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Herrera-Parra N, Pérez-Castaño L, Mendoza-Briñez A. Pacinian corpuscle hyperplasia, case report. Radiol Case Rep 2023; 18:3264-3268. [PMID: 37483376 PMCID: PMC10359712 DOI: 10.1016/j.radcr.2023.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Pacinian corpuscles are mechanoreceptors frequently found between the dermis and subcutaneous tissues of the hands and feet. They are responsible for sensitivity to vibration and pressure. Pacinian corpuscle hyperplasia is a rare cause of induration in the palms of the hands or the soles of the feet, often of unknown origin or occasionally related to neurofibromatosis. It can be characterized by magnetic resonance imaging and is included in the differential diagnosis of anechoic lesions on high-resolution soft tissue ultrasound. The definitive diagnosis is made through histopathologic examination. In this case report, we present the findings of a 29-year-old patient who presented with painful nodules on the palms of both hands, with typical findings on ultrasound and magnetic resonance imaging indicative of Pacinian corpuscle hyperplasia. We also discuss the imaging findings and the differential diagnosis through a non-systematic review. Pacinian corpuscle hyperplasia is a rare condition that can be readily identified by high-resolution ultrasound and magnetic resonance imaging, and it should be considered in the differential diagnosis of hand nodules.
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Affiliation(s)
- Nicolás Herrera-Parra
- Departamento de Radiología E Imágenes Diagnósticas, Facultad de Medicina, Universidad Icesi, Calle 18 No. 122-135, 760032, Cali, Colombia
| | - Leslie Pérez-Castaño
- Departamento de Radiología E Imágenes Diagnósticas, Facultad de Medicina, Universidad Icesi, Calle 18 No. 122-135, 760032, Cali, Colombia
| | - Andrés Mendoza-Briñez
- Departamento de Radiología, Fundacion valle de Lili, Cali, Valle del Cauca, Colombia, Cra 98 No. 18-49, 760032, Cali, Colombia
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2
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Kobayashi M, Muramatsu K, Tani Y, Magtoto IJ. Digital Neuropathy by Hypertrophy and Hyperplasia of Pacinian Corpuscle - Usefulness of Microscopic Resection. J Hand Surg Asian Pac Vol 2023; 28:121-124. [PMID: 36803331 DOI: 10.1142/s2424835523720037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
We present a patient with Pacinian corpuscle hypertrophy and hyperplasia in the hand and discuss the diagnosis and treatment of this rare condition. A 46-year-old woman presented with radiating pain of the left middle finger. A strong Tinel-like sign was elicited between the index and middle fingers. The patient frequently used mobile phone, with the corner of the phone consistently applying pressure on the palm. The surgery was carried out under the microscope and two enlarged cystic lesions under the epineurium were found in the proper digital nerve. Histologic examination revealed hypertrophied Pacinian corpuscle with normal structure. Postoperatively, her symptoms gradually improved. Preoperative diagnosis of this disease is very difficult. Hand surgeons should keep this disease in mind preoperatively. In our case, we would not have been able to identify multiple hypertrophic Pacinian corpuscles without the microscope. An operating microscope is recommended in a surgery of this nature. Level of Evidence: Level V (Therapeutic).
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Affiliation(s)
- Masato Kobayashi
- Department of Hand Surgery, Nagato General Hospital, Nagato, Yamaguchi, Japan
| | - Keiichi Muramatsu
- Department of Hand Surgery, Nagato General Hospital, Nagato, Yamaguchi, Japan
| | - Yasuhiro Tani
- Department of Hand Surgery, Nagato General Hospital, Nagato, Yamaguchi, Japan
| | - Ian Jason Magtoto
- Department of Hand Surgery, Nagato General Hospital, Nagato, Yamaguchi, Japan
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3
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Bilateral symptomatic Pacinian corpuscle hyperplasia of the adult foot. Foot (Edinb) 2021; 49:101709. [PMID: 33036838 DOI: 10.1016/j.foot.2020.101709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/06/2020] [Accepted: 07/03/2020] [Indexed: 02/04/2023]
Abstract
Pacinian hyperplasia in the human body has been rarely described in the literature with most cases reported involving the hand (Fassola et al., 2019). This hyperplasia is considered a reactive lesion as opposed to a neoplasm (Satge et al., 2001), with the most common presenting complaint being pain and swelling (Fassola et al., 2019). In this study, a case of bilateral Pacinian corpuscle hyperplasia in the adult foot not previously described in the literature is presented.
