Stromadominant and Stromapoor

Tumor in this category is characterized by the presence of one or more macroscopic, usually hemor-rhagic neuroblastomatous nodule(s) (stroma-poor component) coexisting with ganglioneuroblastoma, intermixed (stroma-rich component) or with gang-lioneuroma (stroma-dominant component; Fig. 8.1h). On microscopic examination, there is typically abrupt demarcation (pushing border or even fibrous pseudo-capsular formation) between the neu-roblastomatous nodule(s) and the stroma-rich or stro-ma-dominant tumor tissue. Some nodules, however, are not clearly demarcated but rather have a zone of neuroblastic infiltration into the adjacent Schwannian stromal tissue. In rare cases the neuroblastomatous nodule becomes so large, dominating the tumor tissue, that one can recognize stroma-rich/stroma-dom-inant area only by light microscopic examination.

Nodular formation is usually considered to be a feature of the primary tumor, but it may be overlooked on gross examination; thus, those cases with ganglioneuroblastoma, intermixed or ganglioneuro-ma at the primary site and neuroblastoma at the metastatic site should be classified into this category.

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