Neuroblastoma (Schwannianstroma-poor)
Definition: Neuroblastoma (Schwannianstroma-poor) composed of undifferentiated neuroblasts in the most part and interstitial components consist of Schwannian cells and fibroblasts are less than 50% of tumor tissue.
1) Subtype
(1) Undifferentiated (The neuropil in the tumor are not clearly recognized.)
(2) Poorly differentiated (The tumor consists of less than 5% of ganglion like cells differentiation.)
(3) Differentiation (The tumor consists of more than 5% of ganglion like cells differentiation.
The definition of ganglion like cells differentiation: Size of cytoplasm is twice that of nucleus. The things of eosinophilic cytoplasm and eccentric nuclei in the cytoplasm.
2) Mitosis karyorrhexis-index (MKI)
(1) low MKI , < 2% (less than 100 / 5000 cells)
(2) intermediate MKI, 2-4% (100-200/5000 cells)
(3) high MKI, >4% (more than 200/5000 cells)
The mitosis karyorrhexis index (MKI) is defined as the number of tumor cells with karyorrhexis and mitosis in the tumor tissues. MKI is classified with 3 categories according to the number of tumor cells in mitosis.
Table 3: Morphological indication of neuroblastoma and subtypes (INPC).