Cystic schwannoma in neck: Fallacious diagnosis arrived on fine needle aspiration cytology

Satarkar, Rahul N; Kolte, Sachin; Vujhini, Sudhir Kumar

doi:10.1002/dc.21565

Cited by 9 publications

(8 citation statements)

References 45 publications

(52 reference statements)

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“…MRI, CT, USG and FNAC have been suggested in the literature for diagnosing the lesion. 5 USG can help to differentiate the lesion from thyroid in the hands of experienced sonologist as seen in our case. MRI is reliable imaging to capture the tumor, its capsule and the nerve from which the tumor arises.…”

Section: Case Reportmentioning

confidence: 59%

“…2 On histopathological examination, it is composed of an intimate mixture of spindle cells forming highly cellular Antoni A areas and less cellular myxoid Antoni B areas. 5 Immunohistochemistry is further more confirmatory which are positive for S100 and Vimentin and negative for Desmin and SMA. 1…”

Section: Case Reportmentioning

confidence: 96%

“…3 Although FNAC has been suggested for cytological diagnosis, a review literature suggests that it is rarely conclusive. 5,[7][8][9] Trucut biopsy might play a role in tissue diagnosis ahead of planning the surgery and thereby to consent the patient regarding the morbidity and prognosis.…”

Section: Case Reportmentioning

confidence: 99%

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Schwannoma neck: a diagnostic dilemma

Manohar

Abdurahiman

2019

Int J Otorhinolaryngol Head Neck Surg

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<p>Schwannomas are less common benign slow growing tumors originating from Schwann cells. In the head and neck region, schwannomas arise most commonly from the vagus nerve or the sympathetic chain. We present this case as the location of schwannoma is extremely rare and due to the diagnostic difficulties it posed. A 48 year old male presented with right neck swelling and breathing difficulty to our OPD. Patient underwent ultrasonogram of neck, MRI neck and Fine needle aspiration cytology (FNAC) of the lesion. Each of the investigations suggested different pathology which made the diagnosis challenging. During surgery, the lesion was found to arise from right recurrent laryngeal nerve. After excision of the lesion, the patient developed hoarse voice and the pathological examination revealed schwannoma. Schwannomas that originate from Schwann cells can affect any part of the body. MRI, CT, USG and FNAC have been suggested in the literature for diagnosing the lesion. Trucut biopsy should be considered in situations where FNAC becomes inconclusive. Surgical excision is the treatment of choice. Histologically, five variants of schwannomas have been described in the literature namely common, plexiform, cellular, epithelioid and ancient schwannoma. To conclude, schwannoma arising from RLN which masqueraded as a thyroid swelling is a rare entity. The diagnostic modalities suggested in the literature were unable to pin point the diagnosis. Once, FNAC shows an inadequate specimen, a trucut biopsy should be considered as the next investigation modality.</p>

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Section: Case Reportmentioning

confidence: 59%

Section: Case Reportmentioning

confidence: 96%

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Schwannoma neck: a diagnostic dilemma

Manohar

Abdurahiman

2019

Int J Otorhinolaryngol Head Neck Surg

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“…[ 2 ] Intraoral schwannomas most commonly affect the tongue, followed by palate, buccal mucosa, lip, and gingiva. [ 3 ] Schwannomas affecting the tongue arise from the hypoglossal nerve and vagus nerve. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

“…FNAC has been found to be of limited value in achieving a preoperative diagnosis in such cystic lesions. [ 2 3 ]…”

Section: Discussionmentioning

confidence: 99%

Cystic schwannoma of tongue masquerading as mucocele: A cytological pitfall

Nair

Dey

Deshpande

et al. 2018

J Cytol

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Benign peripheral nerve tumors: Analysis of 89 FNA cases emphasizing diagnostic accuracy and their morphologic spectrum

Wakely

2023

Cancer Cytopathology

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Introduction Benign peripheral nerve tumors (BPNTs) are a heterogenous group of soft tissue tumors that include a variety of nerve sheath tumors, granular cell tumor (GCT), and ganglioneuroma. Only a few large studies exist on cytopathology and diagnostic accuracy using fine‐needle aspiration (FNA) biopsy for this set of neoplasms. Materials and methods Both surgical and cytopathology files were searched for cases of BPNT. FNA biopsy was performed using standard techniques. Results Eighty‐nine cases from 88 patients (male:female = 1:1; age range: 16–85 years, mean age, 51 years) met inclusion criteria. FNA sites included extremities (58, 65%), head/neck (14, 16%), deep (9, 10%), and trunk (8, 10%). Aspirates were from primary neoplasms in all but one instance. There were 65 schwannomas, seven neurofibromas, seven perineuriomas, seven GCTs, and three ganglioneuromas/neuromas. Aspirates of schwannoma, GCT, neurofibroma (NF), and perineurioma (PN) were correctly diagnosed in 86%, 100%, 29%, and 0% of cases, respectively. Five tumors (6%) were interpreted as either a specific sarcoma or suspicious for sarcoma. Remaining aspirates were classified as spindle cell neoplasm, salivary gland neoplasm, and nondiagnostic. Cytologic features for schwannoma, NF, PN, and ganglioneuroma showed spindle cell–dominant smears arranged mainly in syncytial clusters. GCT aspirates contained a population of epithelioid cells harboring coarsely granular cytoplasm and bare nuclei. Immunohistochemical (IHC) staining in 55 (62%) cases showed S‐100 expression in 95%. Conclusion FNA biopsy coupled with IHC is reliable in correctly classifying schwannoma and GCT, but less so for NF. Perineurioma can be mistaken for sarcoma.

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Cystic schwannoma in neck: Fallacious diagnosis arrived on fine needle aspiration cytology

Cited by 9 publications

References 45 publications

Schwannoma neck: a diagnostic dilemma

Schwannoma neck: a diagnostic dilemma

Cystic schwannoma of tongue masquerading as mucocele: A cytological pitfall

Benign peripheral nerve tumors: Analysis of 89 FNA cases emphasizing diagnostic accuracy and their morphologic spectrum

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