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4
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Southard EJ, Sands AK, Boyajian DA, Sieczka E, Bryk E, Vigorita VJ. Macrodystrophia Lipomatosa of the Foot: A Case Report of MRI and Histologic Findings Including Pacinian Corpuscle Abnormalities. JBJS Case Connect 2021; 11:01709767-202106000-00122. [PMID: 34129539 DOI: 10.2106/jbjs.cc.20.00785] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
CASE A 37-year-old man presented with pain and macrodactyly of a toe. Imaging and histology demonstrated findings consistent with macrodystrophia lipomatosa (MDL). We compared our findings with control tissue obtained from an identical site of a fresh-frozen cadaveric foot from the same anatomical site. Pacinian corpuscles (PCs) in the MDL tissue were increased in number, size, and shape compared with the control tissue and demonstrated edematous interstitial lamellae and vacuolar degenerative change. We also document the magnetic resonance imaging findings of the PCs. CONCLUSION Peculiar abnormalities of PCs in MDL underline nerve damage and may be a contributing factor in the pain associated with this unusual condition.
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Affiliation(s)
- Edward J Southard
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - Andrew K Sands
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - David A Boyajian
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - Elizabeth Sieczka
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - Eli Bryk
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
| | - Vincent J Vigorita
- Departments of Orthopaedic Surgery and Radiology, New York Presbyterian Lower Manhattan Hospital, New York, New York
- Kingsbrook Jewish Medical Center, Brooklyn, New York
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5
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Stoj VJ, Adalsteinsson JA, Lu J, Berke A, Lipner SR. Pacinian corpuscle hyperplasia: A review of the literature. Int J Womens Dermatol 2021; 7:335-341. [PMID: 34222593 PMCID: PMC8243158 DOI: 10.1016/j.ijwd.2020.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/08/2020] [Accepted: 10/21/2020] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE Pacinian corpuscle hyperplasia typically presents as a tender nodule on the volar aspect of the palm or digit, often after trauma. Histologically, it presents as one to multiple normal-sized to enlarged Pacinian corpuscles in the deep dermis or subcutaneous adipose tissue. Given its rarity, its pathogenesis is debated and nomenclature is poorly defined. Herein, we present a case of Pacinian corpuscle hyperplasia and review the current literature. METHODS A literature review was conducted using PubMed with the following search terms: Pacinian corpuscle hyperplasia, Pacinian corpuscle neuroma, Pacinioma, Pacinian corpuscle hypertrophy, and heterotopic Pacinian corpuscles. All case reports and case series were reviewed for histopathologic evidence of true Pacinian corpuscle hyperplasia. Cadaveric studies, cases without true Pacinian corpuscles, and noncutaneous cases were excluded from our analysis. RESULTS Sixty patients with Pacinian corpuscle hyperplasia of the hands and feet (65 cases, some with >1 location) were reviewed. The mean age of presentation was 49.5 years, and women accounted for 60% of cases. Pain was the most commonly reported symptom (55 of 65 cases; 84.6%). Forty-five cases (69.2%) were localized to a digit, most commonly the second digit (17 of 65 cases; 26.2%), and 18 of 65 cases (27.6%) affected the palm, primarily the distal palm. Surgical excision was curative in 50 of 65 cases (76.9%). CONCLUSION Although relatively uncommon, Pacinian corpuscle hyperplasia should be considered in the differential diagnosis of a tender nodule on the digit or distal palm, particularly after trauma.
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Affiliation(s)
- Victoria J. Stoj
- University of Connecticut School of Medicine, Farmington, CT, United States
| | - Jonas A. Adalsteinsson
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT, United States
| | - Jun Lu
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT, United States
| | - Adrienne Berke
- Department of Dermatology, University of Connecticut Health Center, Farmington, CT, United States
| | - Shari R. Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, NY, United States
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6
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Sampath A, Labadie JG, Guitart J. Agminated Pacinian neuroma - immunohistochemical studies and literature review. J Cutan Pathol 2021; 47:581-583. [PMID: 32569416 DOI: 10.1111/cup.13637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 12/12/2019] [Accepted: 12/16/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Ashwath Sampath
- Department of Dermatology, University of Missouri School of Medicine, Columbia, MO
| | - Jessica G Labadie
- Department of Dermatology, Northwestern Memorial Hospital, Chicago, IL
| | - Joan Guitart
- Department of Dermatology, Northwestern Memorial Hospital, Chicago, IL.,Chair, Division of Dermatopathology, Northwestern Memorial Hospital, Chicago, IL
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Multimodality Pitfalls of Wrist Imaging With a Focus on Magnetic Resonance Imaging: What the Radiologist Needs to Know. Top Magn Reson Imaging 2021; 29:263-272. [PMID: 33021577 DOI: 10.1097/rmr.0000000000000254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Numerous pitfalls are frequently encountered at multimodality imaging of the wrist, which may mimic various tendinous, osseous, capsuloligamentous, muscular, and neurovascular pathologic conditions. These pitfalls may be secondary to variant anatomy, artifactual due to magnetic resonance imaging or sonographic technique, or represent varying ranges of structure-specific normal including a spectrum of findings associated with aging in asymptomatic subjects. When an imaging finding of questionable significance is encountered, it is critical that the interpreting radiologist make every attempt to review any relevant clinical information in an effort to determine whether the imaging findings in question may account for the patient's presenting symptomology. In order to accurately diagnose true pathology at wrist imaging, it is imperative that the radiologist be familiar with the pitfalls discussed throughout this manuscript that may mimic disease. This familiarity will allow the radiologist to provide a more useful report for referring providers focusing on true pathology while eliminating potentially confusing or misleading findings which are inconsistent with the patient's clinical presentation.
