Zellballen

Nest-like clusters of uniform, round-to-polygonal chief cells surrounded by delicate richly vascular tissue and sustentacular cells, a pattern characteristic of paraganglioma
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Histopathological evaluation showed a neoplasm composed of cells arranged in nesting (Zellballen) pattern separated by thin fibrovascular septae.
The World Health Organization (WHO) defines PGL as "a unique neuroendocrine neoplasm, usually encapsulated and benign, arising in specialized neural crest cells associated with segmental or collateral autonomic ganglia; consisting of uniform chief cells exhibiting neuronal differentiation forming compact nests (Zellballen) surrounded by sustentactular cells and a delicate capillary network." (18) They are classified by the site of origin, such as central nervous system PGL, head and neck PGL, (urinary) bladder PGL, mediastinal PGL, organ of Zuckerkandl PGL, extra-adrenal abdominal PGL, pelvic PGL, and pheochromocytoma (PGL of adrenal medulla).
Mikroskopik incelemede; ince fibrovaskuler stroma ile cevrelenmis poligonal hucre kumeleri ile karakterli (Zellballen paterni) feokromasitoma ve schwann benzeri hucrelerin olusturdugu stromada yerlesmis bir kismi multinukleer ozellikte matur ganglion hucrelerine benzer ozellikteki gangliositik komponentleri hemen hemen esit oranda iceren kompozit adrenal meduller tumor izlenmekte idi (Sekil 1a).
They have Zellballen and alveolar pattern with accompanying thin-walled vessels.
Classic pattern of small nests (zellballen) made up of polygonal neuroendocrine cells (chief cells).
These cells form a "zellballen" pattern of nests separated by vascular stroma and spindle-shaped sustentacular cells [28, 43].
In the jugulotympanic paraganglioma, nests and trabeculae are composed of small to medium-sized cells with ovoid nuclei and abundant pink cytoplasm within a rich vascular network, characteristic of the Zellballen pattern (hematoxylin and eosin, original magnification x20).
The tumour had a Zellballen pattern with low cellularity, with the absence of comedonecrosis, lymphovascular invasion, or high Ki-67.
(a) Routine hematoxylin and eosin (H&E) staining at low magnification (20x) highlights the typical "Zellballen" growth pattern characterized by nests of tumor cells surrounded by delicate fibrovascular stroma.
Paraganglioma is composed histologically of a wellcircumscribed mass composed of nested growth pattern of tumor cells known as Zellballen pattern, with a highly vascularized fibrous stroma.
The nests of tumor cells (zellballen pattern) are separated by sustentacular cells ((a) x200; (b) x400).
Histopathological analysis of tissue sections of the adrenal mass yielded an unexpected result: a pheochromocytoma was diagnosed on the basis of typical well-arranged nests called zellballen. This encapsulated adrenal tumor exhibits a low proliferation index (MIB-1, 1 %-2%; 1 mitosis/high power field) without vascular invasion.