Journal of Pathology and Translational Medicine

Case Study

A Rare Case of Aggressive Melanotic Schwannoma Occurred in Spinal Nerve of a 59-Year-Old Male: Sung-eun Choi, Yoon Jin Cha, Jisup Kim, Hyunseo Cha, Jayeong Seo, Sung-Uk Kuh, Sung-Jun Kim, Se Hoon Kim; J Pathol Transl Med. 2017;51(5):505-508. Published online April 4, 2017; DOI: https://doi.org/10.4132/jptm.2017.01.04

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Melanotic schwannoma (MS) is a rare variant of nerve sheath neoplasm that shows ultrastructural and immunophenotypical features of Schwann cells but also has cytoplasmic melanosomes and is reactive for melanocytic markers as well. Unlike conventional schwannoma, which is totally benign, MS has an unpredictable prognosis and is thought to have low-malignant potential. Herein, we present a rare case of recurrent MS in lumbar spine of a 59-year-old male.

Citations

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Case Report: Cutaneous melanocytic schwannoma with concomitant melanocytoma in a canine
Olwam H. Monakali, Nicolize O'Dell, Louise van der Weyden
Wellcome Open Research.2024; 8: 364. CrossRef
A Rare Case of Melanotic Schwannoma Occurred Intraosseous of Sacrum: A Literature Review
Xiaobo Yan, Keyi Wang, Nong Lin, Xin Huang, YanBiao Fu, Zhaoming Ye
Orthopaedic Surgery.2023; 15(2): 655. CrossRef
Sporadic spinal psammomatous malignant melanotic nerve sheath tumor: A case report and literature review
Giulio Bonomo, Alessandro Gans, Elio Mazzapicchi, Emanuele Rubiu, Paolo Alimonti, Marica Eoli, Rosina Paterra, Bianca Pollo, Guglielmo Iess, Francesco Restelli, Jacopo Falco, Francesco Acerbi, Marco Paolo Schiariti, Paolo Ferroli, Morgan Broggi
Frontiers in Oncology.2023;[Epub] CrossRef
Case Report: Cutaneous melanocytic schwannoma with concomitant melanocytoma in a canine
Olwam H. Monakali, Nicolize O'Dell, Louise van der Weyden
Wellcome Open Research.2023; 8: 364. CrossRef
Fine‐needle aspiration cytology of melanotic schwannoma in the submandibular gland
Yu‐Hua Huang, Ying‐Chou Lu, Hsuan‐Ying Huang, Chien‐Chin Chen
Diagnostic Cytopathology.2021; 49(1): 142. CrossRef
Checkpoint inhibitors and radiotherapy in refractory malignant melanocytic schwannoma with Carney complex: first evidence of efficacy
Jyoti Bajpai, Akhil Kapoor, Rakesh Jalali, Mrinal M Gounder
BMJ Case Reports.2021; 14(5): e240296. CrossRef
18F-FDG PET/CT imaging for aggressive melanotic schwannoma of the L3 spinal root
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Hemorrhagic spinal melanotic schwannoma presenting as acute chest pain: A case report and literature review
Dallas J. Soyland, Dylan R. Goehner, Kayla M. Hoerschgen, Troy D. Gust, Shawn M. Vuong
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Retroperitoneal Recurrence of Melanotic Schwannoma on 18F-FDG PET/CT
Xiangliu OuYang, Lichun Zheng, Xiaoming Zhang
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Schwannoma originating from the common iliac artery: a case report
Seung-Myoung Son, Chang Gok Woo
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Intraosseous Melanotic Schwannoma in the Sacrum Mimicking Primary Bone Tumor
Yoshitaka Nagashima, Yusuke Nishimura, Kaoru Eguchi, Takayuki Awaya, Satoshi Yoshikawa, Shoichi Haimoto, Toshihiko Wakabayashi, Masahito Hara
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Extramedullary melanotic schwannoma recurrence in the cervical vertebral arch: a case report and review of the literature
Zongbin Hou, Teng Shi, Guangrun Li, Lin Tian, Xinna Li, Xiaoyang Liu
Journal of International Medical Research.2020; 48(8): 030006052094791. CrossRef
Extramedullary malignant melanotic schwannoma of the spine: Case report and an up to date systematic review of the literature
Georgios Solomou, Adikarige Haritha Dulanka Silva, Adrianna Wong, Ute Pohl, Nikolaos Tzerakis
Annals of Medicine and Surgery.2020; 59: 217. CrossRef
Melanotic Schwannoma of the Vagina: A Report of a Very Rare Tumor and Review of the Literature
Kofi Effah, Stefan Seidl, Edith Gorges, Patrick Kafui Akakpo
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Melanotic Schwannomas Are Rarely Seen Pigmented Tumors with Unpredictable Prognosis and Challenging Diagnosis
Elif Keskin, Sumeyye Ekmekci, Ozgur Oztekin, Gulden Diniz
Case Reports in Pathology.2017; 2017: 1. CrossRef

