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Pleomorphic anaplastic neuroblastoma
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Pleomorphic anaplastic neuroblastoma : ウィキペディア英語版
Pleomorphic anaplastic neuroblastoma
Pleomorphic anaplastic neuroblastoma (PAN) is a striking aspect of neuroblastoma first described by Cozzutto and Carbone in 1988.〔Cozzutto C, Carbone A (1988). Pleomorphic (Anaplastic) neuroblastoma. Arch Pathol Lab Med 112:621-625.〕 Another case was thereafter reported by Cowan, et al. with cytogenetic and immunohistological analysis in a 28-year-old man.〔Cowan J, Dayal Y, Schaitzberg S, Tischler AS (1997). Cytogenetic and immunohistological analysis of an adult anaplastic neuroblastoma. Am J Surg Pathol 21(8):957-963.〕 The case described by Navarro, et al. showed MYCN amplification (more than 10 copies) and a 1p36 deletion as measured with FISH in 13% of cells.〔Navarro S, Noguera R, Pellin A, Mejia C, Ruiz A, Llombart-Bosch A (2000). Pleomorphic anaplastic neuroblastoma. Med Pediat Oncol 35:449-502.〕 Additionally there was a main cell population with a DNA index of 2 indicating a tetraploid DNA content and a high expression of MIBI (Ki-67), bel 2, p53, and P-glycoprotein, either correlated with rapid progression of disease.
==Histopathology==

Appearance of focal or diffuse presence of pleomorphic and anaplastic cells is the hallmark of this neuroblastoma variant.〔〔Fletcher CDM (2007). Diagnostic Histopatholoy of tumors. Churchill Livingstone, p. 1774. Rosai (2004).〕〔Rosai and Ackerman's Surgical Pathology. Philadelphia, Mosby, p.1128.〕 Hyperchromatic and bizarre nuclei in neuroblasts and ganglion cells in undifferentiated or poorly differentiated foci are far too pathognomonic, although anaplastic expressions can be found in differentiating foci alike.〔〔〔 Undifferentiated neuroblasts may show enlarged and vesicular nuclei with thick nuclear membranes and prominent nucleoli, often a clue to forthcoming anaplastic change.

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