An unusual diffuse CD34 staining in an olfactory groove cellular schwannoma: Case report
DOI:
https://doi.org/10.31157/an.v29i1.474Keywords:
schwannoma, CD34, olfactory groove, cellularAbstract
Background: Intracranial schwannomas are benign lesions, expected to exhibit characteristic ultrastructural features and immunophenotypic profile, typically being S-100, SOX10 and collagen-IV positive, while other markers, including CD34, are not usually expressed and are employed in the diagnostic elimination process.
Case presentation: A 51-year-old female presented with a rapidly deteriorating neurological status. MRI showed a heterogeneous enhancing neoplasm of the anterior fossa. Preoperative differential diagnosis predilected an esthesioneuroblastoma. A bifrontal craniotomy with total excision of the lesion was performed. Dural infiltration was present. There was no association with the olfactory system. Microscopic examination revealed a uniform population of spindled to slightly epithelioid cellular proliferation with no significant atypia, low mitotic activity, and foci of necrosis. Upon immunohistochemical investigation the tumor was consistent with cellular schwannoma. Diffuse positivity for CD34 was an unusual finding.
Discussion: Cellular schwannoma should be considered in the presence of an anterior fossa tumefaction. Olfactory nerve is not directly associated with these lesions. Various theories have been proposed, with the meningeal trigeminal branches’ origin being the most probable. The characteristic ultrastructural Antoni formations may be scarce or even absent in cellular schwannomas creating potential diagnostic difficulties. Unusual diffuse CD34 positivity should not be employed for excluding the diagnosis.
References
Machinis TG, Fountas KN, Dimopoulos V, Robinson JS. History of acoustic neurinoma surgery. Neurosurg Focus. Apr 15 2005;18(4):e9. doi:10.3171/foc.2005.18.4.10 DOI: https://doi.org/10.3171/foc.2005.18.4.10
Besharatirad M, Sharifi G, Bidari Zerehpoosh F. An olfactory Schwannoma mimicking esthesioneuroblastoma: A case report. Interdisciplinary Neurosurgery. 2020;21doi:10.1016/j.inat.2020.100726 DOI: https://doi.org/10.1016/j.inat.2020.100726
Sauvaget F, Francois P, Ben Ismail M, Thomas C, Velut S. Anterior fossa schwannoma mimicking an olfactory groove meningioma: case report and literature review. Neurochirurgie. Apr 2013;59(2):75-80. doi:10.1016/j.neuchi.2013.02.003 DOI: https://doi.org/10.1016/j.neuchi.2013.02.003
Yamahata H, Hirahara K, Tomosugi T, et al. Subfrontal schwannoma mimicking neuroblastoma: case report. Skull Base Rep. May 2011;1(1):59-64. doi:10.1055/s-0031-1275637 DOI: https://doi.org/10.1055/s-0031-1275637
Park JY, Park H, Park NJ, Park JS, Sung H-J, Lee SS. Use of Calretinin, CD56, and CD34 for Differential Diagnosis of Schwannoma and Neurofibroma. The Korean Journal of Pathology. 2011;45(1)doi:10.4132/KoreanJPathol.2011.45.1.30 DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.30
Ohashi R, Wakayama N, Kawamoto M, Tsuchiya S, Okubo K. Solitary nasal schwannoma: Usefulness of CD34 and calretinin staining for distinction from histological mimics. J Nippon Med Sch. 2013;80(4):300-6. doi:10.1272/jnms.80.300 DOI: https://doi.org/10.1272/jnms.80.300
Hirose T, Tani T, Shimada T, Ishizawa K, Shimada S, Sano T. Immunohistochemical demonstration of EMA/Glut1-positive perineurial cells and CD34-positive fibroblastic cells in peripheral nerve sheath tumors. Mod Pathol. Apr 2003;16(4):293-8. doi:10.1097/01.MP.0000062654.83617.B7 DOI: https://doi.org/10.1097/01.MP.0000062654.83617.B7
Figueiredo EG, Soga Y, Amorim RL, Oliveira AM, Teixeira MJ. The puzzling olfactory groove schwannoma: a systematic review. Skull Base. Jan 2011;21(1):31-6. doi:10.1055/s-0030-1262945 DOI: https://doi.org/10.1055/s-0030-1262945
Stricsek GP, Evans JJ, Farrell CJ. Cerebellopontine Angle Tumors. Neurocritical Care Management of the Neurosurgical Patient. 2018:199-207. DOI: https://doi.org/10.1016/B978-0-323-32106-8.00019-4
Masuda H, Nemoto M, Okonogi S, et al. Utility of Schwann/2E and Sox10 in distinguishing CD57-negative olfactory groove schwannoma from olfactory ensheathing cell tumor: A case report and review of the literature. Neuropathology. Aug 2020;40(4):373-378. doi:10.1111/neup.12650 DOI: https://doi.org/10.1111/neup.12650
Yoon J, Barton MJ, St John JA, Ekberg JAK, Khan A, Redmond M. Anterior skull base olfactory tumours, which is what? A case report and review. Journal of Clinical Neuroscience. 2020;81:1-5. doi:10.1016/j.jocn.2020.09.008 DOI: https://doi.org/10.1016/j.jocn.2020.09.008
Murtaza M, Chacko A, Delbaz A, et al. Why are olfactory ensheathing cell tumors so rare? Cancer Cell Int. 2019;19:260. doi:10.1186/s12935-019-0989-5 DOI: https://doi.org/10.1186/s12935-019-0989-5
Russel DSR. Pathology of Tumors of the Nervous System. 3rd ed. London: E Arnold; 1971.
