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Updated: May 9, 2026

Isolation of Primary Murine Retinal Ganglion Cells (RGCs) by Flow Cytometry
Published on: July 5, 2017
Ganglion cell like cells, diagnostic dilemma
Anand Shankar Ammanagi1, Panduranga Chikkannaiah, Veerabhadrappa Veerappa Yenni
1Department of Pathology, S.N. Medical College, Bagalkot, Karnataka, India.
Insights
A rare cutaneous swelling initially diagnosed as ganglioneuroma was reclassified as fibromatosis. This highlights the need for immunohistochemistry beyond H and E staining for accurate diagnosis of skin lesions.
Area of Science:
- Dermatopathology
- Oncology
- Surgical Pathology
Background:
- Ganglioneuromas are rare, benign tumors typically found along sympathetic ganglia or in the adrenal medulla.
- Primary cutaneous ganglioneuromas are exceptionally rare.
- Cutaneous swellings can present diagnostic challenges.
Purpose of the Study:
- To report a rare case of a cutaneous swelling initially diagnosed as ganglioneuroma.
- To investigate the histological and immunohistochemical features of the lesion.
- To emphasize the importance of advanced diagnostic techniques for cutaneous lesions.
Main Methods:
- Histopathological examination using Hematoxylin and Eosin (H and E) staining.
- Immunohistochemical analysis to determine cellular origin.
- Gross examination of the excised dermal specimen.
Main Results:
- The excised nodule showed spindle cells with ganglion cell-like features on H and E staining, initially suggesting ganglioneuroma.
- Immunohistochemistry revealed a fibroblastic origin.
- The final diagnosis was fibromatosis with ganglion cell-like fibroblasts.
Conclusions:
- The histological features of ganglioneuromas can be mimicked by other cutaneous lesions.
- Diagnosis solely based on H and E staining can be misleading for cutaneous ganglioneuromas.
- Immunohistochemistry is crucial for accurate diagnosis of such rare skin tumors.
Abstract:
We report a case of cutaneous swelling found on the left anterior axillary fold of a 41-year-old man. Gross examination of specimen excised from the dermis showed a well-circumscribed nodule histologically composed of spindle cells with interspersed ganglion cell like cells. On hematoxylin and eosine (H and E) staining it was diagnosed as ganglioneuroma. Ganglioneuromas are rare, benign, fully differentiated tumors that contain mature schwann cells, ganglion cells, fibrous tissue, and nerve fibers. They are commonly found along the paravertebral sympathetic ganglia and sometimes in the adrenal medulla. However primary cutaneous ganglioneuroma is an extremely rare tumor. Immunohistochemical workup revealed a fibroblastic origin and hence the case was diagnosed as fibromatosis with ganglion cell like fibroblasts. This case report suggests that the features considered diagnostic of ganglioneuromas can occur in other cutaneous lesions and, therefore, this diagnosis cannot be offered only on the basis of H and E.
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