Jully Elisabeth Gundlach, Victor Angelo Martins Montalli, Larissa Araujo Agatti, Thamiris Castro Abrantes, Kelly Tambasco Bezerra, Aline Corrêa Abrahão, Mário José Romañach, Silvio Luiz Vieira Oliveira, Nara Ligia Martins Almeida, Vanessa Soares Lara, Fernanda Aragão Felix, Patrícia Carlos Caldeira, Lucas Guimarães Abreu, Ricardo Alves Mesquita, Cristiane Furuse, Ana Lia Anbinder
{"title":"硬膜内假包膜神经瘤增生和创伤性神经瘤：临床病理特征的回顾性多中心研究。","authors":"Jully Elisabeth Gundlach, Victor Angelo Martins Montalli, Larissa Araujo Agatti, Thamiris Castro Abrantes, Kelly Tambasco Bezerra, Aline Corrêa Abrahão, Mário José Romañach, Silvio Luiz Vieira Oliveira, Nara Ligia Martins Almeida, Vanessa Soares Lara, Fernanda Aragão Felix, Patrícia Carlos Caldeira, Lucas Guimarães Abreu, Ricardo Alves Mesquita, Cristiane Furuse, Ana Lia Anbinder","doi":"10.1007/s12105-025-01771-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>Described in 2013, intraneural pseudoperineuriomatous proliferations (IPP) present perineurial cells concentrically surrounding the axon-Schwann cell complexes, forming pseudo-onion bulbs. Different from intraneural perineuriomas, rare neoplasms with differentiation of perineural cells, IPP are reactive, associated with fibrosis, and frequently diagnosed histologically as traumatic neuroma (TN). The aim of this study was to characterize IPP by exploring its clinicopathological features and differentiating it from the main neural lesions that are part of the histopathological differential diagnosis through a retrospective study in six Brazilian Oral Pathology laboratories.</p><p><strong>Methods: </strong>Cases diagnosed as IPP, TN and intraneural perineuriomas were selected from the archives of the participating centers. Data on age, sex, race, symptoms, site, size, and clinical features and diagnosis were obtained from histopathological reports. Hematoxylin and eosin-stained slides were then re-evaluated by two examiners. Finally, statistical tests were performed to assess the association between clinical, pathological and demographic characteristics (p < 0.05).</p><p><strong>Results: </strong>After reclassification, 152 TN, 48 IPP and no case of intraneural perineurioma were diagnosed. Clinically, IPP and TN are similar, but IPP affects younger individuals, presents less reported pain, and is more commonly found on the tongue, while TN is frequently observed on the lip, alveolar ridge, and mental foramen. Both lesions typically present as fibrous nodules, often clinically misdiagnosed as fibrous hyperplasia. IPP is fibrous in all cases, more superficial in the mucosa, less frequently associated with adipose tissue and inflammation. These features may assist clinical dentists and pathologists in differentiating lesions.</p><p><strong>Conclusion: </strong>Although histologically similar, pathologists should note the perineural cell proliferation in IPP to avoid confusion with TN (a common reactive lesion) or intraneural perineurioma (a rare neoplastic lesion).</p>","PeriodicalId":47972,"journal":{"name":"Head & Neck Pathology","volume":"19 1","pages":"32"},"PeriodicalIF":3.2000,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910474/pdf/","citationCount":"0","resultStr":"{\"title\":\"Intraneural Pseudoperineuriomatous Proliferations and Traumatic Neuromas: A Retrospective Multicenter Study of Clinicopathological Characteristics.\",\"authors\":\"Jully Elisabeth Gundlach, Victor Angelo Martins Montalli, Larissa Araujo Agatti, Thamiris Castro Abrantes, Kelly Tambasco Bezerra, Aline Corrêa Abrahão, Mário José Romañach, Silvio Luiz Vieira Oliveira, Nara Ligia Martins Almeida, Vanessa Soares Lara, Fernanda Aragão Felix, Patrícia Carlos Caldeira, Lucas Guimarães Abreu, Ricardo Alves Mesquita, Cristiane Furuse, Ana Lia Anbinder\",\"doi\":\"10.1007/s12105-025-01771-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>Described in 2013, intraneural pseudoperineuriomatous proliferations (IPP) present perineurial cells concentrically surrounding the axon-Schwann cell complexes, forming pseudo-onion bulbs. Different from intraneural perineuriomas, rare neoplasms with differentiation of perineural cells, IPP are reactive, associated with fibrosis, and frequently diagnosed histologically as traumatic neuroma (TN). The aim of this study was to characterize IPP by exploring its clinicopathological features and differentiating it from the main neural lesions that are part of the histopathological differential diagnosis through a retrospective study in six Brazilian Oral Pathology laboratories.