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From the Department of Soft Tissue Pathology,*
Armed
Forces Institute of Pathology, Washington, District of Columbia; the
Department of Pathology,
Katholieke
Universiteit of Leuven, Leuven, Belgium; and the Department of Biology
and Genetics,
Medical University of Gdansk,
Gdansk, Poland
Perineurial cell tumors (PNTs) are rare neoplasms derived from or
showing differentiation toward specialized lining cells of the nerve
sheath, the perineurial cells. In this study, we have
evaluated neurofibromatosis type 2 (NF2) gene alterations in
eight PNTs using archival formaldehyde-fixed, paraffin-embedded
tissue. Two conventional soft-tissue PNTs from the upper back and chest
wall, one retiform soft tissue variant from the scapular
region, and five sclerosing PNTs from the fingers and palm were
studied. All cases showed histological features of PNTs, and
the neoplastic cells were positive for epithelial membrane antigen and
negative for S100 protein. The coding sequences (exons 1 to 15) of the
NF2 gene were polymerase chain reaction (PCR) amplified and evaluated
for mutations by direct sequencing of the PCR products. Five
NF2 point mutations, two in the 5'-untranslated
region (UTR) and three in exons 3, 6, and 8,
were identified in four of eight cases (50%) studied. Exon mutations
resulted in changes of predicted amino acids sequences: Asp
Asn at
codon 83, Glu
Asp at codon 182, and Leu
Val at
codon 241. In two cases (one with a missense mutation in codon
241), the same point mutation in the 5'-UTR at the nucleotide
position 8958 was identified. A loss of heterozygosity (LOH) study was
performed in three cases. LOH at the NF2 locus was found in one case
with a mutation in the 5'-UTR. However, in another case with
exon 8 and 5'-UTR mutations, deletion of one allele of the NF2
gene was previously documented by fluorescence in situ
hybridization. The coexistence of NF2 gene mutations and LOH at the NF2
locus indicates that the NF2 tumor suppressor gene is altered in PNTs
by the two-hit mechanism.
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