Acoustic neuroma pathophysiology
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Acoustic neuroma Microchapters | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology
Acoustic schwannomas are benign tumours (WHO grade 1), which usually arise from the intracanalicular segment of the vestibular portion of the vestibulocochlear nerve (CN VIII) 2,4, near the transition point between glial and Schwann cells (Obersteiner-Redlich zone) 8. In over 90% of cases these tumours arise from the inferior division of the vestibular nerve 8. They are well circumscribed encapsulated masses, which unlike neuromas, arise from but are separate from nerve fibers 7, which they usually splay and displace rather than incorporated. They can display two types of growth pattern:
- Antoni A
- Elongated cells with cytoplasmic processes arranged in fascicles 7.
- Little stromal matrix.
- Verocay bodies: nuclear free zones of processes lying between regions of nuclear palisading.
- Antoni B
- Loose meshwork of cells.
- Less densely cellular.
- Microcysts and myxoid change.