Fascicles and nests of Schwann cells surrounded by capsules or perineurial cells resemble those found in plexiform neurofibromas. Prominent nuclear palisading or, more specifically, Verocay body formation are distinguishing features. Intraneural patterns can be combined with extraneural patterns in cutaneous plexiform schwannomas. This is in contrast with the exclusive intraneural pattern that is prototypic of noncutaneous Schwannomas.

Foci resembling  plexiform neurofibromas  within a lesion otherwise designated as plexiform  schwannoma raise the possibility that some 'plexiform schwannomas' represent  prominent microscopic schwannomatosis within a plexiform neurofibroma (paraphrased from a personal communication from Richard J. Reed, M.D.).  The relationship of this possibility to the probability of the patient having classical neurofibromatosis (NF1), clinical schwannomatosis (multiple schwannomas without acoustic neuroma/s)  or NF2 (schwannomas with acoustic neuroma/s) is problematical.

A more complete and higher quality discussion of this lesion can be found in the chapter on Tumors of Neural Tissue by Reed and Argenyi in the eighth edition of Lever's Histopathology of the Skin.

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From a young adult:

	Very low power view (direct scan) showing  fascicles of spindle cells in all levels of the reticular dermis. There is preservation of large, native reticular dermis collagen bundles in the peripheral part of the lesion. The central reticular dermis has been replaced by moderately vascular stroma containing more delicate collagen fibers plus spindle cell nuclei having neural features. Nuclear palisading is prominent in the deeper fascicles, but minimal or absent in the more superficial fascicles.
	This photo is from the superficial aspect of the central reticular dermis. There is minimal nuclear palisading in the fascicle in the upper left side of the picture. There is a concentric layer of spindle cells around the periphery of the fascicle that probably are hyperplastic perineurial cells. The stroma in the remainder of the picture has neural qualities (extraneural or diffuse pattern).
	This photo is from the deeper aspect of the peripheral part of the lesion. Large, native reticular dermis collagen bundles are in the left side of the picture. Part of an encapsulated fascicle is in the right side of the picture. Nuclear palisading in prominent.
	Low power view of the interior of another fascicle. Note the prominent nuclear palisading. Actual parallel arrays of palisaded nuclei separated by eosinophilic fibers, defining Verocay bodies, are not clearly identified in this particular case. The watery type of Antoni B tissue was not seen.
	High power view of above. The palisaded nuclei are associated with delicate, eosinophilic fibrils.

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