Intraneural perineurioma: A systematic review with illustrative cases

Archives of Pathology and Laboratory Medicine

Volumn 131, Issue 9, 2007, Pages 1382-1392

  Boyanton Jr , Bobby L ^a,e   Jones, John K ^a,b   Shenaq, Saleh M ^c   Hicks, M John ^a,d   Bhattacharjee, Meenakshi B ^a,d  

^a BAYLOR COLLEGE OF MEDICINE   (United States)

^b Nose and Throat of Houston   (United States)

^c University General Hospital   (United States)

^d TEXAS CHILDREN S HOSPITAL   (United States)

^e WILLIAM BEAUMONT HOSPITAL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EPITHELIAL MEMBRANE ANTIGEN; PROTEIN S 100; CA 15-3 ANTIGEN;

CELL PROLIFERATION; CHROMOSOME 22; CLINICAL EXAMINATION; CLINICAL FEATURE; CYTOGENETICS; DATA BASE; DEMYELINATING DISEASE; DIFFERENTIAL DIAGNOSIS; DISEASE ASSOCIATION; DISEASE DURATION; FAMILY HISTORY; FOLLOW UP; HEREDITARY MOTOR SENSORY NEUROPATHY; HISTOPATHOLOGY; HUMAN; IMMUNOHISTOCHEMISTRY; METASTASIS; MOTOR DYSFUNCTION; NERVE SHEATH TUMOR; NERVE TUMOR; NEURINOMA; NEUROPATHY; OUTCOME ASSESSMENT; REVIEW; SENSORY DYSFUNCTION; STATISTICAL ANALYSIS; SYSTEMATIC REVIEW; TIGHT JUNCTION; TUMOR RECURRENCE; TUMOR VOLUME; ULTRASTRUCTURE; CASE REPORT; CELL DIFFERENTIATION; CHILD; FEMALE; INNERVATION; MALE; METABOLISM; NERVOUS SYSTEM TUMOR; PATHOLOGY; PRESCHOOL CHILD; TONGUE; ULNAR NERVE;

CA-15-3 ANTIGEN; CELL DIFFERENTIATION; CELL PROLIFERATION; CHILD; CHILD, PRESCHOOL; DIAGNOSIS, DIFFERENTIAL; FEMALE; HUMANS; MALE; NERVE SHEATH NEOPLASMS; NERVOUS SYSTEM NEOPLASMS; TONGUE; ULNAR NERVE;

EID: 34548758031     PISSN: 00039985     EISSN: 15432165     Source Type: Journal    
DOI: None     Document Type: Review

References (124)

