The perivascular spaces of the central nervous system. Histophysiological data.
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Biomedical subjects
Publications and source records attributed to J Poirier.
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The perivascular spaces of the central nervous system are involved in various pathological situations. The aim of this paper is to focus on the histopathological lesions of the perivascular spaces which commonly occur in the infectious (bacterial, viral, parasitic), tumoral (carcinoma, lymphoma, leukemia), demyelinating (multiple sclerosis, allergic encephalomyelitis) and vascular diseases of the brain. According to their apparent function in each of these situations an attempt was made to classify the main physiopathological processes involving the perivascular spaces into 3 distinct groups. The perivascular spaces may be considered as follows: (1) double way route between the parenchyma and the leptomeningeal space (extension to the brain of a meningeal pathological process, drainage of parenchymal wastes); (2) elective location of the inflammatory reaction partly as a result of the presence of connective tissue; (3) site of particular lesions such as dilatation, the pathogenesis of which remains unclear.
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A 25-year-old woman presented with left progressive deafness due to an intracranial tumor of the cerebello-pontine angle. Biopsy and subsequent total surgical excision indicated origin from the acoustic nerve. Histologically, the tumor showed typical feature of Schwannoma associated with a population of epithelioid cells. Three years after surgery no local invasion, no relapse, and no metastasis were noted. Immunohistochemistry showed a strong positivity for S100 protein in the cytoplasm of Schwannian and epithelioid tumoral cell components. This positivity in the epithelioid cells correspond to a well differentiated cell population derived from a Schwann cell precursor explaining the benign course of the tumor. In the absence of similar cases of epithelioid Schwannoma of the acoustic nerve in literature, we will discuss the differential diagnosis, potential evolutivity, and origin of the epithelioid cells.