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Gross appearance of Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor). In this case, a whitish yellow, solid component has a picture of Ganglioneuroblastoma, Intermixed. While, a hemorrhagic nodule shows an appearance of Neuroblastoma.

Gross appearance of Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor) In this case, solid component has a picture of Ganglioneuroma, Maturing subtype. Single large nodule is composed of 2 different histologies: hemorrhagic area is Neuroblastoma, poorly differentiated subtype and non-hemorrhagic area is Neuroblastoma, differentiating subtype.

Gross appearance of Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor) In this case, there are multiple neuroblastomatous nodules, hemorrhagic and/or necrotic, in a background of ganglioneuroblastoma, intermixed.

Classic forms and variants of Ganglioneuroblastoma, Nodular: 1) Nodular component can be single or multiple. 2) Size(s) and proportion of the nodule(s) vary from tumor to tumor. In rare cases, no nodule can be found in the primary tumor due most likely to sampling error. White: Ganglioneuroblastoma, Intermixed (Schwannian stroma-rich) or Ganglioneuroma (Schwannian stroma-dominant) component Green: Neuroblastoma (Schwannian stroma-poor) component

Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor) showing a single hemorrhagic nodule of neuroblastomatous component.

Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor) showing a growth of large neuroblastomatous component with a rim of gnaglioneuromatous component. The nodule is clearly demarcated from the ganglioneruomatous tissue by fibrous capsule.

Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor) The nodular component is clearly demarcated from the ganglioneuromatous tissue, but no fibrous capsular formation is seen in this case.

Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor) In this tumor, the neuroblastomatous component (right side) shows an infiltrative growth into the ganglioneuromatous component (left side).

Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor) with 2 neuroblastomatous nodules showing the same histology of poorly differentiated subtype.

Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor) with 2 neuroblastomatous nodules showing different histologies: one (upper nodule) is poorly differentiated subtype and the other (lower nodule) is differentiating subtype.

This is not a case of Ganglioneuroblastoma, Nodular (composite, Schwannian stroma-rich/stroma-dominant and stroma-poor). Note smooth transition between neuroblastomatous component (upper half) and ganglioneuromatous component (lower half).

This is not a case of Ganglioneuroblastoma, Nodular (Schwannian stroma-rich/stroma-dominant and stroma-poor) Note a pre-existing ganglion in neuroblastoma (Schwannian stroma-poor) tumor.

GNB - Nodular / composite

Tumor in this category is composed of at least 2 morphologcally distinct components: One component has an appearance of either Ganglioneuroblastoma, Intermixed or Ganglioneuroma and the other has an appearance of Neruoblastoma.
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Proportion of these components varies depending on the time of surgery. Ganglioneuroblastoma, Intermixed/Ganglioneuroma component grows slowly or even stops growing at its fully mature status. In contrast, Neuroblastoma component keeps growing and even predominates the tumor tissue in the later stage of development of this tumor.


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