Cytologic Findings of Fine Needle Aspiration Biopsy of 23 Schwannomas

슈반세포종 23예의 세침흡인 세포검사에 대한 세포소견

  • Chang, Sun-Hee (Department of Pathology, InJe University Ilsan Paik Hospital) ;
  • Joo, Mee (Department of Pathology, InJe University Ilsan Paik Hospital) ;
  • Kim, Han-Seong (Department of Pathology, InJe University Ilsan Paik Hospital)
  • 장선희 (인제대학교 일산백병원 병리과) ;
  • 주미 (인제대학교 일산백병원 병리과) ;
  • 김한성 (인제대학교 일산백병원 병리과)
  • Published : 2008.03.31

Abstract

In an attempt to better define the cytologic characteristics of schwannomas, we have reviewed aspirates and corresponding histologic sections from 23 schwannomas. Of this number, the original cytologic diagnoses were: schwannoma in 14 cases (61%), benign soft tissue tumor in 2 cases (9%), and insufficient specimen in 7 cases (30%). The cytologic findings common to all cases of schwannoma included fragments of tightly cohesive fascicles with variable cellularity and corresponding Antoni type A area. The Antoni type B area, consisting of scattered spindle cells and some histiocytes and lymphocytes against a myxoid background, was seen in 14 cases. Fibrillary stroma was seen in 12 cases. The tumor cells had spindle- or ovalshaped nuclei, with pointed ends and indistinct cell borders. Nuclear palisading was seen in 10 cases, and distinctive Verocay bodies were seen in 5 cases. In ancient schwannomas, there were no Verocay bodies. Most schwannomas have distinct cytomorphologic features that allow correct diagnosis. The major problem with fine needle aspiration cytology of these tumors is the high frequency of poor cellularity, particularly in lesions with cystic degeneration. Of 7 cases with insufficient specimen, 4 showed marked cystic changes and 1 showed marked hyaline changes on histologic sections. In conclusion, we believe that if cytopathologist reminds the situation such as cystic degeneration or hyaline degeneration, the correct diagnosis of the schwannoma will be easily made.

Keywords

References

  1. Kim SY, Nam HJ, Kim JH, Cho YR, Kang YN, Lee SS. Fine needle aspiration cytologic features of schwannomas. Korean J Cytopathol 1999;10:55-60
  2. Joo HJ, Lee KG. Cytologic findings of fine needle aspiration biopsy of ancient schwannoma. Korean J Cytopathol 1990;1:158-63
  3. Domanski HA, Akerman M, Engellau J, Gustafson P, Mertens F, Rydholm A. Fine-needle aspiration of neurilemoma (schwannoma). A clinicocytopathologic study of 116 patients. Diagn cytopathol 2006;34:403-12 https://doi.org/10.1002/dc.20449
  4. Klijanienko J, Caillaud JM, Lagace R. Cytohistologic correlations in schwannomas (neurilemmomas), including "ancient," cellular, and epithelioid variants. Diagn Cytopathol 2006;34:517-22 https://doi.org/10.1002/dc.20320
  5. Mooney EE, Layfield LJ, Dodd LG. Fine-needle aspiration of neural lesions. Diagn cytopathol 1999;20:1-5 https://doi.org/10.1002/(SICI)1097-0339(199901)20:1<1::AID-DC1>3.0.CO;2-J
  6. Yu GH, Sack MJ, Baloch Z, Gupta PK. Difficulties in the fine needle aspiration (FNA) diagnosis of schwannoma. Cytopathology 1999;10:186-94 https://doi.org/10.1046/j.1365-2303.1999.00132.x
  7. Gray W, Mckee GT. Diagnostic Cytopathology. 2nd ed. Edinburgh: Churchill Livingstone, 2003; 894
  8. Kong CS, Cha I. Nodular fasciitis: diagnosis by fine needle aspiration biopsy. Acta Cytol 2004;48:473-7 https://doi.org/10.1159/000326406
  9. Owens CL, Sharma R, Ali SZ. Deep fibromatosis (desmoid tumor): cytopathologic characteristics, clinicoradiologic features, and immunohistochemical findings on fine-needle aspiration. Cancer 2007;111:166-72 https://doi.org/10.1002/cncr.22689
  10. Resnick JM, Fanning CV, Caraway NP, Varma DG, Johnson M. Percutaneous needle biopsy diagnosis of benign neurogenic neoplasms. Diagn Cytopathol 1997;16:17-25 https://doi.org/10.1002/(SICI)1097-0339(199701)16:1<17::AID-DC5>3.0.CO;2-S
  11. Maitra A, Ashfaq R, Saboorian MH, Lindberg G, Gokaslan ST. The role of fine-needle aspiration biopsy in the primary diagnosis of mesenchymal lesions: a community hospital- based experience. Cancer 2000;90:178-85 https://doi.org/10.1002/1097-0142(20000625)90:3<178::AID-CNCR6>3.0.CO;2-S
  12. Domanski HA, Carlen B, Jonsson K, Mertens F, Akerman M. Distinct cytologic features of spindle cell lipoma. A cytologic-histologic study with clinical, radiologic, electronmicroscopic, and cytogenetic correlations. Cancer 2001;93:381-9 https://doi.org/10.1002/cncr.10142
  13. Dodd LG, Marom EM, Dash RC, Matthews MR, McLendon RE. Fine-needle aspiration cytology of "ancient" schwannoma. Diagn Cytopathol 1999;20:307-11 https://doi.org/10.1002/(SICI)1097-0339(199905)20:5<307::AID-DC12>3.0.CO;2-F
  14. Dodd LG, Martinez S. Fine-needle aspiration cytology of pseudosarcomatous lesions of soft tissue. Diagn Cytopathol. 2001;24:28-35 https://doi.org/10.1002/1097-0339(200101)24:1<28::AID-DC1004>3.0.CO;2-G
  15. Klijanienko J, Caillaud JM, Lagace R, Vielh P. Fine-needle aspiration of leiomyosarcoma: a correlative cytohistopathological study of 96 tumors in 68 patients. Diagn Cytopathol 2003;28:119-25 https://doi.org/10.1002/dc.10249
  16. Akerman M, Ryd W, Skytting B, Scandinavian Sarcoma G. Fine-needle aspiration of synovial sarcoma: criteria for diagnosis: retrospective reexamination of 37 cases, including ancillary diagnostics. A Scandinavian Sarcoma Group study. Diagn Cytopathol 2003;28:232-8 https://doi.org/10.1002/dc.10265
  17. Klijanienko J, Caillaud JM, Lagace R, Vielh P. Cytohistologic correlations in 56 synovial sarcomas in 36 patients: the Institut Curie experience. Diagn Cytopathol 2002;27:96-102 https://doi.org/10.1002/dc.10151