Schwanoma intranodal de localización suprarrenal

Cervical Lymph Node Schwannoma—An Unexpected Diagnosis

“…Intranodal schwannomas are rare and only a few reports have been described in the English literature (<15 cases). In most of these reports, schwannomas were located in retroperitoneal or pericolic lymph nodes 3,5,7–9 , thoracic region, 10,11 and even adjacent to the adrenal gland, 6,12 with only one case report in the cervical region—Jennifer et al 4 Therefore, our case is the second cervical intranodal schwannoma described in literature and, to the best of our knowledge, the first to be reported in our country.…”

“…Besides morphology, Schwannomas can be distinguished from leiomyomas and palisaded myofibroblastoma by demonstration of diffuse immunoreactivity for S100 protein, together with the absence of reactivity for muscle markers (desmin and smooth muscle actin). 2,6 Our case was strongly positive for S100 and negative for smooth muscle actin, thereby ruling out palisaded myofibroblastoma or leiomyoma. In the case of metastatic spindle-cell sarcomas, spindle-cell carcinomas or melanoma, cytological malignant features, and mitotically active spindle cells help distinguishing them from schwannoma.…”

“…Antoni B areas are less cellular with spindle cells dispersed in a loose myxoid stroma. 2,4–6 Mitosis are rare or absent. Ancilary studies can be helpful confirming this diagnosis, with tumor cells being positive for S100 protein 2,4–7 (family of low-molecular weight proteins present in cells derived from the neural crest) and vimentin (protein found in the cytoskeleton of mesenchymal cells), and showing no evidence of smooth muscle or epithelial differentiation.…”

“…The differential diagnosis for schwannomas arising in a lymph node include, for benign lesions: neurofibroma (nonencapsulated lesions-unlike schwannoma), leiomyoma, palisaded myofibroblastoma and inflammatory pseudotumor of lymph node. 1–12 As for malignant lesions, it must be considered as a malignant peripheral nerve sheath tumor or metastatic lesions such as spindle cell carcinoma, melanoma, or spindle-cell sarcoma. 1–12…”

Intranodal Neurofibroma: A Case Report and Literature Review

“…4 For comparison to other nerve sheath tumors, there are 16 reported cases of schwannoma involving the lymph nodes. [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] Lymph node involvement is considered very uncommon in MPNST unless widely metastatic disease is present. 11,12 Benign granular cell tumor occurring in lymph nodes is described as rare by Enzingar and Weiss.…”