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8
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Germann C, Sutter R, Nanz D. Novel observations of Pacinian corpuscle distribution in the hands and feet based on high-resolution 7-T MRI in healthy volunteers. Skeletal Radiol 2021; 50:1249-1255. [PMID: 33156397 PMCID: PMC8035111 DOI: 10.1007/s00256-020-03667-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/23/2020] [Accepted: 11/01/2020] [Indexed: 02/02/2023]
Abstract
Pacinian corpuscles represent special nerve endings that serve as mechanoreceptors sensitive to vibration and pressure and are crucial for proprioception. This work demonstrates that the complex network of Pacinian corpuscles in hands and feet can be examined with three-dimensional Dual Echo Steady State (DESS) MR imaging at 7 T, while previous dedicated MRI reports were either limited to two-dimensional images or focused on the hands. The high-resolution MR images show the detailed architecture of the complex receptor network and reveal a "chain-like" arrangement of Pacinian corpuscles, a predilection for clustering around metacarpophalangeal/metatarsophalangeal joints, proximal phalanges and fingertips, and specific sensor locations both in the superficial subcutaneous tissue and adjacent to deep soft tissue structures such as tendons and joint capsules.
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Affiliation(s)
- Christoph Germann
- Radiology, Balgrist University Hospital, Forchstrasse 340, CH-8008, Zurich, Switzerland.
- University of Zurich, Zurich, Switzerland.
| | - Reto Sutter
- Radiology, Balgrist University Hospital, Forchstrasse 340, CH-8008, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Daniel Nanz
- University of Zurich, Zurich, Switzerland
- SCMI, Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Switzerland
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9
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Pickrell BB, Talbot SG, Costigan DC, Sampson CE. Pacinian hyperplasia presenting with Raynaud's phenomenon. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2019; 6:148-152. [PMID: 32002464 PMCID: PMC6968677 DOI: 10.1080/23320885.2019.1698958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022]
Abstract
Pacinian corpuscle pathology is a rare clinical entity and an uncommonly reported cause of digital pain. While many prior reports implicate hand trauma, we describe a case of Pacinian hyperplasia found in a patient with Raynaud's phenomenon and propose a potential mechanism of disease.
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Affiliation(s)
- Brent B Pickrell
- Division of Plastic Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Simon G Talbot
- Division of Plastic Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Danielle C Costigan
- Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Christian E Sampson
- Division of Plastic Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
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10
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Fassola I, Wenzke L, Ertel W, Krasnici S. Pacinian neuromas and neurofibromas of the hands and fingers: a systematic review. J Hand Surg Eur Vol 2019; 44:925-931. [PMID: 31156019 DOI: 10.1177/1753193419852118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Tumours involving Pacinian corpuscles are rare. The literature identifies two main pathological disorders: the Pacinian corpuscle neuroma or hyperplasia and the Pacinian corpuscle neurofibroma. Published data are confusing and at times conflicting. This systematic review summarizes the available data in order to support clinicians in the differential diagnosis with other tumours responsible for unclear symptoms in the hands and fingers. We identified 67 pertinent articles. Although some similarities have been described, the two tumours have relevant differences, specifically when comparing age of the patient, location, symptoms, characteristic of a mass, and aetiology. All these factors should be taken into account in order to improve diagnostic accuracy. Despite the low incidence of unsuccessful surgeries, extraordinary measures are occasionally necessary to achieve complete resolution of symptoms.
