Neurilemoma of the trachea.

Neurilemomas of the tracheobronchial tree are exceedingly rare. In this article we report what is, to our knowledge, the 12th case--the third such case of tracheal origin. Clinical features are referable to airway obstruction and local pressure effects. The gross appearance is of an encapsulated lesion. Histologically, there is a proliferation of Schwann cells that are found in either an ordered, palisaded configuration (Antoni type A), or a disordered, loosely textured configuration (Antoni type B). The two types may coexist in a single lesion. Endoscopic removal of nonvascular tracheobronchial masses with follow-up, including periodic chest x-ray films, is advocated. Major surgery is reserved for malignant disease or benign disease not amenable to endoscopic excision.