Brief Case Report

A Case of Type II Enteropathy-Associated T-Cell Lymphoma with Epstein-Barr Virus Positivity: Min Jeong Song, Chan Sik Park, Hee Sang Hwang, Cheol Won Suh, Dok Hyun Yoon, Jooryung Huh; Korean J Pathol. 2014;48(6):426-429. Published online December 31, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.426

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Yasuhiro Aoki, Tomohisa Sujino, Kaoru Takabayashi, Makoto Mutakuchi, Katsura Emoto, Naoki Hosoe, Haruhiko Ogata, Takanori Kanai
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A viral map of gastrointestinal cancers
Natália R. Costa, Rui M. Gil da Costa, Rui Medeiros
Life Sciences.2018; 199: 188. CrossRef
Type II Enteropathy-Associated T-cell Lymphoma: A Rare Report from Iran
Neda Nozari
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Unusual Cause of Dysphagia
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Multiple lesions of gastrointestinal tract invasion by monomorphic epitheliotropic intestinal T-cell lymphoma, accompanied by duodenal and intestinal enteropathy-like lesions and microscopic lymphocytic proctocolitis: a case series
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Diagnostic Pathology.2016;[Epub] CrossRef

Original Articles

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

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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
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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
Medicine.2022; 101(40): e31062. CrossRef
Endobronchial schwannoma in adult: A case report
Touil Imen, Boudaya Mohamed Sadok, Aloui Raoudha, Souhir Ksissa, Brahem Yosra, Ben Attig Yosr, Ksontini Meriem, Bouchareb Soumaya, Keskes Boudawara Nadia, Boussoffara Leila, Knani Jalel
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Primary intratracheal schwannoma misdiagnosed as severe asthma in an adolescent: A case report
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PD‐1/PD‐L1 negative schwannoma mimicking obstructive bronchial malignancy: A case report
Daibing Zhou, Xiaoyan Xing, Jie Fan, Youzhi Zhang, Jie Liu, Yi Gong
Thoracic Cancer.2020; 11(8): 2335. CrossRef
Case report: A tracheobronchial schwannoma in a child
Li Zhang, Wen Tang, Qing-Shan Hong, Pei-feng Lv, Kui-Ming Jiang, Rui Du
Respiratory Medicine Case Reports.2020; 30: 101047. CrossRef
Recurrent transmural tracheal schwannoma resected by video-assisted thoracoscopic window resection
Huiguo Chen, Kai Zhang, Mingjun Bai, Haifeng Li, Jian Zhang, Lijia Gu, Weibin Wu
Medicine.2019; 98(51): e18180. CrossRef
Primary intratracheal schwannoma resected during bronchoscopy using argon plasma coagulation
Purva V Sharma, Yash B Jobanputra, Tatiana Perdomo Miquel, J Ryan Schroeder, Adam Wellikoff
BMJ Case Reports.2018; : bcr-2018-225140. CrossRef
Dumbbell posterior mediastinal schwannoma invading trachea: Multidisciplinary management – weight off the chest
Abhijeet Singh, VallandramamR Pattabhiraman, Arjun Srinivasan, Sivaramakrishnan Mahadevan
Lung India.2018; 35(3): 269. CrossRef
Primary tracheal schwannoma a review of a rare entity: current understanding of management and followup
Shadi Hamouri, Nathan M. Novotny
Journal of Cardiothoracic Surgery.2017;[Epub] CrossRef
A Case of Primary Tracheal Schwannoma
Sung Min Choi, Ji Hong You, Sang Bae Lee, Seong Han Kim, Yon Soo Kim
Kosin Medical Journal.2017; 32(2): 258. CrossRef
Endobronchial Neurilemmoma Mimicking a Bronchial Polyp
Ryoung Eun Ko, Seung Yong Park, Yeong Hun Choe, So Ri Kim, Heung Bum Lee, Yong Chul Lee, Seoung Ju Park
Soonchunhyang Medical Science.2015; 21(2): 176. CrossRef
Optimal treatment for primary benign intratracheal schwannoma: A case report and review of the literature
XIAHUI GE, FENGFENG HAN, WENBIN GUAN, JINYUAN SUN, XUEJUN GUO
Oncology Letters.2015; 10(4): 2273. CrossRef

