Mediastinum
Other benign / low grade tumors
Schwannoma



Topic Completed: 1 December 2012

Revised: 13 February 2019

Copyright: 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Schwannoma[TI] mediastinum


Hanni Gulwani, M.B.B.S.
Page views in 2018: 284
Page views in 2019 to date: 514
Cite this page: Gulwani H. Schwannoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/mediastinumschwannoma.html. Accessed September 23rd, 2019.
Definition / general
  • Usually in posterior mediastinum, asymptomatic
  • Most common mediastinal neurogenic tumor
  • May present with symptoms of esophageal or nerve root compression
  • Benign
Terminology
  • Also called neurilemoma
Epidemiology
  • Usually in young adults
Case reports
Treatment
  • Excision is almost always curative
Gross description
  • Encapsulated and sharply demarcated from adjacent soft tissue
  • May appear to "hang" from large nerves
  • Usually yellow cut surface, rarely dark red / black due to hemorrhage
  • Degenerative changes common (fat, hemorrhage, cysts)
Gross images

Images hosted on other servers:

51 year old man

Microscopic (histologic) description
  • Biphasic pattern of fusiform cells
  • Cellular areas with nuclear pallisading (Antoni A) and Verocay bodies and myxoid areas with only occasional cells (Antoni B)
  • Prominent thick walled blood vessels
  • No / rare mitotic figures
  • Ancient change: cystic changes, marked nuclear atypia but no mitotic figures
  • Cellular: densely cellular with herringbone, storiform or fascicular growth patterns, mild nuclear atypia, brisk mitotic activity but no necrosis, no atypical mitotic figures (unlike MPNST or other sarcomas)
  • Glandular: epithelial differentiation is focally present
  • Melanotic: pigment present
  • Psammomatous-melanotic: psammomatous calcification and pigment are present
Microscopic (histologic) images

Images hosted on other servers:

Antoni A

Antoni B

Electron microscopy description
Ancient change / ancient schwannoma:
  • Neural differentiation with elongated overlapping cell processes
  • Primitive junctions may resemble mesaxons
  • Abundant pericellular basal lamina
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