PMC3125655_01
Cutaneous nodules distributed over the entire body. Note the large pigmented macule in the right chest
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His past medical history revealed that multiple cutaneous nodules seen on the entire body [Figures 1 and 2] were present since he was 13 years old.
Cutaneous nodules on the face. Facial asymmetry due to the intraoral swelling can also be appreciated
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His past medical history revealed that multiple cutaneous nodules seen on the entire body [Figures 1 and 2] were present since he was 13 years old. A large pigmented macule was present on the right side chest [Figure 2].
Chest radiograph showing the right mediastinal tumor
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The imaging studies revealed the presence of a mediastinal tumor which was later diagnosed as MPNST [Figures 3-5].
Spiral CT chest showing a large, well-defined soft tissue density mass lesion in the posterior aspect of the right upper hemithorax. The lesion is found to be extending to the chest wall with erosion of right upper ribs
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The imaging studies revealed the presence of a mediastinal tumor which was later diagnosed as MPNST [Figures 3-5].
MRI of the thoracic spine sagittal T1 T2 level showing a large mass in the right thorax of which the medial border is adjacent to the thoracic vertebra. No evidence of vertebral encasement or intraspinal extension seen
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The imaging studies revealed the presence of a mediastinal tumor which was later diagnosed as MPNST [Figures 3-5].
Lobulated, dumbbell shaped mass extending into the buccal vestibule and the palate, causing displacement of 16
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The surface was smooth with superficial candidal infection in some areas [Figure 6].
Orthopantamograph and IOPA radiograph showing bone loss in relation to 16 and 17
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Alternating fascicles of hypercellular and hypocellular areas arranged in a streaming pattern (H and E, 20x)
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Microscopically, the lesion showed alternating fascicles of hypercellular and hypocellular areas arranged in a streaming pattern [Figure 8].
Atypical spindle cells showing pleomorphic, wavy nuclei and indistinct cytoplasm (H and E, 40x)
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The cellular component comprised predominantly atypical spindle cells with hyperchromatic, wavy nuclei, which were pleomorphic, and indistinct cytoplasm [Figure 9].
Vascular changes in MPNST. Sub-endothelial proliferation of tumor cells and herniation of tumor cells into the vessels (H and E, 40x)
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The vascular changes like sub-endothelial proliferation of tumor cells and herniation of tumor cells into the vessels were appreciable in the sections [Figure 10].
Vascular changes in MPNST. Proliferation of small vessels on the large vessel walls can be seen (H and E, 40x)
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The walls of some of the large vessels showed small vascular proliferations [Figure 11].
Areas resembling neurofibroma (H and E, 20x)
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Neurofibromatous areas and areas of necrosis were also present [Figures 12 and 13].
Areas of necrosis (H and E, 20x)
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Neurofibromatous areas and areas of necrosis were also present [Figures 12 and 13].