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RESIDENT
CASE
STUDIES
October 16,
2003: Case 4 Table
of Contents | List
of Diagnoses | Case 1 | Case
2 | Case
4
43 year old female with history of left
branchial cleft cyst several years ago. Patient now presents with left
neck mass.
Discussion by Daniel Klink, MD
Schwannoma is a benign tumor with neural
derivation (specifically, Schwann cells).
Distribution: Typically 3rd to sixth
decade
Gross Appearance: Generally
encapsulated with a pink to white fusiform cut surface and occasional
cystic areas.
Microscopic
Appearance:
- Nuclear palisading
- Antoni A (cellular) areas
- Antoni B (hypocellular) areas
- Low mitotic rate
- Thick hyalinized vessels
Diagnostic Criteria
- Nuclear palisading
- Antoni A areas
- Antoin B areas
- Thick hyalinzed vessels
- Very little atypia (Ancient change
Schwannoma has some atypia)
Immunostains:
Differential Diagnosis:
- Neurofibroma
- Malignant Peripheral Nerve Sheath Tumor
- Leiomyoma
References:
- Haber M. et al, Differential diagnosis in surgical pathology, Copyright 2002.
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