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Affiliation(s)
- Isabella Fassola
- Department of Orthopedic, Trauma and Reconstructive Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Lena Wenzke
- Department of Orthopedic, Trauma and Reconstructive Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Wolfgang Ertel
- Department of Orthopedic, Trauma and Reconstructive Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Senat Krasnici
- Department of Orthopedic, Trauma and Reconstructive Surgery, Johanniter Krankenhaus Genthin-Stendal GmbH, Stendal, Germany
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11
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Fernandez-Flores A, Cassarino DS. Penile pacinian neurofibroma. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2019; 53:126-129. [PMID: 32199595 DOI: 10.1016/j.patol.2019.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/25/2019] [Accepted: 03/30/2019] [Indexed: 11/24/2022]
Abstract
Pacinian neurofibroma (PNF) is a lobulated benign neural tumor with prominent structures resembling pacinian bodies. These tumors most commonly occur in areas where normal pacinian bodies are found, such as the hands and feet. Although pacinian bodies are common in the penis, no cases of penile PNF have been reported to date. We present a case of PNF on the dorsal glans penis of a 47-year-old man. The lesion presented as a single flesh-colored papule and the biopsy showed a dermal neurofibroma consisting of bland spindle cells with wavy nuclei, without mitoses or atypia, and some nodular structures with a concentric arrangement and a pacinian appearance. Immunohistochemistry demonstrated positivity for CD34 and Vimetin and negativity for Epithelial Membrane Antigen (EMA). S100 was highly positive in the most central areas of the pacinian-like nodules, while the periphery and non-nodular parts of the neurofibroma were less intensively expressed.
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Affiliation(s)
- Angel Fernandez-Flores
- Hospital El Bierzo, Cellular Pathology, Ponferrada, Spain; Biomedical Investigation Institute of A Coruña, CellCOM-SB Group, A Coruña, Spain; Hospital de la Reina, Cellular Pathology, Ponferrada, Spain.
| | - David S Cassarino
- Los Angeles Medical Center (LAMC), Southern California Kaiser Permanente, Department of Dermatology, Los Angeles, CA, USA
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12
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Friedrich RE, Hagel C. Painful Vater-Pacini neuroma of the digit in neurofibromatosis type 1. GMS INTERDISCIPLINARY PLASTIC AND RECONSTRUCTIVE SURGERY DGPW 2019; 8:Doc03. [PMID: 30984511 PMCID: PMC6441816 DOI: 10.3205/iprs000129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Vater-Pacini neuromas are rare causes of severe pain in the phalanges. The cause of this change in the tactile corpuscles is unknown. A traumatic cause has been plausibly demonstrated, at least in some cases. Here, the rare occurrence of a Vater-Pacini neuroma in a patient with neurofibromatosis type 1 is reported. The discussion addresses the difficulties of terminology and current diagnostic procedures for differentiating small nodular masses of the palm and digits. The surgical treatment leads to rapid relief of the symptoms.
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Affiliation(s)
- Reinhard E Friedrich
- Department of Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Germany
| | - Christian Hagel
- Institute of Neuropathology, Eppendorf University Hospital, University of Hamburg, Germany
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13
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Riegler G, Brugger PC, Gruber GM, Pivec C, Jengojan S, Bodner G. High-Resolution Ultrasound Visualization of Pacinian Corpuscles. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:2596-2601. [PMID: 30220423 DOI: 10.1016/j.ultrasmedbio.2018.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 06/08/2023]
Abstract
The aim of this study was to evaluate the possibility of visualizing Pacinian corpuscles in the palm of the hand with high-resolution ultrasound (HRUS). In this prospective study, HRUS with a high-frequency probe (22 MHz) was used. The palms of two fresh cadaveric hands were screened for potential Pacinian corpuscles. Still ultrasound images and dynamic video sequences were obtained. In five regions with large amounts of suspected Pacinian corpuscles, tissue blocks were excised and histologically processed, and corresponding slices were compared with ultrasound images. Further, the transverse diameters of five Pacinian corpuscles, at the level of the metacarpal heads in the palm, were assessed on both sides (in total 100) in healthy volunteers. On ultrasound, Pacinian corpuscles presented as echolucent dots in the subcutis, adjacent to digital nerves and vessels and located 2-3 mm beneath the surface. On histologic sections, these echolucent dots corresponded to Pacinian corpuscles with respect to their position and topographic relationships. The mean transverse diameter for all volunteers was 1.40 ± 0.23 mm (range: 0.8-2.2 mm). This study confirms the ability to reliably visualize Pacinian corpuscles with HRUS, which contributes to our basic understanding of ultrasonographically visible subcutaneous structures and may enhance the diagnosis of pathologies related to Pacinian corpuscles.