1. Scheithauer BW, Giannini C, Woodruff JM. Perineurioma. In: Pathology and Genetics of Tumours of the Nervous System. Lyon, France: IARC Press; 2000: 169-171. World Health Organization Classification of Tumours.
2. Midroni G, Bilbao JM. Genetically determined neuropathies. In: Biopsy Diagnosis of Peripheral Neuropathy. Boston, Mass: Butterworth-Heinemann; 1995: 353-410.
3. Chou SM. Immunohistochemical and ultrastructural classification of peripheral neuropathies with onion-bulbs. Clin Neuropathol. 1992;11:109-114.
4. Lallemand RC, Weller RO. Intraneural neurofibromas involving the posterior interosseous nerve. J Neurol Neurosurg Psychiatry. 1973;36:991-996.
5. Lazarus SS, Trombetta LD. Ultrastructural identification of a benign perineurial cell tumor. Cancer. 1978;41:1823-1829.
6. Ohno T, Park P, Akai M, et al. Ultrastructural study of a perineurioma. Ultrastruct Pathol. 1988;12:495-504.
7. Erlandson RA. The enigmatic perineurial cell and its participation in tumors and in tumorlike entities. Ultrastruct Pathol. 1991;15:335-351.
8. Ide F, Shimoyama T, Horie N, Kusama K. Comparative ultrastructural and immunohistochemical study of perineurioma and neurofibroma of the oral mucosa. Oral Oncol. 2004;40:948-953.
9. Weidenheim KM, Campbell WG Jr. Perineural cell tumor: immunocytochemical and ultrastructural characterization: relationship to other peripheral nerve tumors with a review of the literature. Virchows Arch A Pathol Anat Histopathol. 1986;408:375-383.
10. Tranmer BI, Bilbao JM, Hudson AR. Perineurioma: a benign peripheral nerve tumor. Neurosurgery. 1986;19:134-138.
11. Ariza A, Bilbao JM, Rosai J. Immunohistochemical detection of epithelial membrane antigen in normal perineurial cells and perineurioma. Am J Surg Pathol. 1988;12:678-683.
12. de los Reyes RA, Chason JL, Rogers JS, Ausman JI. Hypertrophic neurofibrosis with onion bulb formation in an isolated element of the brachial plexus. Neurosurgery. 1981;8:397-399.
13. Gullotta F. Localized hypertrophic neuropathy (LHN). Pathol Res Pract. 1992;188:815-816.
14. Peckham NH, O'Boynick PL, Meneses A, Kepes JJ. Hypertrophic mononeuropathy: a report of two cases and review of the literature. Arch Pathol Lab Med. 1982;106:534-537.
15. Simpson DA, Fowler M. Two cases of localized hypertrophic neurofibrosis. J Neurol Neurosurg Psychiatry. 1966;29:80-84.
16. Snyder M, Cancilla PA, Batzdorf U. Hypertrophic neuropathy simulating a neoplasm of the brachial plexus. Surg Neurol. 1977;7:131-134.
17. Johnson PC, Kline DG. Localized hypertrophic neuropathy: possible focal perineurial barrier defect. Acta Neuropathol (Berl). 1989;77:514-518.
18. Boker DK, Schonberg F, Gullotta F. Localized hypertrophic neuropathy - a rare, clinically almost unknown syndrome. Clin Neuropathol. 1984;3:228-230.
19. Chang Y, Horoupian DS, Jordan J, Steinberg G. Localized hypertrophic mononeuropathy of the trigeminal nerve. Arch Pathol Lab Med. 1993;117:170-176.
20. Hawkes CH, Jefferson JM, Jones EL, Thomas Smith W. Hypertrophic mononeuropathy. J Neurol Neurosurg Psychiatry. 1974;37:76-81.
21. Iyer VG, Garretson HD, Byrd RP, Reiss SJ. Localized hypertrophic mononeuropathy involving the tibial nerve. Neurosurgery. 1988;23:218-221.
22. Kania RE, Cazals-Hatem D, Bouccara D, et al. Hypertrophic neuropathy of the facial nerve. Ann Otol Rhinol Laryngol. 2001;110:257-262.
23. Kretzer RM, Burger PC, Tamargo RJ. Hypertrophic neuropathy of the cauda equina: case report. Neurosurgery. 2004;54:515-518. discussion 518-519.
24. LaPoint SF, Powers JM, Woodruff JM, et al. Schwann cell-onion bulb tumor of the trigeminal nerve: hyperplasia, dysplasia or neoplasia? Acta Neuropathol (Berl). 2000;99:67-72.
25. Neely JG, Armstrong D, Benson J, Neblett C. "Onion bulb" formation associated with a solitary neoplasm of the eighth nerve sheath. Am J Otolaryngol. 1981;2:307-313.
26. Yassini PR, Sauter K, Schochet SS, Kaufman HH, Bloomfield SM. Localized hypertrophic mononeuropathy involving spinal roots and associated with sacral meningocele. Case report. J Neurosurg. 1993;79:774-778.
