Microcystic/Reticular Schwannoma Arising in the Submandibular Gland: A Rare Benign Entity that Mimics More Common Salivary Gland Carcinomas

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• 作者：Ryan P. Lau ; Jonathan Melamed ; Melissa Yee-Chang ; Sonya Marcus…
• 刊名：Head and Neck Pathology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：10
• 期：3
• 页码：374-378
• 全文大小：962 KB
• 刊物主题：Pathology; Otorhinolaryngology; Oral and Maxillofacial Surgery; Dentistry;
• 出版者：Springer US
• ISSN：1936-0568
• 卷排序：10

文摘

Microcystic/reticular schwannoma is a recently described variant of schwannoma with a predilection for the gastrointestinal tract, rarely involving the head/neck region. This is the first reported case involving the submandibular gland. We present a case in a 34 year old man with 4.5 cm submandibular mass. Fine needle aspiration suggested a spindle cell lesion. Frozen section evaluation raised the possibility of mucoepidermoid carcinoma. Resection showed a well circumscribed mass with a mucoid appearance. Histologic findings include a lobular architecture with fibrous septa, a lympho-plasmacytic infiltrate, and scattered lymphoid aggregates at the periphery. There are two distinct histologic patterns with solid areas of spindle cells and areas of spindle/ovoid cells with a microcystic pattern in a myxoid background. The tumor has a pushing border, with extension into adipose and adjacent parenchyma, without cytologic atypia or necrosis. Immunohistochemical stains are positive for S-100 and CD34, and negative for calponin, mammoglobin, ALK1, p63, ER, GFAP, SMA, desmin, cytokeratin 7, cytokeratin AE1/AE3, and C-Kit. Mucicarmine stain is negative. Recognition of this benign unusual variant of schwannoma is paramount for appropriate conservative treatment due to the morphologic and immunohistochemical overlap with primary salivary gland carcinomas.KeywordsSchwannomaMicrocystic schwannomaReticular schwannomaSubmandibular glandSalivary gland