Figure 4

Microscopic aspect of neurofibroma with floret-like cells. A Overview to show diffuse infiltration of reticular dermis by neurofibroma, wherein cutaneous appendages (eccrine glands) appear permeated rather than dislocated by tumor cells. B Along the border to subcutaneous fat, neurofibroma cells tend to gradually merge with local adipocytes. C The cellular monotony of underlying neurofibroma is focally disrupted by large multinucleated cells (floret-like cells; arrows). These were felt to occur in a haphazard manner irrespective of local variation in tumor architecture. D High magnification view to show cytologic detail of two floret-like giant cells. Peripheral crowding of multiple nuclei along jagged cytoplasmic borders is appreciated in floret-like cell on center left. E Meissnerian-like differentiation is particularly frequent in – if not characteristic of – syndrome-associated neurofibromas. F An occasional tortuous peripheral nerve fascicle expanded by endoneurial tumor cells is felt to represent an elementary form of plexiform neurofibroma. All microphotographs represent slides stained by hematoxylin and eosin. Original magnifications: A – ×40; B, C, F – ×100; D – ×400; E – ×200.