Schwannoma (Neurilemoma)

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原文題目(出處): Schwannoma of the submandibular gland: a case report (journel of medical case report)

原文作者姓名: Gaffar Aslan1*, Fikret Cinar1 and Fatmagul Kusku Cabuk2

通訊作者學校: Istanbul Bilim University 報告者姓名(組別): 黎育廷 D組

報告日期: 103.11.10

內文:

Schwannoma (Neurilemoma)

 First described in 1908 by Verocay

 Who: Women

 When: Commonly occurs between 30 and 50 years old, can be seen in any age

 What: A benign, solitary, well-differentiated and slowly progressive encapsulated tumor originating from the sheath of myelinated nerve fibers (Schwann cell)

 Where: 45 % of extracranical schwannoma present in head and neck area: Most commonly affected regions are the temporal bone, lateral neck, and paranasal sinuses

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 Where: most common origin acoustic nerve

 How: neurologic symptom and pain are rare, slow growing, malignant transformation are rare

 Diagnostic investigations: CT, MRI ultrasound scan, fine needle aspiration

 Diagnosis is confirmed by histopathology showing the presence of Antoni A(cellular fascicular) and Antoni B (myxoid; vacuolated) cells, nuclear palisading, whirling of cells and Verocay bodies

 Treatment : resistance to radiotherapy, surgical excision

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is necessary. More than half of the case exhibited postoperative neural deficits.

Our case

 Who: Caucasian man

 When: 19 year old

 Where: right side of his neck

 How: painless mass for four months

 Neck examination: a smooth-surfaced, mobile, firm, and painless mass, 6cm in its greatest diameter, on the right side of the submandibular region.

 Neck examination: No regional lymphadenitis was detected.

 Cranial nerve examinations: normal.

 Ultrasound examination: a well-circumscribed and heterogeneous mass

 Diagnostic investigation: Fine-needle aspiration suggest submandibular gland Schwannoma

 Treatment: surgical excision, lesion was completely excised with submandibular gland

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 Diagnosis by: microscopic and immunohistochemical studies

(hematoxylin & eosin X100).

Areas of organized spindle-shaped cells in a palisading arrangement around acellular, eosinophilic areas, forming

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Verocay bodies giving an Antoni type A pattern

staining for S-100 protein (X200).

 S-100:S100 is normally present in cells derived from the neural crest (Schwann cells,

and melanocytes), chondrocytes, adipocytes,myoepithelial cells, macrophages, Langerhans cells, dendritic cells, and keratinocytes

 One-year follow-up: no evidence of recurrence

題號 題目

1 Which of the following is not the character of Schwannoma?

(A) slow-growing, encapsulated (B) most common in tongue (C) usually asymptomatic (D) most common in adult 答案

(B)

出處:oral and maxillofacial pathology p. 526.527

題號 題目

2 Among the histologic features, which is wrong

(A) There are two microscopic patterns, including Antoni A and Antoni B.

(B) Antoni A tissue are characterized by streaming fascicles of spindle-shaped Schwann cells.

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(C) Verocay bodies are cells forming a palisaded arrangement around central acellular, eosinophilic area

(D) Antoni B tissue are characterized by more cellular and more organized spindle cells

答案 (D)

出處:出處:oral and maxillofacial pathology p.527

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