Use of Calretinin, CD56, and CD34 for Differential Diagnosis of Schwannoma and Neurofibroma.: Ji Young Park, Hoon Park, Nam Jo Park, June Sik Park, Hyun Jung Sung, Sang Sook Lee; Korean J Pathol. 2011;45(1):30-35.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.1.30

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Abstract PDF

BACKGROUND
It is important to differentiate between schwannomas and neurofibromas for the cases in which the histopathologic features overlap. Depending on the tumor type, surgeons can decide on a treatment method and whether to preserve or sacrifice the nerve; the possibility of malignant transformation in the case of neurofibromas also needs to be considered.
METHODS
We studied 101 cases of schwannoma and 103 cases of neurofibroma. All the hematoxylin and eosin slides for these cases were reviewed, and tissue microarrays were prepared from the representative areas. Immunohistochemical analysis was performed using antibodies for S-100 protein, calretinin, CD56 and CD34.
RESULTS
All the tumors except 3 neurofibromas were positive for the S-100 protein. Calretinin was found in 26.7% of the schwannomas (27/101), but it was not found in any of the neurofibromas. CD56 was positive in 77.2% of the schwannomas (78/101) and in 9.8% of the neurofibromas (10/102). CD34 was positive in 42.5% of the schwannomas (43/101) and in 80.2% of the neurofibromas (81/101). Statistically, calretinin was significantly specific for schwannomas (p<0.001) and CD56 was also sensitive for these tumors (p<0.001). On the other hand, a CD34 expression seemed highly sensitive (p<0.001) for neurofibromas.
CONCLUSIONS
We concluded that combined immunohistochemical analysis for calretinin, CD56, and CD34 may be very useful for differentiating schwannomas from neurofibromas.

