Journal of Pathology and Translational Medicine

Case Study

Diagnostic conundrums of schwannomas: two cases highlighting morphological extremes and diagnostic challenges in biopsy specimens of soft tissue tumors: Chankyung Kim, Yang-Guk Chung, Chan Kwon Jung; J Pathol Transl Med. 2023;57(5):278-283. Published online August 24, 2023; DOI: https://doi.org/10.4132/jptm.2023.07.13

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Abstract PDF: Schwannomas are benign, slow-growing peripheral nerve sheath tumors commonly occurring in the head, neck, and flexor regions of the extremities. Although most schwannomas are easily diagnosable, their variable morphology can occasionally create difficulty in diagnosis. Reporting pathologists should be aware that schwannomas can exhibit a broad spectrum of morphological patterns. Clinical and radiological examinations can show correlation and should be performed, in conjunction with ancillary tests, when appropriate. Furthermore, deferring a definitive diagnosis until excision may be necessary for small biopsy specimens and frozen sections. This report underscores these challenges through examination of two unique schwannoma cases, one predominantly cellular and the other myxoid, both of which posed significant challenges in histological interpretation.

Original Article

Bronchial Schwannomas: Clinicopathologic Analysis of 7 Cases: Yoon Yang Jung, Min Eui Hong, Joungho Han, Tae Sung Kim, Jhingook Kim, Young-Mog Shim, Hojoong Kim; Korean J Pathol. 2013;47(4):326-331. Published online August 26, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.4.326

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Abstract PDF

Background

It has long been recognized that bronchial schwannomas are extremely rare. As such, diagnosing tumors in this extraordinary location can sometimes be problematic.

Methods

We reviewed seven cases of bronchoscopically or surgically resected endobronchial schwannomas and evaluated their clinical and pathologic features.

Results

The present study included five female and two male patients, with ages ranging from 16 to 81 years (mean age, 44.9 years). The clinical presentation varied according to tumor size and location. Patients with more centrally (trachea or main bronchus) located tumors experienced respiratory symptoms (80%) more often than patients with more peripherally (lobar or segmental bronchus) located tumors (0%). Histologically, the tumors were composed of spindle cells that stained with S100 protein. Some of the tumors showed typical Antoni A areas with Verocay body formation. Five of six patients (83.3%) underwent complete tumor removal by rigid bronchoscopy.

Conclusions

Pathologists should consider endobronchial schwannoma in the differential diagnosis of a spindle cell tumor involving the bronchus. Additionally, our results showed that rigid bronchoscopy is an effective tool for tumor removal in endobronchial schwannoma patients.

Citations

Citations to this article as recorded by

Video-assisted thoracic surgery for an endobronchial ancient schwannoma obstructing the left main bronchus
Jiyeon Kang, Yeon Soo Kim, Ji-Ye Kim
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Two cases of large tracheobronchial schwannomas completely resected by rigid bronchoscopy with multiple instruments
Changhwan Kim, Hae‐Seong Nam, Yousang Ko
Respirology Case Reports.2023;[Epub] CrossRef
Tracheobronchial schwannoma: a case report and literature review
Guo Lina, Hou Pengguo, Xiao Zhihua, Wang Jianxin, Bai Baoqin, Zhang Mingyue, Sun Junping
Journal of International Medical Research.2023; 51(1): 030006052211498. CrossRef
Malignant and Benign Tracheobronchial Neoplasms: Comprehensive Review with Radiologic, Bronchoscopic, and Pathologic Correlation
Francis Girvin, Alexander Phan, Sharon Steinberger, Eugene Shostak, Jamie Bessich, Fang Zhou, Alain Borczuk, Geraldine Brusca-Augello, Margaret Goldberg, Joanna Escalon
RadioGraphics.2023;[Epub] CrossRef
Clinicopathological Characteristics and Pathogenesis of Granular Cell Tumours of the Airways
Jesús Machuca-Aguado, Fernando Cózar-Bernal, Enrique Rodríguez-Zarco, Juan José Ríos-Martin, Miguel Ángel Idoate Gastearena
Journal of Bronchology & Interventional Pulmonology.2023; 30(4): 390. CrossRef
Treatment of primary tracheal schwannoma with endoscopic resection: A case report
Yong-Shuai Shen, Xiang-Dong Tian, Yi Pan, Hua Li
World Journal of Clinical Cases.2022; 10(28): 10279. CrossRef
Primary bronchial schwannoma: A case report
Yosuke Aoyama, Atsushi Miyamoto, Takeshi Fujii, Sakashi Fujimori, Meiyo Tamaoka, Daiya Takai
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Endobronchial schwannoma in adult: A case report
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Recurrent transmural tracheal schwannoma resected by video-assisted thoracoscopic window resection
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Case Report