27. Agaimy A, Wuensch PH. Perineurioma of the stomach. A rare spindle cell neoplasm that should be distinguished from gastrointestinal stromal tumor. Pathol Res Pract. 2005;201:463-467.
28. Aoki T, Hisaoka M, Hashimoto H, et al. Giant degenerative perineurial cell tumor. Skeletal Radiol. 1996;25:757-761.
29. Augusto D, Aubert S, Leroy X. Pathologic quiz case: a deep-seated tumor of the shoulder. Arch Pathol Lab Med. 2003;127:e283-e284.
30. Balarezo FS, Muller RC, Weiss RG, et al. Soft tissue perineuriomas in children: report of three cases and review of the literature [corrected]. Pediatr Dev Pathol. 2003;6:137-141.
31. Baran R, Perrin C. Perineurioma: a tendon sheath fibroma-like variant in a distal subungual location. Acta Derm Venereol. 2003;83:60-61.
32. Barrett AW, Hopper C, Landon G. Intra-osseous soft tissue perineurioma of the inferior alveolar nerve. Oral Oncol. 2002;38:793-796.
33. Beckwith LG, Devaney K, Kragel PJ. Perineurioma. South Med J. 1995;88:964-968.
34. Begin LR. Perineurioma of the finger: case report of a rare peripheral nerve sheath neoplasm of pure perineurial cell lineage. J Hand Surg [Am]. 1998;23:342-347.
35. Burgues O, Monteagudo C, Noguera R, et al. Cutaneous sclerosing Pacinian-like perineurioma. Histopathology 2001;39:498-502.
36. Canales-Ibarra C, Magarinos G, Olsoff-Pagovich P, Ortiz-Hidalgo C. Cutaneous sclerosing perineurioma of the digits: an uncommon soft-tissue neoplasm. Report of two cases with immunohistochemical analysis. J Cutan Pathol. 2003;30:577-581.
37. D'Antonio A, Marra L, Franco R, Ninfo V. A 52-year-old man with a mass in the perineal region. Perineurioma. Arch Pathol Lab Med. 2006;130:e87-e89.
38. Donnellan R. Test and teach. Number eighty five. Extraneural perineurioma. Pathology. 1997;29:277-316.
39. Donnellan R, Rughubar K, Govender D, Chetty R. Perineurioma: an unusual cause of an external auditory canal polyp. ORL J Otorhinolaryngol Relat Spec. 1997;59:336-338.
40. Fagerli JC, Hasegawa SL, Schneck FX. Paratesticular perineurioma: initial description. J Urol. 1999;162:881-882.
41. Gamblin TC, McKinney WB, Stephens RE Jr., Barron T. Perineuroma of the scrotum. Urology. 2002;60:515.
42. Giannini C, Scheithauer BW, Steinberg J, Cosgrove TJ. Intraventricular perineurioma: case report. Neurosurgery. 1998;43:1478-1481; discussion 1481-1482.
43. Graadt van Roggen JF, McMenamin ME, Belchis DA, et al. Reticular perineurioma: a distinctive variant of soft tissue perineurioma. Am J Surg Pathol. 2001;25:485-493.
44. Gullotta F. Localized hypertrophic neuropathy: a perineurialoma? Clin Neuropathol. 1985;4:92.
45. Halkic N, Ksontini R. Case in point. Perineuroma. Hosp Pract (Minneap). 2001;36:48.
46. Hornick JL, Fletcher CD. Intestinal perineuriomas: clinicopathologic definition of a new anatomic subset in a series of 10 cases. Am J Surg Pathol. 2005;29:859-865.
47. Hornick JL, Fletcher CD. Soft tissue perineurioma: clinicopathologic analysis of 81 cases including those with atypical histologic features. Am J Surg Pathol. 2005;29:845-858.
48. Housini I, Dabbs DJ. Fine needle aspiration cytology of perineurioma: report of a case with histologic, immunohistochemical and ultrastructural studies. Acta Cytol. 1990;34:420-424.
49. Huang HY, Sung MT. Sclerosing perineuriomas affecting bilateral hands. Br J Dermatol. 2002;146:129-133.
50. Meer S, Coleman H, Altini M. Intraoral perineurioma: report of a case with a review of the literature. Oral Dis. 2003;9:99-103.
51. Mirchandani N, Dill SW, Lapidus C, Schappell D, Robinson-Bostom L. A painless palmar nodule. Pediatr Dermatol. 2004;21:606-607.
52. Rank JP, Rostad SW. Perineurioma with ossification: a case report with immunohistochemical and ultrastructural studies. Arch Pathol Lab Med. 1998;122:366-370.
53. Robson AM, Calonje E. Cutaneous perineurioma: a poorly recognized tumour often misdiagnosed as epithelioid histiocytoma. Histopathology 2000;37:332-339.
