Gastrointestinal Tract Perineurioma
Differential Diagnosis
We consider Fibroblastic Polyp to be the same lesion as GI Perineurioma
| Inflammatory Fibroid Polyp |
GI Perineurioma |
| Submucosal |
Predominantly lamina propria |
| Eosinophil rich inflammatory infiltrate |
Eosinophils and inflammation infrequent |
| Perivascular concentric cuffing common |
Lacks prominent concentric cuffing |
| Fibromyxoid background with regular vascular pattern |
Rarely may be myxoid but lacks regular vascular pattern |
| CD34 positive in 80% |
CD34 weak focal in 15-30% |
| GI Schwannoma |
GI Perineurioma |
| Peripheral lymphoid cuff common |
Lacks lymphoid cuff |
| Frequent cell size variation |
Generally uniform cell size |
| Most cases intramural |
Predominantly lamina propria |
| S100 100% |
S100 negative |
| GFAP 65-100% |
GFAP negative |
| Perineurial markers negative |
Perineurial markers positive |
| GI Neurofibroma |
GI Perineurioma |
| S100 positive |
S100 negative |
| Perineurial markers negative |
Perineurial markers positive |
| Axons present |
No axons in lesion |
| GI Mucosal Schwann Cell Hamartoma |
GI Perineurioma |
| Abundant cytoplasm |
Scant cytoplasm |
| No association with hyperplastic crypts |
Frequently associated with hyperplastic crypts |
| Perineurial markers negative |
Perineurial markers positive |
| S100 positive |
S100 negative |
| Mucosal Prolapse / Cloacogenic Polyp |
GI Perineurioma |
| Fibrovascular stroma |
Lacks vascularity |
| Inflammatory infiltrate |
Inflammation infrequent |
| Prominent gland component |
Mostly a spindled stromal lesion, crypts pushed aside |
| Villiform eroded surface |
Surface intact and normal |
| Smooth muscle extends into lamina propria around crypts |
Lamina propria spindled lesion is smooth muscle actin negative and positive for perineurial markers |
