Fine Needle Aspiration Cytology of Schwannoma of The Parotid Gland

PhiliPPine Journal of otolaryngology-head and neck Surgery 51 This 52-year-old male underwent fine needle aspiration biopsy of a 2-cm diameter parotid mass that was firm, well-delineated and vaguely moveable, The mass was not painful and was noted for about a year. The aspiration biopsy smear was quite cellular and showed fragments of spindle-shaped cells with cigar shaped nuclei and scanty to indistinct cytoplasms. Nuclei were vesicular and Verocay-like bodies were identified by cell patterns. The biopsy was read as a benign spindle cell tumor, probably a schwannoma. Excision of the mass revealed a typical schwannoma by histopathology. Schwannomas of the parotid gland are rare1 and arise from the intraparotid branches of the facial nerve. Clues to the cytologic diagnosis include the cellular but benign spindly cell population clustered into Verocay body patterns and evidence of cyst degeneration in the form of histiocytes and even lymphocytes.2 Main differential diagnoses include the predominant spindle cell myoepitheliomas3 and some of the low grade sarcomas that may arise from the parotid gland. The even rarer schwannomalike mixed tumor of the parotid4 gland must be also considered. Jose Ma. C. Avila, M.D. Department of Pathology College of Medicine University of the Philippines Manila