54. Saft C, Andrich JE, Neuen-Jacob E, et al. Supracubital perineurioma misdiagnosed as carpal tunnel syndrome: case report. BMC Neurol. 2004;4:19.
55. Senghore N, Cunliffe D, Watt-Smith S, Hollowood K. Extraneural perineurioma of the face: an unusual cutaneous presentation of an uncommon tumour. Br J Oral Maxillofac Surg. 2001;39:315-319.
56. Shelekhova K, Kazakov DV, Michal M. Infiltrating retiform perineurioma: a case report. Ann Diagn Pathol. 2005;9:293-294.
57. Skelton HG, Williams J, Smith KJ. The clinical and histologic spectrum of cutaneous fibrous perineuriomas. Am J Dermatopathol. 2001;23:190-196.
58. Thomas C, Yousefi M, Pride H, Maroon M, Tyler W. Soft tissue perineurioma of the finger: expanding the differential diagnosis of a soft tissue tumor presenting on a digit. Cutis. 2005;75:233-237.
59. Tsang WY, Chan JK, Chow LT, Tse CC. Perineurioma: an uncommon soft tissue neoplasm distinct from localized hypertrophic neuropathy and neurofibroma. Am J Surg Pathol. 1992;16:756-763.
60. Yamaguchi U, Hasegawa T, Hirose T, et al. Sclerosing perineurioma: a clinicopathological study of five cases and diagnostic utility of immunohistochemical staining for GLUT1. Virchows Arch. 2003;443:159-163.
61. Zamecnik M. Perineurioma with adipocytes (lipomatous perineurioma). Am J Dermatopathol. 2003;25:171-173; author reply 173-174.
62. Zamecnik M, Gomolcak P. A case of perineurioma. Gen Diagn Pathol. 1997;143:261.
63. Zamecnik M, Koys F, Gomolcak P. Atypical cellular perineurioma. Histopathology. 2002;40:296-299.
64. Hayman M, Roland EH, Hill A. Newborn radial nerve palsy: report of four cases and review of published reports. Pediatr Neurol. 1999;21:648-651.
65. Weig SG, Waite RJ, McAvoy K. MRI in unexplained mononeuropathy. Pediatr Neurol. 2000;22:314-317.
66. Sciacco M, Scarpini E, Baron PL, et al. Sural nerve immunoreactivity for nerve growth factor receptor in a case of localized hypertrophic neuropathy. Acta Neuropathol (Berl). 1992;83:547-553.
67. Gruen JP, Mitchell W, Kline DG. Resection and graft repair for localized hypertrophic neuropathy. Neurosurgery. 1998;43:78-83.
68. Bilbao JM, Khoury NJ, Hudson AR, Briggs SJ. Perineurioma (localized hypertrophic neuropathy). Arch Pathol Lab Med. 1984;108:557-560.
69. Alfonso DT, Sotrel A, Grossman JA. Carpal tunnel syndrome due to an intraneural perineurioma in a 2-year-old child. J Hand Surg [Br]. 2001;26:168-170.
70. Almefty R, Webber BL, Arnautovic KI. Intraneural perineurioma of the third cranial nerve: occurrence and identification: case report. J Neurosurg. 2006;104:824-827.
71. Beekman R, Slooff WB, Van Oosterhout MF, Lammens M, Van Den Berg LH. Bilateral intraneural perineurioma presenting as ulnar neuropathy at the elbow. Muscle Nerve. 2004;30:239-243.
72. Brock JE, Perez-Atayde AR, Kozakewich HP, et al. Cytogenetic aberrations in perineurioma: variation with subtype. Am J Surg Pathol. 2005;29:1164-1169.
73. Chen L, Li Y, Lin JH. Intraneural perineurioma in a child with Beckwith-Wiedemann syndrome. J Pediatr Surg. 2005;40:E12-E14.
74. Cortes W, Cheng J, Matloub HS. Intraneural perineurioma of the radial nerve in a child. J Hand Surg [Am]. 2005;30:820-825.
75. da Cruz Perez DE, Amanajas de Aguiar FC Jr, Leon JE, et al. Intraneural perineurioma of the tongue: a case report. J Oral Maxillofac Surg. 2006;64:1140-1142.
76. Damm DD, White DK, Merrell JD. Intraneural perineurioma - not restricted to major nerves. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:192-196.
77. de La Jarte-Thirouard AS, Jacquier I, de Saint-Maur PP. Intraneural reticular perineurioma of the neck. Ann Diagn Pathol. 2003;7:120-123.
78. Dundr P, Povysil C, Tvrdik D, Mazanek J. Intraneural perineurioma of the oral mucosa [published online ahead of print June 3, 2006]. Br J Oral Maxillofac Surg.
79. Emory TS, Scheithauer BW, Hirose T, et al. Intraneural perineurioma: a clonal neoplasm associated with abnormalities of chromosome 22. Am J Clin Pathol. 1995;103:696-704.
