Scientific letters
Schwann cell hamartoma as an incidental finding in a colonoscopy
Hamartoma de células de Schwann como hallazgo incidental en una colonoscopia
Vanesa Jusué Iruritaa,
, María Teresa García-Gallegob, Almudena Marinero Martínez-Lázaroc, José Ignacio Busteros Morazad, Elvira Poves Martínezb
Corresponding author
a Department of Gastroenterology, Complejo Hospitalario de Navarra, Pamplona, Spain
b Department of Gastroenterology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
c Department of Gastroenterology, Hospital Clínico San Carlos, Madrid, Spain
d Department of Pathology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
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The colon biopsy displayed with immunohistochemistry proliferated cells with positivity for S-100 and CD-34 (left side of the figure).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report a case of a 39-year-old male who underwent a colonoscopy after an episode of acute diverticulitis without other relevant medical or family history. In the descending colon an 8<span class="elsevierStyleHsp" style=""></span>mm sessile polyp (Paris 0-Is, NICE 1) was removed. Histopathological analysis revealed proliferation of spindle cells in the colonic mucosa without atypia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). With immunohistochemistry these cells displayed positivity for S-100 and CD-34, all of it being compatible with a benign mesenchymal polyp with a suggestive Schwann cell hamartoma phenotype (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Discussion: In a study based on series of colorectal lesions composed by Schwamm cell proliferation in 2009, a new lesion named Schwann cell hamartoma was described. Schwann cell hamartomas are rare colorectal polyps with a mesenchymal origin.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> 90% of the gastrointestinal hamartomas are gastric and rarely in the colon.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> They consist of pure Schwann cells with S-100 protein immunoreactivity proliferation in the lamina propria.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> In the majority of cases they are incidental endoscopic findings ranging between 1 and 6<span class="elsevierStyleHsp" style=""></span>mm in size and they usually occur in women of middle age, in the left colon.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> They are considered benign polyps and have not demonstrated any association with inherited syndromes.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> It is important to differentiate this polyp from other mesenchymal lesions (neurofibromas, ganglioneuromas, perineuromas or schwannomas) that do tend to be associated with inherited syndromes such as Cowden syndrome, multiple endocrine neoplasia 2b (MEN-2b) and neurofibromatosis type 1 as well as from others with malignant potential such as gastrointestinal stromal tumours (GIST).<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1,4</span></a> Schwann cell hamartomas are a rare entity with an uncertain clinical significance. Further studies are needed in order to increase our knowledge on these lesions, mainly on establishing the appropriate follow up, as well as its possible nature as component of an unknown inherited syndrome. A careful histological assessment is mandatory to avoid mislabelling patients with malignant potential lesions or with inherited syndromes.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 677 "Ancho" => 1600 "Tamanyo" => 416677 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Histological staining showed a colonic polyp with mucosal proliferation of spindle cells without atypia (right side of the figure). The colon biopsy displayed with immunohistochemistry proliferated cells with positivity for S-100 and CD-34 (left side of the figure).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mucosal Schwann cell “hamartoma”: clinicopathologic study of 26 neural colorectal polyps distinct from neurofibromas and mucosal neuromas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.A. Gibson" 1 => "J.L. 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| 2023 November | 23 | 5 | 28 |
| 2023 October | 16 | 4 | 20 |
| 2023 September | 39 | 0 | 39 |
| 2023 August | 12 | 0 | 12 |
| 2023 July | 23 | 2 | 25 |
| 2023 June | 13 | 5 | 18 |
| 2023 May | 20 | 1 | 21 |
| 2023 April | 16 | 4 | 20 |
| 2023 March | 12 | 2 | 14 |
| 2023 February | 24 | 5 | 29 |
| 2023 January | 17 | 3 | 20 |
| 2022 December | 17 | 3 | 20 |
| 2022 November | 17 | 19 | 36 |
| 2022 October | 5 | 5 | 10 |
| 2022 September | 5 | 4 | 9 |
| 2022 August | 5 | 7 | 12 |
| 2022 July | 1 | 1 | 2 |
| 2022 June | 1 | 2 | 3 |
| 2021 November | 1 | 0 | 1 |
| 2021 October | 0 | 2 | 2 |
| 2021 May | 1 | 0 | 1 |
| 2021 April | 1 | 0 | 1 |
| 2021 February | 2 | 0 | 2 |
| 2020 December | 1 | 0 | 1 |
| 2020 November | 26 | 10 | 36 |
| 2020 May | 0 | 1 | 1 |
Show all
