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Perineurial cell hypertrophic mononeuropathy manifesting as carpal tunnel syndrome
Author(s) -
Mitsumoto Hiroshi,
Estes Melinda L.,
Wilbourn Asa J.,
Culver James E.
Publication year - 1992
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.880151212
Subject(s) - mononeuropathy , carpal tunnel syndrome , lesion , medicine , median nerve , axon , carpal tunnel , nerve sheath neoplasm , biopsy , pathology , anatomy , immunohistochemistry , surgery , peripheral neuropathy , malignant peripheral nerve sheath tumor , endocrinology , diabetes mellitus
A 42‐year‐old man showed signs and symptoms suggestive of carpal‐tunnel syndrome, but EMG showed an isolated motor axon‐loss lesion affecting the right median nerve distally. After the MRI revealed a mass in the median nerve, surgical exploration showed a diffusely swollen median motor branch. Biopsy showed a lesion with marked onion‐bulb formation composed of perineurial cells as identified by immunohistochemical analyses and electron microscopic examination. Although we previously coined the term “perineurioma” for this condition, re‐reviews of our cases do not support the idea that the onion‐bulb lesion is a benign tumor; instead, it appears to be reactive hyperplasia. Although rare, electromyographers and neurologists need to be aware of this problem because it is selflimited and does not require surgical resection. © 1992 John Wiley & Sons, Inc.