Society for Pediatric Pathology

Atlas Chapters

Ganglioneuroblastoma, Intermixed (Schwannian stroma-rich). A high power view of this microscopic neuroblastomatous area contains neuroblastic cells with various stages of differentiation towards ganglion cells in a background of neuropil. Note ganglion cells embedded in the Schwannian stroma (arrow).

Ganglioneuroblastoma, Intermixed (Schwannian stroma-rich). A higher view of the picture #55. Neuroblastic cells have either an undifferentiated or a differentiating appearance. A considerable number of them are apoptotic.

Ganglioneuroblastoma, Intermixed (Schwannian stroma-rich). Individual neuroblastomatous foci are distinct and composed mainly of differentiating neuroblasts/maturing ganglion cells in a background of neuropil. Also seen are differentiating neuroblasts/ganglion cells individually scattered in a Schwannian stroma making a ganglioneuromatous appearance of this tumor.

Ganglioneuroblastoma, Intermixed (Schwannian stroma-rich). In this tumor, numbers of neuroblastic cells/ganglion cells are markedly reduced in the individual neuroblastomatous foci.

Ganglioneuroblastoma, Intermixed (Schwannian stroma-rich). There are multiple neuroblastomatous foci making distinct microscopic nests (pockets) embedded in the Schwannian (ganglioneruomatous) stroma. Neuroblastomatous foci are composed of neuroblastic cells with various stages of differentiation in a background of neuropil.

Gross appearance of ganglioneuroblastoma, Intermixed (Schwannian stroma-rich). Note: a solid tumor with elastic consistency with no grossly visible hemorrhagic nodules.

GNB - Intermixed

Tumor in this category is characterized by the presence of ganglioneuromatous tissue (Schwannian stroma with individually scattered neuroblasts/ganglion cells) occupying more than 50% of the tissue. There are still microscopic foci or “pockets” of neuroblastomatous components.

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