Cellular Neurothekeoma



Cellular Neurothekeoma


Cyril Fisher, MD, DSc, FRCPath










Scanning magnification of a transverse section of whole tumor shows the smooth, dome-shaped outline. The lesion is confined to the dermis. The epidermis is thinned, except at the lateral margins.






High magnification shows cellular features. The nuclei are uniform, rounded, and vesicular, and some have small nuclei image. The cytoplasm is eosinophilic, finely granular, or focally clear.


TERMINOLOGY


Abbreviations



  • Neurothekeoma (NTK)


Definitions



  • Multinodular dermal tumor composed of nests of rounded cells separated by delicate fibrous septa


  • Differs from dermal nerve sheath myxoma (also termed myxoid neurothekeoma)


  • Cell type unknown



    • Possibly related to plexiform fibrous histiocytoma


    • Cells may be myofibroblastic or fibrohistiocytic


CLINICAL ISSUES


Epidemiology



  • Incidence



    • Rare


  • Age



    • Young adults, most 15-25 years


  • Gender



    • M = F


  • Ethnicity



    • No predilection


Site



  • Head and neck and upper extremity most common


Presentation



  • Slow growing



    • Elevated dermal nodule


    • Painless


Treatment



  • Surgical approaches



    • Simple excision


Prognosis



  • Reported cases have behaved in benign fashion


  • Occasional recurrence, especially if incompletely excised


  • Atypical histologic features have no prognostic significance


MACROSCOPIC FEATURES


General Features



  • Rounded or dome-shaped skin lesion


  • Pale or tan


Size



  • ≤ 2 cm diameter


MICROSCOPIC PATHOLOGY


Histologic Features

Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Cellular Neurothekeoma
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