Tactoid body features in a Schwann cell hamartoma of colonic mucosa.

[cowden syndrome]

Background . Mesenchymal colorectal polyps are uncommon lesions , particularly those of neurogenic origin . We describe a mucosal Schwann cell hamartoma of the colon with tactoid features , so far reported in peripheral nerve sheath tumours , and address its differential diagnosis and clinical implications . Case presentation . A 72 -year -old man underwent screening colonoscopy that presented a 5 -mm polyp on distal sigmoid . Histologically , it displayed a lesion in the lamina propria comprising oval structures with tactoid features and bland spindle cells , entrapping adjacent crypts . No ganglion cells were seen . Spindle cells expressed only S-100 protein and vimentin . Discussion . Mucosal Schwann cell hamartoma was recently recognized as distinct from common (submucosal ) colorectal Schwannomas and so far not associated to inherited syndromes . Thus , it should be considered in the differential diagnosis of look-alike lesions (eg , ganglioneuroma , neuroma , and neurofibroma ) that may occur in the setting of inherited syndromes such as Cowden syndrome , multiple endocrine neoplasia -2 B , and type 1 neurofibromatosis .

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cowden syndrome

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