title: Cutaneous ganglioneuroma associated with overlying hyperkeratotic epidermal changes: a report of 2 cases.
abstract: The occurrence of primary cutaneous ganglioneuroma is rare. We report 2 separate cases of primary cutaneous ganglioneuroma, both of which are associated with prominent overlying hyperkeratosis. The first case was in a 38-year-old woman with overlying verrucous keratosis. The second case was in a 93-year-old man with epidermal changes reminiscent of a seborrheic keratosis. Histologically, both lesions were composed of a proliferation of hyperplastic nerve fibers with spindled Schwann cells and axons with intermingled ganglion cells. Immunohistochemistry for neurofilament highlighted nerve fascicles; S100 protein displayed the associated Schwann cells, and neuron-specific enolase stained the interspersed ganglion cells. Variation in immunohistochemical staining was present between the 2 cases. A review of the literature demonstrates variable immunohistochemical staining of ganglion and Schwann cells in prior cases. Familiarity with these findings is important in establishing a diagnosis. The significance of the associated hyperkeratosis remains speculative.
authors.affiliation: University of Washington, Department of Pathology, Seattle, WA 98195-6100, USA. pfurman@u.washington.edu
authors.forename: Paul S
authors.initials: PS
authors.lastname: Furmanczyk
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Hughes
authors.forename: John S
authors.initials: JS
authors.lastname: Walsh
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bass
authors.forename: Joe R
authors.initials: JR
authors.lastname: McFarlane
authors.forename: Zsolt B
authors.initials: ZB
authors.lastname: Argenyi
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D049109:Cell Proliferation; D005260:Female; D045888:Ganglion Cysts / Q000378:metabolism / Q000473:pathology; D005729:Ganglioneuroma / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007642:Keratosis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D010751:Phosphopyruvate Hydratase / Q000378:metabolism; D009418:S100 Proteins / Q000378:metabolism; D012583:Schwann Cells / Q000378:metabolism / Q000473:pathology; D012878:Skin Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology
chemical_list: D009418:S100 Proteins; D010751:Phosphopyruvate Hydratase