Review for 10.1186/s12876-021-01607-w (2021)

Reviewer’s report
Title: 
Multiple non-polypoid mucosal Schwann cell hamartomas presenting as
edematous and submucosal tumor-like lesions: a case report
Version: 
0 
Date: 
05 Dec 2020
Reviewer's report:
Dear authors,
Congratulation on this interesting and very intriguing case that you report.
I think it is represents a valuable addition to the, as you state, scarce literature on
MSCH.
However, there are some issues that I would like for you to address:
-The terminology you use could be clearer. For the vanishing lesion, the term
"sub-epithelial lesion" would be more suitable since it we have no evidence from
which layer of the bowel wall it raised from (please check the ASGE guideline
on subepithelial lesions on the GI tract). 
-Line 37: would add the characteristic "single", like it appears on the abstract
-Line 43: in the seminal work by Gibson, "intramucosal perineuromas" and
"mucosal benign epithelioid nerve sheath tumor" are included in the differential
diagnosis. Why did you choose not to include those lesions?
-Line 44: would make a more complete description of the MSCH, including the
missing features: entrapment of colonic crypts, poorly circumscribed; dense
eosinophilic cytoplasm
-Line 46: although mostly negative, some MSCH may stain for NFP, revealing
rare axons. Would correct this
-Line 49: multiple MSCH reference is missing: "[2,7]"
-Line 58: in which colonic segment was the lesion? That is very important and
should be made clear
-Line 62: you mention the pharmacological class in the treatment of hypertension
and diabetes, but then the specific drug to AF. This should be coherent (say the
specific drug to HTA/DM or refer to dabigaran as a NOAC)
-Line 73: specify the colonic segments from which the additional lesions were
resected
-Line 74: was the diagnosis of hyperplasic nodule based on the
chromoendoscopy, biopsy or resection?
-Line 81: would make a more detailed description about the presence of
inflammatory cells (mononuclear vs polymorphonuclear; density;
distribution…). They are not mentioned on other case reports on MSCH. Does
their presence compromise the diagnosis? Would made a comment on that.
-Line 103: would not use "asymptomatic" since a substantial part of individuals
who undergo screening colonoscopy may have mild GI symptoms, even though
they are not the indication for the examination. 
-Line 119: please confirm your references. Reference 8: small whitish nodules; I
cannot find the other two lesions in reference 1 or 8
Table 1: eliminate the term "asymptomatic" and substitute for "screening" or
"non-diagnostic colonoscopy" for the reasons mentioned above. In study [1], two
cases had "unkown" indication/symptom for colonoscopy, however there is no
"unkwown" line in this table. Please correct
About the figures, they would benefit from arrows/arrow heads and
corresponding legend so that the reader can identify the lesions more easily. If
you could get a higher definition image of the histologic pictures that would be
great.
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
Yes
Are the methods sufficiently described to allow the study to be repeated?
Yes
Is the use of statistics and treatment of uncertainties appropriate?
Yes
Is the presentation of the work clear?
Yes
Are the images in this manuscript (including electrophoretic gels and blots) free
from apparent manipulation?
Yes