80. Hamazaki S, Fujiwara K, Okada S. Intraneural perineurioma involving the ulnar nerve. Pathol Int. 2004;54:371-375.
81. Heilbrun ME, Tsuruda JS, Townsend JJ, Heilbrun MP. Intraneural perineurioma of the common peroneal nerve: case report and review of the literature. J Neurosurg. 2001;94:811-815.
82. Huguet P, de la Torre J, Pallares J, et al. Intraosseous intraneural perineurioma: report of a case with morphological, immunohistochemical and FISH study. Med Oral. 2004;9:64-68.
83. Isaac S, Athanasou NA, Pike M, Burge PD. Radial nerve palsy owing to localized hypertrophic neuropathy (intraneural perineurioma) in early childhood. J Child Neurol. 2004;19:71-75.
84. Jazayeri MA, Robinson JH, Legolvan DP. Intraneural perineurioma involving the median nerve. Plast Reconstr Surg. 2000;105:2089-2091.
85. Li D, Schauble B, Moll C, Fisch U. Intratemporal facial nerve perineurioma. Laryngoscope. 1996;106:328-333.
86. Mitsumoto H, Estes ML, Wilbourn AJ, Culver JE Jr. Perineurial cell hypertrophic mononeuropathy manifesting as carpal tunnel syndrome. Muscle Nerve. 1992;15:1364-1368.
87. Mitsumoto H, Wilbourn AJ, Goren H. Perineurioma as the cause of localized hypertrophic neuropathy. Muscle Nerve. 1980;3:403-412.
88. Rankine AJ, Filion PR, Platten MA, Spagnolo DV. Perineurioma: a clinicopathological study of eight cases. Pathology. 2004;36:309-315.
89. Simmons Z, Mahadeen ZI, Kothari MJ, et al. Localized hypertrophic neuropathy: magnetic resonance imaging findings and long-term follow-up. Muscle Nerve. 1999;22:28-36.
90. Stanton C, Perentes E, Phillips L, VandenBerg SR. The immunohistochemical demonstration of early perineurial change in the development of localized hypertrophic neuropathy. Hum Pathol. 1988;19:1455-1457.
91. Suarez GA, Giannini C, Smith BE, et al. Localized hypertrophic neuropathy. Mayo Clin Proc. 1994;69:747-748.
92. Takao M, Fukuuchi Y, Koto A, et al. Localized hypertrophic mononeuropathy involving the femoral nerve. Neurology. 1999;52:389-392.
93. Shantha TR, Bourne GH. The perineurial epithelium - a new concept. In: Bourne GH, ed. The Structure and Function of the Nervous Tissue. New York, NY: Academic Press; 1968:379-459.
94. Midroni G, Bilbao JM. Normal anatomy of peripheral (sural) nerve. In: Biopsy Diagnosis of Peripheral Neuropathy. Boston, Mass: Butterworth-Heinemann; 1995:13-33.
95. Perentes E, Nakagawa Y, Ross GW, Stanton C, Rubinstein LJ. Expression of epithelial membrane antigen in perineurial cells and their derivatives: an immunohistochemical study with multiple markers. Acta Neuropathol (Berl). 1987;75:160-165.
96. Theaker JM, Gatter KC, Puddle J. Epithelial membrane antigen expression by the perineurium of peripheral nerve and in peripheral nerve tumours. Histopathology 1988;13:171-179.
97. Michal M. Extraneural retiform perineuriomas: a report of four cases. Pathol Res Pract. 1999;195:759-763.
98. Fetsch JF, Miettinen M. Sclerosing perineurioma: a clinicopathologic study of 19 cases of a distinctive soft tissue lesion with a predilection for the fingers and palms of young adults. Am J Surg Pathol. 1997;21:1433-1442.
99. Rey JA, Bello MJ, de Campos JM, et al. Abnormalities of chromosome 22 in human brain tumors determined by combined cytogenetic and molecular genetic approaches. Cancer Genet Cytogenet. 1993;66:1-10.
100. Giannini C, Scheithauer BW, Jenkins RB, et al. Soft-tissue perineurioma: evidence for an abnormality of chromosome 22, criteria for diagnosis, and review of the literature. Am J Surg Pathol. 1997;21:164-173.
101. Lasota J, Fetsch JF, Wozniak A, et al. The neurofibromatosis type 2 gene is mutated in perineurial cell tumors: a molecular genetic study of eight cases. Am J Pathol. 2001;158:1223-1229.
102. Sciot R, Cin PD, Hagemeijer A, et al. Cutaneous sclerosing perineurioma with cryptic NF2 gene deletion. Am J Surg Pathol. 1999;23:849-853.
103. Kazakov DV, Pitha J, Sima R, et al. Hybrid peripheral nerve sheath tumors: Schwannoma-perineurioma and neurofibroma-perineurioma: a report of three cases in extradigital locations. Ann Diagn Pathol. 2005;9:16-23.