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Lung schwannomas, an unusual entity: A series of five cases
NaziaM Walvir, RumanaH Makhdoomi, Meesa Zargar, Aiffa Aiman, Shadab Maqsood
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A Spectrum of Histomorphological and Immunohistochemical Expression Profiles of S-100, CD56 and Calretinin in Benign Peripheral Nerve Sheath Tumours
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An unusual diffuse CD34 staining in an olfactory groove cellular schwannoma: Case report
Marios Theologou, Jorge D. Perez Ruiz, Panagiotis Varoutis, Nicolaos Flaris, Nikolaos `Skoulios
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An unusual diffuse CD34 staining in an olfactory groove cellular schwannoma: Case report
Marios Theologou, Jorge D. Perez Ruiz, Panagiotis Varoutis, Nicolaos Flaris, Nikolaos `Skoulios
Archivos de Neurociencias.2023;[Epub] CrossRef
Intranodal Neurofibroma: A Case Report and Literature Review
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A rare case of pseudoglandular schwannoma
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Gastric Schwannoma as an Important and Infrequent Differential Diagnosis of Gastric Mesenchymal Tumours: A Case Report and Review of Literature
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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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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?
Siti Farhana Abdul Razak, Hardip Singh Gendeh, Anuar Idris
BMJ Case Reports.2023; 16(8): e253868. CrossRef
Intranodal Neurofibroma: A Case Report and Literature Review
Steven H. Adams, Tara L. Huston, Daniel Lozeau
The American Journal of Dermatopathology.2022; 44(4): 306. CrossRef
Cervical Lymph Node Schwannoma—An Unexpected Diagnosis
Catarina Falcão Silvestre, Joana Almeida Tavares, Dolores López-Presa, Vanessa Rebelo dos Santos, José Rocha, Maria João Bugalho
Clinical Pathology.2019; 12: 2632010X1982923. CrossRef
Mesenteric intranodal schwannoma: uncommon case of neurogenic benign tumor
Adrian Medina-Gallardo, Yuhamy Curbelo-Peña, Jose Molinero-Polo, Maria Saladich-Cubero, Xavier De Castro-Gutierrez, Helena Vallverdú-Cartie
Journal of Surgical Case Reports.2017;[Epub] CrossRef
Intranodal Hybrid Benign Nerve Sheath Tumor
Brian D. Hayes, Maureen J. O'Sullivan
Pediatric and Developmental Pathology.2011; 14(4): 313. CrossRef
Intranodal Schwannoma Mimicking a Gastrointestinal Stromal Tumor of the Stomach: A Case Report
Kyung Bum Nam, Sook Namkung, Heung Cheol Kim, Hae Sung Kim, Byoung Yoon Ryu, Young Hee Choi
Journal of the Korean Society of Radiology.2011; 65(4): 395. CrossRef

Original Article

Cytologic Findings of Fine Needle Aspiration Biopsy of 23 Schwannomas.: Sunhee Chang, Mee Joo, Hanseong Kim; Korean J Cytopathol. 2008;19(1):41-46.; DOI: https://doi.org/10.3338/kjc.2008.19.1.41

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Abstract PDF

In an attempt to better define the cytologic characteristics of schwannomas, we have reviewed aspirates and corresponding histologic sections from 23 schwannomas. Of this number, the original cytologic diagnoses were: schwannoma in 14 cases (61%), benign soft tissue tumor in 2 cases (9%), and insufficient specimen in 7 cases (30%). The cytologic findings common to all cases of schwannoma included fragments of tightly cohesive fascicles with variable cellularity and corresponding Antoni type A area. The Antoni type B area, consisting of scattered spindle cells and some histiocytes and lymphocytes against a myxoid background, was seen in 14 cases. Fibrillary stroma was seen in 12 cases. The tumor cells had spindle- or oval-shaped nuclei, with pointed ends and indistinct cell borders. Nuclear palisading was seen in 10 cases, and distinctive Verocay bodies were seen in 5 cases. In ancient schwannomas, there were no Verocay bodies. Most schwannomas have distinct cytomorphologic features that allow correct diagnosis. The major problem with fine needle aspiration cytology of these tumors is the high frequency of poor cellularity, particularly in lesions with cystic degeneration. Of 7 cases with insufficient specimen, 4 showed marked cystic changes and 1 showed marked hyaline changes on histologic sections. In conclusion, we believe that if cytopathologist reminds the situation such as cystic degeneration or hyaline degeneration, the correct diagnosis of the schwannoma will be easily made.

Citations

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Multiple Cervical Schwannomas Mimicking Metastatic Lymph Nodes from Papillary Thyroid Cancer
Ji-Sun Kim, Chang-Young Yoo, Rae-Hyung Kim, Jung-Hae Cho
Journal of Korean Thyroid Association.2014; 7(1): 102. CrossRef

Case Reports

Cellular Schwannoma Arising in a Facial Nerve.: Mee Joo, Hye Sung Kim, Yun Kyung Kang, Hye Kyung Lee, Jae Young Park; Korean J Pathol. 1997;31(7):688-691.

