Intraneural Perineuroma

Synonyms:

formerly localized hypertrophic mononeuropathy

Diagnosis:

Suggested by MRI and confirmed by pathology (brain biopsy/resection)

Findings on Investigations:

MRI:

  • MRI neurography (fat saturated T2 or fat saturated T1 post Gadolinium):
  • Hypertrophic nerve, fusiform, several 5-10cm or more.
  • Upper limb: posterior interosseus, radial, ulnar nerves. Or lower limb: sciatic, peroneal, tibial, femoral nerves

Pathology:

Histology:

  • HE: thickened perineurium, Endoneurial “Pseudoonion bulbs”= Whorles of perineurial cells

Immunohistochemistry: EMA positive, S100 negative

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