104. Campbell LK, Thomas JR, Lamps LW, Smoller BR, Folpe AL. Protein gene product 9.5 (PGP 9.5) is not a specific marker of neural and nerve sheath tumors: an immunohistochemical study of 95 mesenchymal neoplasms. Mod Pathol. 2003;16:963-969.
105. Folpe AL, Billings SD, McKenney JK, et al. Expression of claudin-1, a recently described tight junction-associated protein, distinguishes soft tissue perineurioma from potential mimics. Am J Surg Pathol. 2002;26:1620-1626.
106. Hirose T, Tani T, Shimada T, et al. Immunohistochemical demonstration of EMA/Glut1-positive perineurial cells and CD34-positive fibroblastic cells in peripheral nerve sheath tumors. Mod Pathol. 2003;16:293-298.
107. Mentzel T, Kutzner H. Reticular and plexiform perineurioma: clinicopathological and immunohistochemical analysis of two cases and review of perineurial neoplasms of skin and soft tissues. Virchows Arch. 2005;447:677-682.
108. Alvarado-Cabrero I, Folpe AL, Srigley JR, et al. Intrarenal schwannoma: a report of four cases including three cellular variants. Mod Pathol. 2000;13:851-856.
109. Boyle JL, Haupt HM, Stern JB, Multhaupt HA. Tyrosinase expression in malignant melanoma, desmoplastic melanoma, and peripheral nerve tumors. Arch Pathol Lab Med. 2002;126:816-822.
110. Goldblum JR, Beals TF, Weiss SW. Neuroblastoma-like neurilemoma. Am J Surg Pathol. 1994;18:266-273.
111. Lau SK, Spagnolo DV, Weiss LM. Schwannoma of the adrenal gland: report of two cases. Am J Surg Pathol. 2006;30:630-634.
112. Prevot S, Bienvenu L, Vaillant JC, de Saint-Maur PP. Benign schwannoma of the digestive tract: a clinicopathologic and immunohistochemical study of five cases, including a case of esophageal tumor. Am J Surg Pathol. 1999;23:431-436.
113. Guarino M. Plexiform schwannoma: immunohistochemistry of Schwann cell markers, intermediate filaments and extracellular matrix components. Pathol Res Pract. 1993;189:913-920.
114. Johnson MD, Glick AD, Davis BW. Immunohistochemical evaluation of Leu-7, myelin basic-protein, S100-protein, glial-fibrillary acidic-protein, and LN3 immunoreactivity in nerve sheath tumors and sarcomas. Arch Pathol Lab Med. 1988;112:155-160.
115. Lopez JI, Ballestin C. Intraoral schwannoma: a clinicopathologic and immunohistochemical study of nine cases. Arch Anat Cytol Pathol. 1993;41:18-23.
116. Michal M, Fanburg-Smith JC, Mentzel T, et al. Dendritic cell neurofibroma with pseudorosettes: a report of 18 cases of a distinct and hitherto unrecognized neurofibroma variant. Am J Surg Pathol. 2001;25:587-594.
117. Ewy MF, Demmy TL, Perry MC, Krishnan MS, Curtis JJ. Massive phrenic perineurioma mimicking an unresectable cardiac tumor. Ann Thorac Surg. 1995;60:188-189.
118. Karaki S, Mochida J, Lee YH, Nishimura K, Tsutsumi Y. Low-grade malignant perineurioma of the paravertebral column, transforming into a high-grade malignancy. Pathol Int. 1999;49:820-825.
119. Hirose T, Sano T, Hizawa K. Heterogeneity of malignant schwannomas. Ultrastruct Pathol. 1988;12:107-116.
120. Hirose T, Maeda T, Furuya K, Kiyasu Y, Kawasaki H. Malignant peripheral nerve sheath tumor of the pancreas with perineurial cell differentiation. Ultrastruct Pathol. 1998;22:227-231.
121. Hirose T, Scheithauer BW, Sano T. Perineurial malignant peripheral nerve sheath tumor (MPNST): a clinicopathologic, immunohistochemical, and ultrastructural study of seven cases. Am J Surg Pathol. 1998;22:1368-1378.
122. Hirose T, Sumitomo M, Kudo E, et al. Malignant peripheral nerve sheath tumor (MPNST) showing perineurial cell differentiation. Am J Surg Pathol. 1989;13:613-620.
123. Rosenberg AS, Langee CL, Stevens GL, Morgan MB. Malignant peripheral nerve sheath tumor with perineurial differentiation: "malignant perineurioma." J Cutan Pathol. 2002;29:362-367.
124. Zamecnik M, Michal M. Malignant peripheral nerve sheath tumor with perineurial cell differentiation (malignant perineurioma). Pathol Int. 1999;49:69-73.