Muzzafar S, Ketonen L, Weinberg JS, Schellingerhout D. Imaging and clinical features of an intra-axial brain stem schwannoma. AJNR Am J Neuroradiol. Mar 2010;31(3):567-9. doi:10.3174/ajnr.A1758 DOI: https://doi.org/10.3174/ajnr.A1758
Gao Y, Qin Z, Li D, et al. Intracerebral schwannoma: A case report and literature review. Oncol Lett. Aug 2018;16(2):2501-2510. doi:10.3892/ol.2018.8949 DOI: https://doi.org/10.3892/ol.2018.8949
D'Almeida Costa F, Dias TM, Lombardo KA, et al. Intracranial cellular schwannomas: a clinicopathological study of 20 cases. Histopathology. Jan 2020;76(2):275-282. doi:10.1111/his.13967 DOI: https://doi.org/10.1111/his.13967
Perry A, Reus D, Rodriguez F. Neurofibroma. In: Tumors STaB, ed. WHO Classification of Tumors 5th ed. WHO; 2019:232-236.
Rodriguez FJ, Folpe AL, Giannini C, Perry A. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems. Acta Neuropathol. Mar 2012;123(3):295-319. doi:10.1007/s00401-012-0954-z DOI: https://doi.org/10.1007/s00401-012-0954-z
Chaubal A, Paetau A, Zoltick P, Miettinen M. CD34 immunoreactivity in nervous system tumors. Acta Neuropathol. 1994;88(5):454-8. doi:10.1007/BF00389498 DOI: https://doi.org/10.1007/BF00389498
Khalifa MA, Montgomery EA, Ismiil N, Azumi N. What are the CD34+ cells in benign peripheral nerve sheath tumors? Double immunostaining study of CD34 and S-100 protein. Am J Clin Pathol. Jul 2000;114(1):123-6. doi:10.1309/C7N9-J2AU-5TB9-5FRL DOI: https://doi.org/10.1309/C7N9-J2AU-5TB9-5FRL
Weiss SW, Nickoloff BJ. CD-34 Is Expressed by a Distinctive Cell Population in Peripheral Nerve, Nerve Sheath Tumors, and Related Lesions. The American Journal of Surgical Pathology. 1993;17(10):1039-1045. doi:10.1097/00000478-199310000-00009 DOI: https://doi.org/10.1097/00000478-199310000-00009
Zhou H, Coffin CM, Perkins SL, Tripp SR, Liew M, Viskochil DH. Malignant peripheral nerve sheath tumor: a comparison of grade, immunophenotype, and cell cycle/growth activation marker expression in sporadic and neurofibromatosis 1-related lesions. Am J Surg Pathol. Oct 2003;27(10):1337-45. doi:10.1097/00000478-200310000-00006 DOI: https://doi.org/10.1097/00000478-200310000-00006
Guedes-Corrêa J, Cardoso R. Immunohistochemical Markers for Schwannomas, Neurofibromas and Malignant Peripheral Nerve Sheath Tumors—What Can the Recent Literature Tell Us? Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery. 2018;37(02):105-112. doi:10.1055/s-0038-1667180 DOI: https://doi.org/10.1055/s-0038-1667180
Arvanitis LD. Melanotic schwannoma: a case with strong CD34 expression, with histogenetic implications. Pathol Res Pract. Oct 15 2010;206(10):716-9. doi:10.1016/j.prp.2010.02.011 DOI: https://doi.org/10.1016/j.prp.2010.02.011
Additional Files
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
September 2022-present © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.
January-September 2022 © The authors. Open access articles under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. No commercial re-use is allowed.
January 2014-December 2021 © Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez. Open access articles under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) license, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
