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
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
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
Diagnosis by: microscopic and immunohistochemical studies
(hematoxylin & eosin X100).
Areas of organized spindle-shaped cells in a palisading arrangement around acellular, eosinophilic areas, forming
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.
(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