Histologic spectrum of neurothekeoma and the value of immunoperoxidase staining for S-100 protein in distinguishing it from melanoma.
Neurothekeoma, a benign cutaneous lesion of probable nerve sheath origin, is divided histologically into two subtypes--myxoid and cellular. However, we believe that neurothekeoma encompasses a wider spectrum of lesions, with the myxoid and cellular subtypes falling at either end of the morphologic spectrum. Because the cellular variant of neurothekeoma sometimes resembles melanoma, it presents a difficult diagnostic problem. We report the histologic and immunohistochemical findings in 14 cases of neurothekeoma and review the findings in 35 additional cases from the literature. A detailed analysis of the histologic spectrum is also included. When examined by immunostains, only the myxoid variants of neurothekeoma stain positively for S-100 protein. We conclude that when the histological differential diagnosis is between cellular neurothekeoma and melanoma, an S-100-positive lesion should be regarded as melanoma.
Husain
S
S
Department of Pathology, College of Physicians and Surgeons, Columbia-Presbyterian Medical Center, New York, New York.
Silvers
D N
DN
Halperin
A J
AJ
McNutt
N S
NS
D000328:Adult; D000368:Aged; D002467:Cell Nucleus / Q000648:ultrastructure; D002675:Child, Preschool; D003094:Collagen; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008562:Membrane Glycoproteins / Q000032:analysis; D008875:Middle Aged; D018396:Mucin-1; D009077:Mucins / Q000032:analysis; D004676:Myelin Basic Protein / Q000032:analysis; D009363:Neoplasm Proteins / Q000032:analysis; D018321:Neurothekeoma / Q000473:pathology*; D009418:S100 Proteins / Q000032:analysis*; D012878:Skin Neoplasms / Q000473:pathology*; D013194:Staining and Labeling; D011503:Transglutaminases / Q000032:analysis
D008562:Membrane Glycoproteins; D018396:Mucin-1; D009077:Mucins; D004676:Myelin Basic Protein; D009363:Neoplasm Proteins; D009418:S100 Proteins; D003094:Collagen; D011503:Transglutaminases