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Affiliation(s)
- Georg Riegler
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Peter C Brugger
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria.
| | - Gerlinde M Gruber
- Division of Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria
| | | | - Suren Jengojan
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gerd Bodner
- PUC Private Ultrasound Center, Vienna, Austria
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14
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Rhodes NG, Murthy NS, Lehman JS, Rubin DA. Pacinian corpuscles: an explanation for subcutaneous palmar nodules routinely encountered on MR examinations. Skeletal Radiol 2018; 47:1553-1558. [PMID: 29632963 DOI: 10.1007/s00256-018-2934-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/21/2018] [Accepted: 03/21/2018] [Indexed: 02/02/2023]
Abstract
Pacinian corpuscles, the main touch receptors to pressure and vibration, are ubiquitous in the deep dermis and hypodermis of the fingers and palms. Nevertheless, their existence is largely unknown to most radiologists. We frequently noted hyperintense nodules in the palms of patients on water-sensitive MRI sequences, but were unable to explain their etiology. We recently encountered two patients who had Pacinian corpuscles identified at surgical exploration and pathological analysis. Pre-operative MRI examinations in these patients showed T2 hyperintense subcutaneous palmar nodules corresponding to these corpuscles in a pattern identical to those seen incidentally in other patients. Descriptions from the dermatopathological and orthopedic literature closely correspond to our MRI observations. Based on these data, we hypothesize that the MRI finding that we previously noted represents normal Pacinian corpuscles.
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Affiliation(s)
- Nicholas G Rhodes
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
| | - Naveen S Murthy
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Julia S Lehman
- Departments of Dermatology and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - David A Rubin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, St. Louis, MO, 63110, USA
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15
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Abstract
The proliferation of Pacinian corpuscles is a rare benign lesion that occurs frequently in the fingers of hands, with the only clinical sign of pain when a drastic temperature change happens. A case of an extremely rare lesion in which we observed hypertrophy and hyperplasia of Pacinian corpuscles has been reported.
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16
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Mahipathy SRRV, Durairaj AR, Parthasarathy J. Pacinian Neuroma Presenting as Congenital Macrodactyly: A Rare Case Report. J Clin Diagn Res 2015; 9:PD22-3. [PMID: 26500954 DOI: 10.7860/jcdr/2015/14525.6528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 07/25/2015] [Indexed: 11/24/2022]
Abstract
Pacinian neuromas are rare benign tumours of pacinian corpuscles of the digits. They generally occur on the volar aspect of the fingertips. Pacinian corpuscles are specialised nerve endings with a lamellated structure and are regarded as pressure and vibration receptors. Here, we report a case of pacinian neuroma presenting as congenital macrodactyly of the right little finger with pain for which the lesion was surgically excised.
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Affiliation(s)
| | - Alagar Raja Durairaj
- Associate Professor, Department of Plastic Surgery, Saveetha Medical College Hospital , Thandalam, Kanchipuram, India
| | - Jayaganesh Parthasarathy
- Associate Professor, Department of Pathology, Saveetha Medical College Hospital , Thandalam, Kanchipuram, India
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17
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Garrido-Colmenero C, Aneiros-Fernandez J, Blasco-Morente G, Perez-Lopez I, Tercedor-Sanchez J. Severe pain in the fingertip. Int J Dermatol 2015; 55:709-10. [PMID: 26267262 DOI: 10.1111/ijd.13003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/26/2015] [Accepted: 02/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Israel Perez-Lopez
- Department of Dermatology, Virgen de Las Nieves University Hospital, Granada, Spain
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18
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Lee HM, Lee HK, Lee JS, Koo DW, Jung KE. Pacinian neuromas presenting as soft tumors on the volar aspect of the fingertips. Ann Dermatol 2014; 26:551-2. [PMID: 25143700 PMCID: PMC4135126 DOI: 10.5021/ad.2014.26.4.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 09/05/2013] [Accepted: 09/26/2013] [Indexed: 11/08/2022] Open
Affiliation(s)
- Hye Min Lee
- Department of Dermatology, Eulji University School of Medicine, Daejeon, Korea
| | - Hye Kyung Lee
- Department of Pathology, Eulji University School of Medicine, Daejeon, Korea
| | - Joong Sun Lee
- Department of Dermatology, Eulji University School of Medicine, Daejeon, Korea
| | - Dae Won Koo
- Department of Dermatology, Eulji University School of Medicine, Daejeon, Korea
| | - Kyung Eun Jung
- Department of Dermatology, Eulji University School of Medicine, Daejeon, Korea
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19
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Narayanamurthy V, Winston AT, Gupta A. A rare case of Pacinian corpuscle neuroma. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2013; 13:43-5. [PMID: 24223003 DOI: 10.1177/229255030501300103] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors discuss an interesting case of a Pacinian corpuscle neuroma in the thumb of an elderly woman who presented with severe digital pain. The pain was initially attributed to osteoarthritis of the interphalangeal joint of the thumb. The clinical signs were very subtle. The patient had complete pain relief following excision of the tumour. Pacinian corpuscle neuromas are rare, with only about 70 cases reported in the literature. The histology, presenting features and associated conditions are discussed in detail. In addition to a neuroma or glomus tumour, Pacinian corpuscle hyperplasia should be considered in the differential diagnosis of digital or palmar pain of unknown etiology.