Collision of Adenocarcinoma and Schwannoma of the Stomach: A Case Report: Jai Hyang Go; Korean J Pathol. 2012;46(4):373-376. Published online August 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.4.373

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Abstract PDF

The simultaneous occurrence of an adenocarcinoma and schwannoma is extremely rare in the stomach, and only one such case has been previously reported, which presented as two separate masses. Indeed, the collision of these tumors has never been reported. We report the case of a 61-year-old male patient who was diagnosed with the synchronous development of a schwannoma and advanced mucinous adenocarcinoma of the stomach, in which the carcinoma cells focally invaded the schwannoma.

Citations

Citations to this article as recorded by

What About Gastric Schwannoma? A Review Article
Sara Lauricella, Sergio Valeri, Gianluca Mascianà, Ida Francesca Gallo, Erica Mazzotta, Chiara Pagnoni, Saponaro Costanza, Lorenza Falcone, Domenico Benvenuto, Marco Caricato, Gabriella Teresa Capolupo
Journal of Gastrointestinal Cancer.2021; 52(1): 57. CrossRef
SYNCHRONOUS DEVELOPMENT OF SCHWANNOMA AND PRIMARY ADENOCARCINOMA IN THE STOMACH: A CASE REPORT
Algirdas Šlepavičius, Valdas Gasilionis, Alvydas Česas
Visuomenės sveikata.2019; 28(7): 75. CrossRef
Gastric Collision Tumors: An Insight into Their Origin and Clinical Significance
Adamantios Michalinos, Anastasia Constantinidou, Michael Kontos
Gastroenterology Research and Practice.2015; 2015: 1. CrossRef
Coexistence of gastrointestinal stromal tumor and inflammatory myofibroblastic tumor of the stomach presenting as a collision tumor: first case report and literature review
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Diagnostic Pathology.2015;[Epub] CrossRef

Short Case Report

Schwannoma Arising in a Lymph Node : A Brief Case Report.: Ji Han Jung, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2009;43(3):271-273.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.3.271

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6 Crossref

Abstract PDF

Intranodal schwannomas are extremely rare and only three cases have currently been reported in the English language literature. We report here on a case of a schwannoma that arose in a retroperitoneal lymph node. A 59-year-old male patient had experienced abdominal discomfort for two months. An abdominal CT scan demonstrated a heterogeneous density mass in the retroperitoneum. Histological examination of the mass identified it as a lymph node due to the presence of a peripheral rim of compressed lymphoid tissue that contained a well-demarcated benign spindle cell tumor in its center. The spindle cells were positive for S-100 protein, and they were negative for smooth muscle actin, desmin, and CD 34. Although an intranodal schwannoma is histologically benign, it is important to distinguish this lesion from an intranodal metastasis of a spindle cell tumor and other common benign spindle cell tumors that can arise in a lymph node.

