi Gupta Department of Ear Nose & Throat and Head & Neck Surgery Grant Government Medical College Mumbai India

Neurogenic tumor is the name given to any tumor that arises from the nerve tissue or its coverings. Neurogenic tumors of Sino-nasal cavity are a very rare entity. The most common types are Schwannomas and Neurofibromas and the plexiform subtype is one form of these neuroendocrine tumors. We report the case series of two such cases of a plexiform neurofibroma of the nasal tip, which were excised via an open rhinoplasty approach.

关键词： plexiform Neurofibroma Schwannoma Nasal Tip External Nasal Deformity Open Rhinoplasty

plexiform Schwannoma: A Report of Two Unusual Cases, and a Review of the Literature

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Open Journal of Stomatology 2014年第4期4卷 174-178页

作者： Shabnum Ali Leandros Vassiliou Philip Stenhouse Department of Oral and Maxillofacial Surgery Queen Mary’s Hospital Sidcup UK

plexiform schwannoma is a benign tumour arising from the sheath of myelinated nerve fibres that may occur in any part of the body. It is very rare in the head and neck region and poses diagnostic challenges. Here we present two unusual cases. The first is about a fifteen-year-old boy with a large plexiform schwannoma in the right retro maxillary region, extending up to but not invading the orbit. Initial cytology reported it as a pleomorphic adenoma, but histological findings after excision confirmed it to be a benign plexiform schwannoma. A zygomatic osteotomy was required to excise the tumour in its entirety. The second reported case is about solitary lesion on the tongue of a 46-year-old Chinese man, clinically mimicking a mucocoele. This case report highlights the diagnostic challenges posed by plexiform schwannoma, and the role of imaging and cytopathology, as well as the importance of definitive histopathological analysis. It also describes the surgical management of these lesions, and provides a review of the literature, in particular of cases occurring in the head and neck region.

关键词： plexiform Schwannoma Benign Nerve Sheath Tumour

Solitary plexiform neurofibroma of the stomach:A case report

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World Journal of Gastroenterology 2014年第17期20卷 5153-5156页

作者： Lei Shi Fu-Jian Liu Qiu-Hong Jia Hang Guan Zhao-Jiong Lu Department of Gastroenterology the Eighth Affiliated Hospital of Guangxi Medical University

plexiform neurofibroma(PN)of the digestive tract is very rare and usually part of the generalized syndrome of neurofibromatosis type 1(von Recklinghausen disease).Solitary PN of the stomach is extremely rare and has not been reported in the literatures.Here we present a case of solitary PN of the stomach,which was not associated with von Recklinghausen disease.A38-year-old male presented abdominal pain and distention for 7 d.The patient underwent endoscopy of the upper gastrointestinal tract,which revealed a 3.5 cm protruding and cauliflower-shaped mass with a shallow1 cm central ulcer in the greater curvature of the stomach.The lesion was removed by laparoscopic surgery.Histological examination demonstrated characteristic histological findings of spindle-shaped cells.Immunohistochemical analysis showed that the tumor cells were positive for S-100 protein,but negative for CD34,KI-67,CD117,and actin.Based on histological findings,gastrointestinal stromal tumor could be excluded,and thus the case was confirmed as PN.We described the clinical features,physical examination,endoscopic findings,and histopathological examination of this case.

关键词： plexiform neurofibroma Neurofibromatosis Von Reckl

plexiform Angiomyxoid Myofibroblastic Tumor of the Stomach

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Open Journal of Pathology 2012年第4期2卷 147-149页

作者： Peifeng Li Qingqing Zhang Xuchun Jia Qinlong Li Zengshan Li Zhe Wang Department of Hepatobiliary Surgery Weifang People’s Hospital Weifang China State Key Laboratory of Cancer Biology Department of Pathology Xijing Hospital and School of Basic Medicine Fourth Military Medical University Xi’an China

plexiform angiomyxoid myofibroblastic tumor (PAMT) is a recently described gastric tumor with a peculiar plexiform pattern, bland spindle cells and a myxoid stroma rich in arborizing blood vessels. PAMT of the stomach is a very rare tumor without distinctive clinical manifestations. In this study, we report a new case of PAMT which is the first Chinese case in English literature. A 47-year-old Chinese woman was admitted with a 6-month history of intermittent epigastric discomfort, and abdominal pain for 2 months. Gastroscopy showed an elevated mass in the anterior wall of the gastric antrum. Endoscopic ultrasound revealed a focal hypoechoic lesion protruding into the lumen. A laparoscopic distal gastrectomy was performed, and the patient made an uneventful recovery and remains well 1.5 years later. A diagnosis of PAMT was made by histopathology and immunochemistry.

关键词： plexiform Angiomyxoid Myofibroblastic Tumor Stomach Gastrointestinal Stromal Tumor Myofibroblast