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Affiliation(s)
- Vb Narayanamurthy
- Department of Plastic Surgery, Sundaram Medical Foundation, IV Avenue, Shanthi Colony, Anna Nagar, Chennai, India
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Cho HH, Hong JS, Park SY, Park HS, Cho S, Lee JH. Tender papule rising on the digit: Pacinian neuroma should be considered in differential diagnosis. Int J Med Sci 2012; 9:83-5. [PMID: 22211094 PMCID: PMC3245416 DOI: 10.7150/ijms.9.83] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 11/27/2011] [Indexed: 12/05/2022] Open
Abstract
Pacinian corpuscles are sensory nerve-end organs located in the deep dermis and subcutaneous tissue of the palms or soles. Pacinian neuroma is an extremely rare feature, defined as hyperplasia or hypertrophy of Pacinian corpuscles. About half of Pacinian neuromas present with point tenderness. There have been a limited number of cases reported around the world. We observed a 45-year-old woman with an 8-month history of a tender whitish papule on her left thumb tip. Histopathologically, an enlarged hypertrophic Pacinian corpuscle in subcutaneous tissue, surrounded by numerous nerve fibers, was found. Herein, we report a case of Pacinian neuroma presenting as a tender papule on a fingertip that was clearly related to repetitive trauma at that site. This case shows that a meticulous history and histological examination can lead to an exact diagnosis and proper treatment.
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Affiliation(s)
- Hyun Hee Cho
- Department of Dermatology, Seoul National University, College of Medicine, Boramae Medical Center, Seoul, Korea
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Irie H, Kato T, Yakushiji T, Hirose J, Mizuta H. Painful heterotopic pacinian corpuscle in the hand: a report of three cases. ACTA ACUST UNITED AC 2011; 16:81-5. [PMID: 21348037 DOI: 10.1142/s0218810411005114] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Revised: 08/03/2010] [Accepted: 08/09/2010] [Indexed: 11/18/2022]
Abstract
Severe pain in the finger caused by an abnormal Pacinian corpuscle is a rare condition. We have recently encountered three patients diagnosed with a heterotopic Pacinian corpuscle, based on histopathological findings. When making a differential diagnosis of unexplained severe pain in the finger, abnormal Pacinian corpuscles must be taken into account in addition to glomus tumour and other types of painful soft-tissue tumour.
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Affiliation(s)
- Hiroki Irie
- Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto 860-8556, Japan.
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Maurya S, Bhandari PS. Post traumatic entrapment neuropathy of digital nerve — A case report and review of literature. INDIAN JOURNAL OF NEUROTRAUMA 2011. [DOI: 10.1016/s0973-0508(11)80029-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vijayaraghavan R, Chandrashekar R, Belagavi CS, Murthy NB. Painful digital Pacinian corpuscle hyperplasia following dog bite: a case report. Int J Surg 2007; 6:e42-5. [PMID: 19059135 DOI: 10.1016/j.ijsu.2007.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Revised: 12/27/2006] [Accepted: 01/01/2007] [Indexed: 11/26/2022]
Abstract
Digital Pacinian corpuscle hyperplasia is an extremely rare, painful condition that generally follows local trauma. We report a case of painful digital Pacinian corpuscle hyperplasia of the right index finger that was preceded by a dog bite at the same site over one and a half years ago. To the best of our knowledge, this is the first instance of a Pacinian corpuscle hyperplasia following dog bite. The literature is reviewed and immunohistological features are outlined.
