MEETING No. 46 - OCTOBER 12th, 2002 - SONDRIO HOSPITAL

Case 1
Case 2
Case 3
Case 4
Case 5

Case 3


“SUBCUTANEOUS NODULE IN THE HAND”
E.B. LEONE – Monza Hospital
(pict. by dr. Leone)

Clinical history: a 1 and half year old child presents to the surgeon for a tumor of the first finger of the right hand (pict. 1); a previous biopsy has been performed in other hospital with the diagnosis of schwannoma.
The neoplasia doesn't involve the bone (pict. 2) but at the operation there is wide infiltration of the muscles and the skin (pict. 3).
Macroscopical description: the tumor is multinodular, yellow-whitish in colour, elastic and fasciculated on cut section (pict. 4).
Microscopical description: the tumor consists of spindled cells with plexiform and nodular architecture (pict. 5 - pict. 6 - pict. 7) with infiltration of the skin (pict. 8) and of the deep soft tissues.
The neoplasia is highly cellular with storiform pattern in the more compact areas (pict. 9 - pict. 10 - pict. 11) with very high mitotic index (more than 20 mitoses/10HPF) (pict. 12) and high proliferation index (25%) revealed by the immunohistochemical staining for Mib1 (pict. 13).
The cells are strongly and diffusely positive with immunohistochemical staining for S100 (pict. 14). There are no necrosis and vascular invasion.

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9	pict. 10
pict. 11	pict. 12
pict. 13	pict. 14

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