Gastrointestinal Tract Schwannoma
Differential Diagnosis
| GI Schwannoma |
GIST (spindled, bland) |
| Peripheral lymphoid cuff common |
Lacks lymphoid cuff |
| Frequent cell size variation |
Generally uniform cell size |
| No skeinoid fibers |
May have skeinoid fibers |
| S100 100% |
S100 5% (20% in small intestine) |
| GFAP 65-100% |
GFAP negative |
| CD117 negative |
CD117 74-95% |
Palisading is more accentuated in GIST; CD34 stains 0-33% of GI schwannomas
| Inflammatory Fibroid Polyp |
GI Schwannoma |
| Eosinophil rich inflammatory infiltrate throughout |
Peripheral lymphoid cuff common |
| Perivascular concentric cuffing common, palisading rare |
May palisade, no concentric pattern |
| Fibromyxoid background with regular vascular pattern |
May be myxoid but lacks regular vascular pattern |
| S100 negative |
S100 100% |
| 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 Schwannoma |
GI Ganglioneuroma |
| No ganglion cells |
Contains ganglion cells |
| Most cases intramural |
Predominantly lamina propria |
| Peripheral lymphoid cuff common |
Lacks lymphoid cuff |
| GI Schwannoma |
GI Neurofibroma |
| Most cases intramural |
Predominantly lamina propria |
| No association with neurofibromatosis |
Frequently associated with neurofibromatosis |
| Peripheral lymphoid cuff common |
Lacks lymphoid cuff |