</p><p><strong>Methods: </strong>Cases diagnosed as IPP, TN and intraneural perineuriomas were selected from the archives of the participating centers. Data on age, sex, race, symptoms, site, size, and clinical features and diagnosis were obtained from histopathological reports. Hematoxylin and eosin-stained slides were then re-evaluated by two examiners. Finally, statistical tests were performed to assess the association between clinical, pathological and demographic characteristics (p < 0.05).</p><p><strong>Results: </strong>After reclassification, 152 TN, 48 IPP and no case of intraneural perineurioma were diagnosed. Clinically, IPP and TN are similar, but IPP affects younger individuals, presents less reported pain, and is more commonly found on the tongue, while TN is frequently observed on the lip, alveolar ridge, and mental foramen. Both lesions typically present as fibrous nodules, often clinically misdiagnosed as fibrous hyperplasia. IPP is fibrous in all cases, more superficial in the mucosa, less frequently associated with adipose tissue and inflammation. 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Intraneural Pseudoperineuriomatous Proliferations and Traumatic Neuromas: A Retrospective Multicenter Study of Clinicopathological Characteristics.
Background and purpose: Described in 2013, intraneural pseudoperineuriomatous proliferations (IPP) present perineurial cells concentrically surrounding the axon-Schwann cell complexes, forming pseudo-onion bulbs. Different from intraneural perineuriomas, rare neoplasms with differentiation of perineural cells, IPP are reactive, associated with fibrosis, and frequently diagnosed histologically as traumatic neuroma (TN). The aim of this study was to characterize IPP by exploring its clinicopathological features and differentiating it from the main neural lesions that are part of the histopathological differential diagnosis through a retrospective study in six Brazilian Oral Pathology laboratories.
Methods: Cases diagnosed as IPP, TN and intraneural perineuriomas were selected from the archives of the participating centers. Data on age, sex, race, symptoms, site, size, and clinical features and diagnosis were obtained from histopathological reports. Hematoxylin and eosin-stained slides were then re-evaluated by two examiners. Finally, statistical tests were performed to assess the association between clinical, pathological and demographic characteristics (p < 0.05).
Results: After reclassification, 152 TN, 48 IPP and no case of intraneural perineurioma were diagnosed. Clinically, IPP and TN are similar, but IPP affects younger individuals, presents less reported pain, and is more commonly found on the tongue, while TN is frequently observed on the lip, alveolar ridge, and mental foramen. Both lesions typically present as fibrous nodules, often clinically misdiagnosed as fibrous hyperplasia. IPP is fibrous in all cases, more superficial in the mucosa, less frequently associated with adipose tissue and inflammation. These features may assist clinical dentists and pathologists in differentiating lesions.
Conclusion: Although histologically similar, pathologists should note the perineural cell proliferation in IPP to avoid confusion with TN (a common reactive lesion) or intraneural perineurioma (a rare neoplastic lesion).
期刊介绍：
Head & Neck Pathology presents scholarly papers, reviews and symposia that cover the spectrum of human surgical pathology within the anatomic zones of the oral cavity, sinonasal tract, larynx, hypopharynx, salivary gland, ear and temporal bone, and neck.
The journal publishes rapid developments in new diagnostic criteria, intraoperative consultation, immunohistochemical studies, molecular techniques, genetic analyses, diagnostic aids, experimental pathology, cytology, radiographic imaging, and application of uniform terminology to allow practitioners to continue to maintain and expand their knowledge in the subspecialty of head and neck pathology. Coverage of practical application to daily clinical practice is supported with proceedings and symposia from international societies and academies devoted to this field.
Single-blind peer review
The journal follows a single-blind review procedure, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Single-blind peer review is the traditional model of peer review that many reviewers are comfortable with, and it facilitates a dispassionate critique of a manuscript.
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