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Abstract PDF: Cellular schwaninoma is a variant of schwannoma, which is characterized by predominance of cellular Antoni A area, presence of mitotic activity, nuclear hyperchromasia, pleomorphism, and absence of Verocay body. These pathologic features often prompted a misdiagnosis of malignancy. However, the clinical outcome has indicated the benignity of the tumor. We have experienced a case of cellular schwannoma arising from right facial nerve with right hemifacial weakness and erosion of mastoid process. Grossly, it was a 3.5 x 3 cm sized and relatively well encapsulated mass with yellowish, friable cut surface. Microscopically, cellular growth with moderate cellular pleomorphism and some mitotic activity (5/40 HPFS, up to 2/HPF) were noted. Immunostaining for S-100 protein showed diffuse strong positive reaction.

Multiple Plexiform Schwannomas Associated with Neurofibromatosis Type 2: A case report.: Ho Sung Park, Myoung Ja Chung, Myoung Jae Kang, Dong Geun Lee, Byung Cook Ahn; Korean J Pathol. 2000;34(5):389-392.

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Abstract PDF: Plexiform schwannoma is a rare benign tumor arising from the peripheral nerve sheath and characterized by a multinodular and plexiform growth pattern. This tumor usually arises sporadically. In rare cases, plexiform schwannomas have been associated with neurofibromatosis type 2. Plexiform schwannoma should be differentiated from plexiform neurofibroma, because the latter is pathognomonic tumor of neurofibromatosis type 1 and has a potential of malignant transformation. We report a case of multiple plexiform schwannomas associated with bilateral acoustic neuromas and meningioma.

Original Articles

A Clinicopathologic Study of 53 Gastrointestinal Mesenchymal Tumors.: Young Kyung Bae, Dong Sug Kim, Mi Jin Gu, Joon Hyuk Choi, Mi Jin Kim, Young Jin Kim, Won Hee Choi, Sun Kyo Song, Koing Bo Kwun; Korean J Pathol. 2000;34(11):909-918.

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Abstract PDF: The gastrointestinal mesenchymal tumors (GIMTs) form a heterogenous group with controversy centering on both the cell of origin and the prediction of clinical behavior. They include a small group of tumors with mature smooth muscle or Schwann cell differentiation and a larger group with inconsistent or no evidence of differentiation. Tumors in the latter are now referred to as gastrointestinal stromal tumors (GISTs). A clinicopathologic and immunohistochemical study was performed on 53 cases of GIMTs to identify cellular differentiation and predictors of clinical behavior. Fifty three cases of GIMTs could be histologically and immunophenotypically divided into three categories, 6 leiomyomas (11.3%), 4 schwannomas (7.6%), and 43 GISTs (81.1%). All leiomyomas (SMA desmin ) and schwannomas (S-100 ) were located in stomach and negative for CD34 and CD117. Thirty nine cases of GISTs were either CD34 (n=26) or CD117 (n=23) immunoreactive. Of these 39 GISTs, 26 were negative for myoid (SMA, desmin) and neural marker (S-100), 10 SMA desmin-S-100-, two SMA-desmin-S-100 , and one SMA desmin-S-100 . Two out of 4 GISTs, which were negative for CD34 and CD117, were immunohistochemically considered leiomyosarcoma (SMA desmin ). GISTs of small intestine had a tendency to be malignant than those of stomach. Pathologic grade of GISTs was not correlated with cellular differentiation. In 29 GISTs with clinical follow-up information, tumor size, mitotic counts, Ki-67 labelling index, tumor necrosis, mucosal invasion, and CD34 expression were significantly correlated with metastasis/recurrence.

Cytologic Findings of Fine Needle Aspiration Biopsy of Ancient Schwannoma.: Hee Jae Joo, Kwang Gil Lee; Korean J Cytopathol. 1990;1(2):158-163.

