Cervical schwannoma with intranuclear vacuoles by fine‐needle sampling without aspiration

Vendraminelli, Roberto; Fiorentino, Renzo; Collazzo, R; Filippo, Luigi di; Delendi, N

doi:10.1002/dc.2840040412

Cited by 5 publications

(5 citation statements)

References 3 publications

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“…Numerous descriptions of the cytologic features of schwannoma exist in the literature [13][14][15][16][17][18][19][20][21][22][23][24][25] . The two largest series of schwannoma aspirations reported to date are a group of 28 cases reported by Dahl et al 26 and 19 cases reported by Resnick et al 27 .…”

Section: Discussionmentioning

confidence: 99%

Difficulties in the fine needle aspiration (FNA) diagnosis of schwannoma

Sack

Baloch

et al. 1999

Cytopathology

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The results of nine FNAs of eight histologically proven schwannomas are presented. In only one of the aspirates was a diagnosis of schwannoma made; three additional cases were diagnosed as 'spindle cell neoplasm'. Two of the cases were considered to be non-diagnostic due to hypocellularity, while two cases containing cellular material raised the differential diagnosis of granulation tissue and granulomatous inflammation due to the presence of epithelioid cells and an inflammatory infiltrate, and are illustrated here. The remaining FNA was felt suggestive of branchial cleft cyst due to the presence of only cystic fluid in a neck mass. We observe that: (i) the acquisition of an adequate, representative specimen via FNA is often difficult in schwannoma, and (ii) diagnostic difficulties may be encountered in cases in which cellular material is obtained.

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Section: Discussionmentioning

confidence: 99%

Difficulties in the fine needle aspiration (FNA) diagnosis of schwannoma

Sack

Baloch

et al. 1999

Cytopathology

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“…4 The results of FNA from only 17 other schwannomas appear in the recent literature. [5][6][7][8][9][10][11][12][13][14][15][16][17] Schwannomas are reported to yield cellular aspirates comprising spindle cells arranged singly and in variably sized tissue fragments with a fibrillar ground substance. Some fragments show the spindle cells to be arranged haphazardly, while others display a parallel arrangement, sometimes with nuclear palisading and Verocay body formation.…”

Section: Discussionmentioning

confidence: 99%

“…Ancient schwannomas are reported to show bizarre nuclei without mitotic activity. 4,[8][9][10][11][12][13][15][16][17][18][19] Cell block material and demonstration of S-100 immunoreactivity are reported to be helpful in the diagnosis of schwannoma by aspiration cytology. 9,14 Willems has commented that the aspirates of neurofibromas generally are less cellular than those of schwannomas.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous needle biopsy diagnosis of benign neurogenic neoplasms

et al. 1997

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Preoperative diagnosis of benign neurogenic neoplasms (BNNs) provides useful information in guiding management. To assess the effectiveness of fine‐needle aspiration (FNA) and needle core biopsy (NCB) in diagnosing schwannomas and neurofibromas, 40 percutaneous biopsies interpreted as BNNs or obtained from lesions subsequently shown by excision to be BNNs were reviewed. The 13 aspirates diagnostic of BNN revealed spindle cells arranged haphazardly in irregular tissue fragments and in parallel as elongated ropy fascicles, with a myxoid to fibrillary background. The nuclei were buckled, often with intranuclear cytoplasmic inclusions. Four lesions showed nuclear pleomorphism without mitoses. Of 19 schwannomas evaluated by FNA, four (21%) were diagnosed as schwannomas and seven (37%) as BNNs. Ten neurofibromas were aspirated, revealing two (20%) BNNs. Of seven nondiagnostic FNAs accompanied by NCB, three (43%) indicated a BNN. The sensitivities of FNA, NCB, and both modalities in diagnosing BNNs were 43, 60, and 71%, respectively. For the 16 FNAs showing features of BNNs, subsequent excisions revealed 11 schwannomas, two neurofibromas, one neurogenic sarcoma, one fibromyxoid neoplasm of uncertain malignant potential, and one unclassified low‐grade myxoid sarcoma. FNA can be effective in diagnosing BNNs. If collagenous or myxoid lesions yield paucicellular nondiagnostic aspirates. NCB is helpful. Low‐grade sarcoma and neurofibromatous areas of neurogenic sarcoma may be misinterpreted as BNNs by percutaneous biopsy. BNNs may show nuclear pleomorphism without mitotic activity, and should not be mistaken for sarcoma. Diagn. Cytopathol. 16:17–25, 1997. © 1997 Wiley‐Liss, Inc.

