Tactoid body features in a Schwann cell hamartoma of colonic mucosa

Int J Surg Pathol. 2014 Aug;22(5):438-41. doi: 10.1177/1066896913501384. Epub 2013 Aug 30.

Abstract

Background: Mesenchymal colorectal polyps are uncommon lesions, particularly those of neurogenic origin. We describe a mucosal Schwann cell hamartoma of the colon with tactoid features, so far reported in peripheral nerve sheath tumours, and address its differential diagnosis and clinical implications.

Case presentation: A 72-year-old man underwent screening colonoscopy that presented a 5-mm polyp on distal sigmoid. Histologically, it displayed a lesion in the lamina propria comprising oval structures with tactoid features and bland spindle cells, entrapping adjacent crypts. No ganglion cells were seen. Spindle cells expressed only S-100 protein and vimentin.

Discussion: Mucosal Schwann cell hamartoma was recently recognized as distinct from common (submucosal) colorectal Schwannomas and so far not associated to inherited syndromes. Thus, it should be considered in the differential diagnosis of look-alike lesions (eg, ganglioneuroma, neuroma, and neurofibroma) that may occur in the setting of inherited syndromes such as Cowden syndrome, multiple endocrine neoplasia-2B, and type 1 neurofibromatosis.

Keywords: Schwann cell; colon; hamartoma; tactoid body.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Colon / metabolism
  • Colon / pathology
  • Colonic Neoplasms / metabolism
  • Colonic Neoplasms / pathology*
  • Colonic Polyps / metabolism
  • Colonic Polyps / pathology
  • Diagnosis, Differential
  • Hamartoma / metabolism
  • Hamartoma / pathology*
  • Humans
  • Intestinal Mucosa / metabolism
  • Intestinal Mucosa / pathology*
  • Male
  • Schwann Cells / metabolism
  • Schwann Cells / pathology*
  • Vimentin / metabolism

Substances

  • Vimentin