Reticular and microcystic schwannoma of the parotid gland.
Reticular and microcystic schwannoma of the parotid gland.
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DOI：
10.1097/pat.0b013e32835be3ec
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发表时间：
2013
期刊：
影响因子：
4.5
通讯作者：
J. Pang;A. Mahar;K. Shannon;J. Kench;Charles Chan;Ruta Gupta
中科院分区：
文献类型：
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作者：
J. Pang;A. Mahar;K. Shannon;J. Kench;Charles Chan;Ruta Gupta
微囊/网状型神经鞘瘤是一种罕见的、独特的神经鞘瘤，多发于内脏部位。文献报道的病例少于20例，累及头颈部的病例以前未见报道。微囊/网状神经鞘瘤表现出与普通神经鞘瘤相似的生物学行为，应与腮腺肿瘤区分开来，腮腺肿瘤如果不完全切除可能会侵袭性复发。目的报告1例腮腺微囊/网状变异型神经鞘瘤，复习文献并探讨其鉴别诊断。病例报告一名59岁女性，以耳前肿胀为主诉。FNA显示黏液样间质间质为淡色梭形细胞。术中发现肿瘤与面神经密切相关，切除保留神经。组织病理学检查显示一个边界清晰，未被包裹的病变，由细长的纺锤形细胞组成，黏液样间质中有胞浆内空泡。可见手风琴样线状细胞排列、网状结构及微囊。没有典型的神经鞘瘤、异型性、有丝分裂或坏死的特征。观察到S100的弥漫性免疫反应。免疫组织化学有助于排除鉴别诊断，如肌上皮瘤、多形性腺瘤、周围神经瘤、脊膜副瘤和上皮样血管内皮瘤。结论我们报告了一例头颈部的微囊/网状神经鞘瘤，据我们所知，这是该部位首次报告这种实体。
Background Microcystic/reticular variant of schwannoma is a rare, distinctive variant of schwannoma with predilection for visceral sites. Fewer than 20 cases are described in the literature and involvement of head and neck has not previously been reported. Microcystic/reticular variant of schwannoma demonstrates similar biological behaviour to usual schwannoma and should be distinguished from parotid gland tumours that may recur aggressively if incompletely excised. Aim To present a case of microcystic/reticular variant of schwannoma in the parotid gland with literature review and discuss pertinent differential diagnoses. Case report A 59-year-old female presented with a preauricular swelling. FNA showed cytologically bland spindle shaped cells amidst myxoid stroma. At operation, the tumour was found to be closely associated with facial nerve and was resected with nerve preservation. Histopathological examination showed a well circumscribed, unencapsulated lesion composed of slender, spindle shaped cells with intracytoplasmic vacuoles amidst myxoid stroma. Areas with accordion-like linear cellular arrays, reticular pattern and microcysts were present. Features of typical schwannoma, atypia, mitoses, or necrosis were absent. Diffuse immunor-eactivity with S100 was noted. Immunohistochemistry helped exclude differential diagnoses like myoepithelioma, pleomorphic adenoma, perineuroma, parachordoma, and epithelioid haemangio-endothelioma. Conclusion We present a case of microcystic/reticular variant of schwannoma in the head and neck, to our knowledge the first report of this entity in this location.