Department of Plastic Surgery and Reconstructive Microsurgery, Department of Anesthesia and Intensive Care, Emergency Clinical Hospital of Bucharest, Romania;
Rom J Morphol Embryol. 2022 Jan-Mar;63(1):209-212. doi: 10.47162/RJME.63.1.23.
Intranodal schwannoma is a rare benign tumor, which originates from the peripheral nerve sheath (Schwann cells), fewer cases being reported with lymphatic involvement. We present the case of a middle-aged female patient, with one-year growing mass in the lateral-cervical area, in intimate relation with the vascular package of the neck. Preoperative cervical computed tomography examination showed the tumor features. There was no intraoperative complication, with the piece being completely removed. The morphological examination revealed the structure of a lymph node, and after Hematoxylin-Eosin staining, there were eosinophilic cytoplasm, euchromatic nuclei, with round, elongated or slightly wavy form and reduced pleomorphism, rare degenerative nuclear atypia, and no mitotic activity nor necrosis. The expression of S100 protein on immunohistochemistry, along with negative results for smooth muscle actin and desmin sustained the diagnosis of intranodal schwannoma of the neck. With a low index of cellular proliferation (Ki67), this case is in line with the reported features of schwannoma having extremely rare malignant transformation.
神经内腱鞘瘤是一种罕见的良性肿瘤，起源于周围神经鞘（施万细胞），较少见有淋巴浸润的报道。我们报告了一例中年女性患者，其颈外侧有一年生长的肿块，与颈部血管包块关系密切。术前颈 CT 检查显示了肿瘤的特征。术中无并发症，整块切除。形态学检查显示淋巴结结构，经苏木精-伊红染色后，有嗜酸性细胞质、染色质核，呈圆形、长形或略带波浪形，轻度多形性，罕见退行性核异型性，无有丝分裂活动或坏死。免疫组织化学 S100 蛋白表达阳性，平滑肌肌动蛋白和结蛋白阴性，支持颈部神经内腱鞘瘤的诊断。细胞增殖指数（Ki67）较低，本例符合报道的神经鞘瘤特征，恶性转化极为罕见。
