Surgical Pathology Criteria

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

GI Schwannoma GI Mucosal Benign Epithelioid Nerve Sheath Tumor
Most cases intramural Most cases confined to lamina propria
Peripheral lymphoid cuff common Lacks lymphoid cuff
Frequent pleomorphic hyperchromatic cells No pleomorphism
Spindled cells Epithelioid cells

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