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Abstract PDF: Ancient (degenerated) schwannomas are benign tumors that display pronounced degenerative changes including cyst formation, calcification, hemorrhage, and hyalinization. The tumors are usually infiltrated by large numbers of inflammatory cells such as neutrophils, lymphocytes, siderophages, and histiocytes. They are located in deep locations such as the retroperitoneum and must be differentiated from malignant soft tissue tumors because spindle cells with nuclear atypia may be present in the fine needle aspiration biopsy. The cytologic findings of two cases of ancient schwannoma occurring in posterior mediastinum and retroperitoneum, respectively, are described. Computerized tomographic findings of both cases showed changes of cystic degeneration or necrosis. A case occurred in retroperitoneum revealed features of destruction of vertebral body to suggest a malignant soft tussue tumor radiologically. The cytologic findings of aspiration biopsy of both tumors revealed that the tumor cells were spindle in shape with elongated nuclei. Some of tumor cells were arranged in a palisading fashion. Cell structures that resemble the Verocay bodies were observed. Some of the tumor cells showed pleomorphic bizarre nuclei, but no mitotic activity or chromatin clumping was seen. Inflammatory cells, siderophages and histiocytes were scattered in fibrillar material. These cytologic findings are important in the diagnosis of ancient schwannoma and in the differentiation of this tumor from the malignant spindle cell tumor.

Crush Cytology Features and Differential Diagnosis of Meningiomas and Schwannomas in Central Nervous System.: Young Ju Kim, Mi Yeong Jeon, Young Il Yang, Chan Hwan Kim, Hae Kyoung Yoon, Shin Kwang Khang; Korean J Cytopathol. 1996;7(2):169-176.

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Abstract PDF: This study was performed in order to evaluate the usefulness of the crush cytologic features and differential diagnosis between meningiomas and schwannomas in the central nervous system. Deeply seated and unusually located meningiomas and schwannomas with equivocal or erroneous frozen section diagnosis can be correctly diagnosed cytologically in crush preparations. Twenty-four meningiomas and nine schwannomas were studied by frozen section and crush preparation technique. These tumors displayed distinctive cytologic features. In meningiomas, the tumor tissue fragments were easy to crush, and the tumor cells were arranged in small clusters, flat sheets, papilla-like, whorling pattern or singly. Individual tumor cells displayed round or oval nuclei with finely granular chromatin pattern and inconspicuous small nucleoli. Occasionally psammoma bodies, nuclear pseudoinclusion or nuclear grooves were found. In schwannomas, tissue fragments were hard in consistency and difficult to crush. The crushed tissue presented as thick, irregular fragments with sharp borders. The cells showed ill-defined cytoplasm and round, oval, cigar-shaped or curved nuclei. It is important to emphasize that the smear pattern under low-power view and cytologic features are helpful in discriminating between these two tumors.

Fine Needle Aspiration Cytologic Features of Schwannomas .: Sun Young Kim, Hae Joo Nam, Jung Hee Kim, Young Rok Cho, Yu Na Kang, Sang Sook Lee; Korean J Cytopathol. 1999;10(1):55-60.

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Abstract PDF: Schwannoma is a benign encapsulated nerve sheath tumor and is histologically characterized by a mixture of Antoni type A and B tissue. A preoperative diagnosis of schwannoma by fine needle aspiration cytology or by any other means is important to preserve clinically important nerves. Therefore, it is necessary to make a specific cytological diagnosis of nerve sheath tumor. However, there are a few reports regarding cytological features of schwannoma in Korea. We experienced seven cases of solitary schwannoma and here we report their characteristic cytological features with a review of literatures. The characteristic features of schwannoma on cytology were the presence of both Antoni type A and B tissue. The cytologic findings common to all cases of schwannoma generally corresponded to the histologic findings of Antoni type A tissue, consisting of fragments of tightly cohesive fascicles with variable cellularity. Dense fibrillary substances were found, along with palisading nuclei and Verocay bodies. Individual tumor cells consisted of cohesive cells having spindle or oval nuclei, with pointed ends and indistinct cell borders. Variation in nuclear size and shape was also present. The Antoni type B consisted of scattered wavy or short spindle cells and some histiocytes and lymphocytes in the abundant myxoid background with formation of microcysts. Immunohistochemistry for S-100 protein revealed a uniformly strong positive reaction and was helpful to make more accurate diagnosis of schwannoma.

