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Localized Neurofibroma

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Localized neurofibromas present as slow-growing painless lesions in individuals 20-30 years of age. They are small, circumscribed but not encapsulated nodular lesions usually located in the dermis or subcutis.

They contain varying amounts of cellular elements (neoplastic Schwann cells, axons, perineurial-like cells, fibroblasts, CD34+ spindle cells, and mast cells), mucinous stroma, and collagen. The Schwann cells appear as intersecting bundles of spindle cells with compact, hyperchromatic wavy nuclei with pointed ends. Wire-like strands of collagen (nicely seen here) are interspersed among cells. The background stroma is mucoid and contains lymphocytes and xanthoma cells in addition to mast cells. A mast cell is seen in the center of this high magnification view. Plexiform neurofibromas also contain EMA-positive perineurial cells.

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