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“…Some studies allude to the high frequency of nuclear pseudoinclusions (illustrated in Figures 5B and 8C) also being present in these ancient schwannoma cases 15,17,27 . Unfortunately, this atypia has misled some authors to issue false‐positive diagnoses of sarcoma or another neoplasm 11,14,36,37 . Dodd et al.…”

Section: Discussionmentioning

confidence: 99%

“…This heterogeneous category is dominated by schwannoma which is by far the most common peripheral nerve sheath tumor (PNST), 1 but neurofibroma 2 hybrid PNST, perineurioma, neuroma, dermal nerve sheath myxoma, ganglioneuroma, and granular cell tumor are among the other benign nerve sheath tumors listed by the WHO in this classification. 3,4 Although numerous case reports and small series of fine-needle aspiration (FNA) biopsy cytopathology of benign peripheral nerve tumors (BPNTs) exist, [5][6][7][8][9][10][11][12] only a handful of large series (≥20 cases) are published. [13][14][15][16][17][18][19] We undertook a review of our FNA biopsy experience to assess diagnostic accuracy, role of ancillary studies, and diagnostic traps associated with this category of neoplasms.…”

Section: Introductionmentioning

confidence: 99%

Benign peripheral nerve tumors: Analysis of 89 FNA cases emphasizing diagnostic accuracy and their morphologic spectrum

Wakely

2023

Cancer Cytopathology

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Introduction Benign peripheral nerve tumors (BPNTs) are a heterogenous group of soft tissue tumors that include a variety of nerve sheath tumors, granular cell tumor (GCT), and ganglioneuroma. Only a few large studies exist on cytopathology and diagnostic accuracy using fine‐needle aspiration (FNA) biopsy for this set of neoplasms. Materials and methods Both surgical and cytopathology files were searched for cases of BPNT. FNA biopsy was performed using standard techniques. Results Eighty‐nine cases from 88 patients (male:female = 1:1; age range: 16–85 years, mean age, 51 years) met inclusion criteria. FNA sites included extremities (58, 65%), head/neck (14, 16%), deep (9, 10%), and trunk (8, 10%). Aspirates were from primary neoplasms in all but one instance. There were 65 schwannomas, seven neurofibromas, seven perineuriomas, seven GCTs, and three ganglioneuromas/neuromas. Aspirates of schwannoma, GCT, neurofibroma (NF), and perineurioma (PN) were correctly diagnosed in 86%, 100%, 29%, and 0% of cases, respectively. Five tumors (6%) were interpreted as either a specific sarcoma or suspicious for sarcoma. Remaining aspirates were classified as spindle cell neoplasm, salivary gland neoplasm, and nondiagnostic. Cytologic features for schwannoma, NF, PN, and ganglioneuroma showed spindle cell–dominant smears arranged mainly in syncytial clusters. GCT aspirates contained a population of epithelioid cells harboring coarsely granular cytoplasm and bare nuclei. Immunohistochemical (IHC) staining in 55 (62%) cases showed S‐100 expression in 95%. Conclusion FNA biopsy coupled with IHC is reliable in correctly classifying schwannoma and GCT, but less so for NF. Perineurioma can be mistaken for sarcoma.

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Cervical schwannoma with intranuclear vacuoles by fine‐needle sampling without aspiration

Cited by 5 publications

References 3 publications

Difficulties in the fine needle aspiration (FNA) diagnosis of schwannoma

Difficulties in the fine needle aspiration (FNA) diagnosis of schwannoma

Percutaneous needle biopsy diagnosis of benign neurogenic neoplasms

Benign peripheral nerve tumors: Analysis of 89 FNA cases emphasizing diagnostic accuracy and their morphologic spectrum

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