Case Reports

Solitary Schwannoma of the Breast: A Case Report.: Jung Uee Lee, Hae Joung Sul, Byoung Jeon Park; Korean J Pathol. 2005;39(1):66-68.

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Abstract PDF: Schwannomas arise from the neural crest-derived Schwann cells. Their most common locations are the extremities, neck, mediastinum, retroperitoneum, and cerebellopontine angle. They have rarely been reported to occur in the breast. We herein report on a case of schwannoma of the breast in a 30-year-old woman. The ultrasonographic examination showed a well defined ovoid hypoechoic mass in the upper outer quadrant of her left breast. A presumptive diagnosis of fibroadenoma was made, and the mass was then removed. The histopathologic and immunohistochemical features confirmed the diagnosis of schwannoma of the breast.

Pigmented(melanotic) Schwannoma of the Cervical Spinal Canal: A case report.: Hyunee Yim, Jai Hyang Go, Chang Soo Ahn, Sun Woon Hong, Woo Hee Jung; Korean J Pathol. 1995;29(2):256-262.

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Abstract PDF: Pigmented(melanotic) schwannoma is a very rare variant of schwannoma that characteristically has massive cytoplasmic melanin. Since it was described in 1946 by Bjorneboe, about 44 cases have been reported in the English literature. It has a relatively benign clinical course, but the cases arising in the cranial nerve and sympathetic chain show aggressive behavior with malignant potential. We herein report a typical case of pigmented schwannoma with light microscopic findings. The results of immunohistochemical and electronmicroscopic study are also presented. The patient was a 30 year-old Korean male who had a mass in his posterior neck for 10 years that recently.began to induce neurologic manifestations. The tumor, which was mainly in the extramedullary intradural space of the cervical canal extending to the extradural space and soft tissues of the neck, was relatively well defined and composed of black solid tissue. Microscopic, densely pigmented spindle cells forming fascicles, nuclear palisading, whorling and polygonal cells with vacuolated or clear cytoplasm were characteristic. Immunohistochemically, the tumor cells were positive for vimentin, S-100 protein, and HMB-45. Electron microscopic study revealed that the tumor cells have interdigitating cytoplasmic processes containing varying stages of melanosomes with a very focal basal lamina and Luse body like collagen bundles.

Schwannoma of the Adrenal Gland: A case report.: Yong Chan Chun, Sun Hee Sung, Chan Il Park; Korean J Pathol. 1993;27(4):424-426.

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Abstract PDF: Retroperitoneum is often the site of occurrence of schwannoma, but reports on schwanoma of the adrenal gland is exceptional and only 4 cases have been documented in the literature. This report is to add one such case occurred in a 53 year-old male who had anorexia, nausea and indigestion for one month. Whole body bone scan and abdominal CT scan revealed a 10 cm sized solid mass at upper pole of the left kidney. Under the impression of renal cell carcinoma, an operation was performed. The tumor was well encapsulated and appeared not to involve the kidney. The cut surfaces were light yellow and seemed to be composed of several hard lobules with areas of mucoid, cystic and calcific changes. No adrenal gland was identified grossly. But microscopically, the tumor was found to be partly surrounded by a small portion of adrenal cortical tissue. Histologically the tumor was a typical schwannoma with Verocay bodies, although modified in some extents by mucoid degeneration, cystic change, hyaline change and focal calcification. It is worthwhile to remember that the retroperitoneal schwannoma commonly had a huge size, sometimes involving the adjacent structures.

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