Qap (Anatomical Pathology) 

QAP Peer Review

AP335
Case History: M/46. Enlarging nodule in neck
Intended diagnosis: Malignant peripheral nerve sheath tumour. Contributed by:MW
Code Diagnosis Comment Score
anonymous Plexiform neurofibroma with suggestion of malignant transformation nil  100
anonymous Plexiform schwannoma nil  40
anonymous MALIGNANT PERIPHERAL NERVE SHEATH TUMOUR, in background of plexiform neurofibroma (100%). nil  100
anonymous Malignant peripheral nerve sheath tumor 100% Confirm with immunohistochemical studies for S100, SOX10; correlate with clinical history of neurofibromatosis.  100
anonymous Plexiform schwannoma. Diffuse S100+. Unlikely ddx: Plexiform neurofibroma with less diffuse S100+ and distinct clinical picture. Remote ddx: MPNST shows only focal S100+.  50
anonymous Malignant transformation (malignant peripheral nerve shealth tumor) of plexiform neurofibroma Neurofibromatosis needs to be considered. Suggest clinical correlation.  100
anonymous Malignant peripheral nerve sheath tumour 100% nil  100
anonymous MPNST in the backrgound of Plexiform Neurofibroma (100%) nil  100
anonymous Low grade malignant peripheral nerve sheath tumor, probably arising from plexiform neurofibroma nil  100
anonymous Malignant peripheral nerve sheath tumor, plexiform pattern, involving nerve fascicles and feature suggestive of vascular involvement nil  100
anonymous NECK - MALIGNANT TRANSFORMATION of PLEXIFORM NEUROFIBROMA nil  100
anonymous Plexiform neurofibroma with malignant peripheral nerve sheath tumor transformation. nil  100
anonymous Malignant peripheral nerve sheath tumour (80%). Differential diagnosis is plexiform schwannoma (20%). Immunohistochemical staining for S-100 would be performed, for which diffuse positive staining would favour plexiform schwannoma and negative or patchy staining would favour MPNST. Further sampling is also recommended, as well as correlation with any history of neurofibromatosis or previous excision of tumour.  80
anonymous sarcoma, favor malignant peripheral nerve shealth tumor, with extensive intraneural infiltration and plexiform pattern (100%) perform immunostaining for S100  95
anonymous Atypical/cellular plexiform neurofibroma in neurofibromatosis, need to rule out low grade malignant nerve sheath tumor (100% Probability). nil  50
anonymous Neurogenic tumour. DDx: 1. Plexiform schwannoma. 2. Neurogenic sarcoma nil  50
anonymous Plexiform neurofibroma with malignant change (100%) nil  100
anonymous Neck - Malignant peripheral nerve sheath tumour arising from plexiform neurofibroma nil  100