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Affiliation(s)
- Rajagopalan Vijayaraghavan
- Department of General and Laparoscopic Surgery, RMV Hospital, 138, AECS Layout, Sanjaynagar, Bangalore 560094, India
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Yan S, Horangic NJ, Harris BT. Hypertrophy of Pacinian corpuscles in a young patient with neurofibromatosis. Am J Dermatopathol 2006; 28:202-4. [PMID: 16778485 DOI: 10.1097/00000372-200606000-00004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Hypertrophy of Pacinian corpuscles is a condition that has been reported very infrequently. It was thought not to be connected with neurofibromatosis. A 24-year-old female with a lifelong history of neurofibromatosis type 1, who presented with left ring finger pain and decreased sensation for over 1 year is reported. Histopathology showed hypertrophy of Pacinian corpuscles. Hypertrophy of Pacinian corpuscles should be considered in the differential diagnosis of any patient with persistent pain localized to the distal palm or digits. This is the first case reported in a patient with neurofibromatosis. The finding of this lesion in a patient with neurofibromatosis is somewhat intriguing, though the relationship of these two entities is unclear.
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Affiliation(s)
- Shaofeng Yan
- Department of Pathology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire 05756, USA
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Mashoof AA, Levy HJ, Soifer TB, Miller-Soifer F, Bryk E, Vigorita V. Neural anatomy of the transverse carpal ligament. Clin Orthop Relat Res 2001:218-21. [PMID: 11347839 DOI: 10.1097/00003086-200105000-00028] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Carpal tunnel syndrome is one of the most commonly diagnosed disorders of the upper extremity. The etiology of the neuropathy is known to be associated with many disorders, with the etiology of carpal tunnel syndrome mainly attributable to ischemia of the median nerve. The purpose of this study was to determine the presence of neural elements within the transverse carpal ligament. Fourteen transverse carpal ligaments were harvested from seven male and seven female fresh frozen cadavers with an average age of 76 years. The tissues were stained with S-100 using a standard immunoperoxidase technique used to localize neural tissue. The transverse carpal ligament consisted of interwoven bundles of fibrous connective tissue. It was found to have an intraligamentous and extraligamentous neural network consisting mostly of free nerve endings and pacinian corpuscles. Ruffini's corpuscles were not identified. This study showed that there is neural innervation to the transverse carpal ligament. Pacinian corpuscles have been shown to be mechanoreceptors which respond to changes in joint position, whereas free nerve endings have been identified as nociceptors. Neural innervation were present in the transverse carpal ligament, and the nociceptive information relayed by these neural elements may contribute to the pain associated with carpal tunnel syndrome. In addition to being a mechanical wrist stabilizer, the transverse carpal ligament also may play a role in proprioception of the wrist.
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Affiliation(s)
- A A Mashoof
- Department of Orthopaedic Surgery, Kingsbrook Jewish Medical Center, Brooklyn, NY 11203, USA
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Abstract
A case of Pacinian hyperplasia of the right great toe is reported. Pacinian hyperplasia is a rare benign and recently recognized painful lesion composed of an excess of well formed or hyperplastic Pacinian corpuscules, normaly involved in sensory innervation. This lesion that is usually observed in the hand, must be distinguished from nerve tumors harboring onion-bulb structure which are not true well formed Pacinian corpuscules and from Morton neuroma. Pacinian hyperplasia is considered a reactive lesion and not a true neoplasm. To our knowledge, this case is the first described in the foot.
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Affiliation(s)
- D Satge
- Laboratory Pathology, Centre Hospitalier, Tulle, France.
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Reznik M, Thiry A, Fridman V. Painful hyperplasia and hypertrophy of pacinian corpuscles in the hand: report of two cases with immunohistochemical and ultrastructural studies, and a review of the literature. Am J Dermatopathol 1998; 20:203-7. [PMID: 9557793 DOI: 10.1097/00000372-199804000-00019] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hypertrophy and hyperplasia of pacinian corpuscles in the hand are very rare, with only 29 cases previously published. We describe two new cases in middle-aged patients whose chief complaint was progressive digital pain. Immunohistochemical and electronmicroscopic investigations indicated that the lump replicates the structure of enlarged pacinian corpuscles and should not be considered as a real tumor, nor connected to neurofibromatosis. No recurrence was observed after surgical excision. Although local trauma was encountered in 55% of the reported cases, the pathogenesis of such a lesion is still speculative.