Citations

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Submandibular nodal schwannoma: where did it come from?
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Cervical Lymph Node Schwannoma—An Unexpected Diagnosis
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Mesenteric intranodal schwannoma: uncommon case of neurogenic benign tumor
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Intranodal Hybrid Benign Nerve Sheath Tumor
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Case Reports

Intraosseous Neurilemmoma of the Mandible: A Case Report.: Kyu Yun Jang, Woo Sung Moon, Ho Sung Park; Korean J Pathol. 2009;43(1):88-91.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.88

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Abstract PDF

Neurilemmoma (Schwannoma) is a benign nerve sheath tumor that's composed entirely of well-differentiated Schwann cells. Intraosseous neurilemmomas are rare and they represent less than 1% of all benign primary bone tumors. We report here on an additional case of intraosseous neurilemmoma that was located in the mandible of a 77-year-old woman. CT revealed an expansile, well-defined lesion on the right side of the mandibular body with thinning of the cortex. The lesion was surgically removed and it was found to be a 2x1.7 cm-sized, bright yellowish, hard mass with hemorrhage and cyst formation. Histologically, the mass was a moderately cellular neoplasm and it showed distinct nuclear palisading, numerous Verocay bodies and tumor cells that were positively immunohistostained for S-100 protein. Two months after the operation, the patient has remained in a good condition with no signs or symptoms of tumor recurrence.

Citations

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Imaging Features of Intraosseous Schwannoma: A Case Series and Review of the Literature
Firoozeh Shomal Zadeh, Arash Azhideh, Jose G. Mantilla, Vijaya Kosaraju, Nitin Venugopal, Cree M. Gaskin, Atefe Pooyan, Ehsan Alipour, Majid Chalian
Diagnostics.2023; 13(9): 1610. CrossRef
Gnathic Schwannomas: A Report of Two Cases and Systematic Review of the Literature
Alberto Jose Peraza Labrador, Luciano Hermios Matos Valdez, Nestor Ricardo Gonzalez Marin, Karem Annelise Rodriguez Ibazetta, Marcelo Villacis, Joan Lopez Chacon, Hebert Ochoa Huaman, Harold Cuzcano Pariahuamán, Hosting Barría Angulo, Victoria Woo
Head and Neck Pathology.2023; 17(4): 984. CrossRef
Intraosseous schwannoma of the humerus: a rarity yet warrants consideration
Jagannath Kamath, Harshit Bhaskar Shetty, Arkesh Madegowda, Anusha S Bhatt
BMJ Case Reports.2021; 14(9): e240007. CrossRef
Intraosseous Schwannoma of the Jaws: An Updated Review of the Literature and Report of 2 New Cases Affecting the Mandible
Dru Perkins, Tudor I. Stiharu, James Q. Swift, Tran Volong Dao, Gisele N. Mainville
Journal of Oral and Maxillofacial Surgery.2018; 76(6): 1226. CrossRef

Endotracheal Neurilemmoma.: Hwa Sook Jeong, Jong Myeon Hong, Yoon Woo Noh, Hyung Geun Song; Korean J Pathol. 1997;31(1):79-82.

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Abstract PDF: Neurilemmomas of the trachea are extremely rare. The most common site of them is the distal third of the trachea and the age of the patients at presentation varied from 6 to 78 years old. They usually have a freqeuntly very long natural history, causing symptoms only after they have attained a considerable size. We experienced a case of near-total obstruction of the trachea by an intraluminal sessile neurilemmoma. The patient was a 66-year-old man with 2-year history of progressive exertional dyspnea and had several episodes of pneumonitis associated with productive cough. Grossly, the tumor was a well-circumscribed mass. Microscopically, typical cellular Antoni A and myxoid Antoni B areas were revealed.

Primary Intrasellar Schwannoma: A Case Report.: Na Rae Kim, Yeon Lim Suh; Korean J Pathol. 2002;36(4):274-277.

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Abstract PDF: Primary intrasellar schwannomas or neurilemmomas occur rarely and mimic pituitary adenoma, radiologically and clinically. The authors describe the 6th case of primary intrasellar schwannoma mimicking a nonfunctioning pituitary macroadenoma, clinically as well as radiologically. Light microscopically, the present case did not show the typical histology of conventional schwannoma and the confirmative diagnosis was made with the aid of immunohistochemistry and electron microscope. Here, we review the possible hypotheses for pathogenesis of sellar schwannomas on unusual locations.

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