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colorectal neural lesions

Monday 31 December 2012

Neural lesions of the colon

Neural lesions of the colon are a rare group of colorectal disorders that may frequently present as small polyps.

This heterogeneous group includes ganglion cells and nerve sheath tumors that have been frequently described as multiple lesions in association with inherited syndrome such as:
- von Recklinghausen (or type 1) neurofibromatosis (NF-1),
- multiple endocrine neoplasia type 2B (MEN 2B),
- Cowden syndrome.

Moreover, sporadic forms of these neural lesions have been reported including:
- solitary colonic polypoid ganglioneuroma,
- solitary colonic neurofibroma,
- mucosal benign epithelioid nerve sheath tumors.

Recently, Gibson and Hornick have analysed 26 cases of colorectal polypoid lesions comprising pure Schwann cell proliferation, which were different from gastrointestinal tract (GI) schwannomas, and with no association with inherited syndromes. This entity was designated as mucosal Schwann cell hamartoma [2009].

Reference

- Greenson JK. Gastrointestinal Stromal Tumors and Other Mesenchymal Lesions of the Gut. Mod Pathol. 2003;16:366–375. doi: 10.1097/01.MP.0000062860.60390.C7. PMID: #12692202#

- Gibson JA, Hornick JL. Mucosal Schwann cell "hamartoma": clinicopathologic study of 26 neural colorectal polyps distinct from neurofibromas and mucosal neuromas. Am J Surg Pathol. 2009;33:781–7. doi: 10.1097/PAS.0b013e31818dd6ca.

- Finkel M, Finkel ER, Harris AI. Von Recklinghausen’s disease with involvement of the colon: an endoscopic view. Mt Sinai J Med. 1978;45:387–9.

- Fuller CE, Williams GT. Gastrointestinal manifestations of type 1 neurofibromatosis (von Recklinghausen’s disease) Histopathology. 1991;19:1–11. doi: 10.1111/j.1365-2559.1991.tb00888.x.

- Lee NC, Norton J. Multiple endocrine neoplasia type 2B—genetic basis and clinical expression. Surg Oncol. 2000;9:111–8. doi: 10.1016/S0960-7404(00)00038-4.

- Hizawa K, Iida M, Matsumoto T, Kohrogi N, Suekane H, Yao T, Fujishima M. Gastrointestinal manifestations of Cowden’s disease. Report of four cases. J Clin Gastroenterol. 1994;18:13–8. doi: 10.1097/00004836-199401000-00005.

- Mendez IM, Pereda T, Rodriguez FJ, Funez R, Sanchez A. Solitary colonic polypoid ganglioneuroma. Diagn Pathol. 2008;3:20. doi: 10.1186/1746-1596-3-20

- Panteris V, Vassilakaki T, Vaitsis N, Elemenoglou I, Mylonakou I, Karamanolis DG. Solitary colonic neurofibroma in a patient with transient segmental colitis: case report. World J Gastroenterol. 2005;11:5573–6

- Abramson LP, Orkin BA, Schwartz AM. Isolated colonic neurofibroma manifested by massive lower gastrointestinal bleeding and intussusception. South Med J. 1997;90:952–4. doi: 10.1097/00007611-199709000-00020

- Lewin MR, Dilworth HP, Abu Alfa AK, Epstein JI, Montgomery E. Mucosal benign epithelioid nerve sheath tumors. Am J Surg Pathol. 2005;29:1310–5. doi: 10.1097/01.pas.0000162762.03068.7a