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Affiliation(s)
- M Reznik
- Department of Neuropathology, Centre Hospitalier Universitaire de Liège, Belgium
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Deshpande GU, Bhatoe HS, Rai R, Panicker NK. PACINIAN NEUROFIBROMA OF SCALP: A Case Report. Med J Armed Forces India 1997; 53:135-136. [PMID: 28769463 PMCID: PMC5530886 DOI: 10.1016/s0377-1237(17)30685-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- G U Deshpande
- Reader, Dept of Pathology, Armed Forces Medical College, Pune - 411040
| | - H S Bhatoe
- Classified Specialist (Surgery & Neurosurgery), Command Hospital (Northern Command), C/O 56 APO
| | - Ramji Rai
- Prof & Head, Dept of Pathology, Armed Forces Medical College, Pune - 411040
| | - N K Panicker
- Assoc Prof, Dept of Pathology, Armed Forces Medical College, Pune - 411040
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Calder JS, Holten I, Terenghi G, Smith RW. Digital nerve compression by hyperplastic Pacinian corpuscles. A case report and immunohistochemical study. JOURNAL OF HAND SURGERY (EDINBURGH, SCOTLAND) 1995; 20:218-21. [PMID: 7797975 DOI: 10.1016/s0266-7681(05)80055-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
A 68-year-old lady developed digital pain within days of the excision of a palmar ganglion. This was found to be due to a mass of hyperplastic Pacinian corpuscles compressing the digital nerve. Immunohistochemistry was carried out on the resected corpuscles using antisera to a range of neuropeptides. Possible mechanisms of hyperplasia are discussed.
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Affiliation(s)
- J S Calder
- Blond-McIndoe Medical Research Centre, Queen Victoria Hospital, East Grinstead, Sussex, UK
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Fraitag S, Gherardi R, Wechsler J. Hyperplastic pacinian corpuscles: an uncommonly encountered lesion of the hand. J Cutan Pathol 1994; 21:457-60. [PMID: 7868758 DOI: 10.1111/j.1600-0560.1994.tb00289.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The occurrence of hyperplastic pacinian corpuscles in the hand is rare, with only 13 cases reported in the literature. We describe such a case in a 70-year-old male who had worked as a locksmith for many years. A grape-like cluster of firm, rice-sized nodules was discovered in the subcutaneous tissue of the finger following a glass-induced injury. Histopathological findings revealed pacinian corpuscles to be increased in size and number. Individual corpuscles consisted of a central nerve fiber surrounded by 35 to 60 concentric lamellae (normal controls from other specimens: 13-15 lamellae). The external corpuscular diameter ranged from 1.8 to 3.2 mm (normal controls from other specimens: 1.6 mm). Immunohistochemistry showed positive staining with Leu 7 antibody and antiglial fibrillary acidic protein in the small nerves situated in the vicinity of the pacinian corpuscles, but not in the corpuscles themselves. The lesion reported here clearly differed from both neurofibroma with occasional pacinian differentiation and the so-called pacinian neurofibroma. There was no evidence of neurofibromatosis.
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Affiliation(s)
- S Fraitag
- Department of Anatomy and Cytopathology, Necker-Enfants Malades Hospital, Paris, France
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Affiliation(s)
- J Bell
- Department of Mathematics, University at Buffalo, SUNY 14214, USA
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Abstract
A case of digital pacinian corpuscle neuroma leading to erosive changes in the adjacent proximal phalanx is reported. Characteristics and previous reports of this relatively uncommon hand tumor are discussed.
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Affiliation(s)
- S A McPherson
- University of California Los Angeles School of Medicine
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Abstract
Proliferation of pacinian corpuscles adjacent to the digital nerves in the hand is very rare. Patients are usually seen initially with a history of previous trauma and severe localized pain. The symptoms, signs, and surgical treatment of previously reported cases are reviewed and histological criteria from this case are proposed to define this condition. In addition to a neuroma or glomus tumor, pacinian corpuscle hyperplasia should be considered in the differential diagnosis of digital or palmar pain.
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Affiliation(s)
- N F Jones
- Division of Plastic and Reconstructive Surgery, University of Pittsburgh, Pa 15261
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Affiliation(s)
- A S Dembinski
- Department of Pathology and Microbiology, University of Nebraska, Omaha 68198-3135
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Abstract
Neural tumours composed solely of Pacinian corpuscles or showing focal Pacinian differentiation are extremely rare and have only occasionally been reported in the literature. All such lesions to date have been benign. Three lesions are described herein which presented as painful digital masses in middle-aged adults and which were composed of abnormal aggregates of morphologically mature Pacinian corpuscles and intervening small nerves. Only five similar cases have been previously recorded. Possible pathogenetic mechanisms of this unusual hyperplastic phenomenon are discussed.
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Affiliation(s)
- C D Fletcher
- Department of Histopathology, St Thomas's Hospital Medical School, London, UK
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Abstract
Features of the glomus tumor and the relatively recently described pacinian hyperplasia are described including signs and symptoms, differential diagnosis and treatment. The role of trauma as an etiology is proposed. A case is reported and discussed in which the patient had a glomus tumor and pacinian hyperplasia in an index finger, and a glomus tumor in the small finger of one hand. Treatment of both entities was surgical excision.
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