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Cytohistologic correlations in schwannomas (neurilemmomas), including “ancient,” cellular, and epithelioid variants
Author(s) -
Klijanienko Jerzy,
Caillaud JeanMichel,
Lagacé Réal
Publication year - 2006
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.20320
Subject(s) - medicine , neurilemoma , schwannoma , pathology , atypia , epithelioid cell , nodular fasciitis , neurofibroma , epithelioid hemangioendothelioma , nerve sheath neoplasm , cytology , pleomorphic adenoma , soft tissue , malignant peripheral nerve sheath tumor , neurofibromatosis , immunohistochemistry , salivary gland
Schwannoma accounts for one of the most common benign mesenchymal neoplasms of soft tissues. Although it is well defined in the cytology literature, particular histologic subtypes such as “ancient,” cellular and epitheliod variants could be a source of diagnostic difficulties. We have reviewed cytology aspirates and corresponding histologic sections from 34 schwannomas diagnosed at Institut Curie. Histologically, 24 cases were classic, 5 were “ancient,” 4 were cellular, and 1 was epithelioid schwannomas. No example of melanotic schwannoma was recorded. Original cytologic diagnosis was schwannoma in 13 (38.2%) cases, benign soft tissue tumor in 11 (32.4%), pleomorphic adenoma in 2 (6%) cases, angioma in 1 (2.9%) case, nodular fasciitis in 1 (2.9%) case, suspicious in 3 (8.8%) cases, and not satisfactory in 3 (8.8%) cases. There were no major differences between classical, “ancient,” cellular, and epithelioid variants on cytology smears. Myxoid stroma, mast cells, and intranuclear inclusions were limited to classical subtype. Similarly, cyto‐nuclear atypia was more frequent in classical subtype than in other subtypes. Schwannoma should be differentiated from well‐differentiated malignant peripheral nerve sheath tumor, neurofibroma, and pleomorphic adenoma, in the last instance particularly for head and neck lesions. Diagn. Cytopathol. 2006;34:517–522. © 2006 Wiley‐Liss, Inc.