Diagnostic Image: Perineural infiltration

Femela M

Consultant – Pathology, Kauvery Hospital, Radial Road, Chennai, Tamil Nadu

Fig (1): Photomicrograph of a case of sigmoid colon adenocarcinoma showing perineural infiltration by the tumor cells.

Discussion

Perineural invasion (PNI) specifically involves cancer cells invading the space surrounding a nerve (the perineural space). This is a significant factor in cancer progression and can affect prognosis and treatment strategies. PNI is a common feature in many adenocarcinomas, including pancreatic, prostate, and colorectal cancers. PNI is often associated with poorer outcomes, increased risk of recurrence, and can indicate tumors that are more aggressive. Cancer cells can interact with nerves through various mechanisms, including the release of growth factors and the alteration of the nerve’s microenvironment. Identifying PNI is crucial for staging and treatment planning, as it can influence the choice of surgical margins, radiation therapy, or chemotherapy.

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