Swelling of Tongue Diagnosed by Fine Needle Aspiration Cytology: A Case Report and Short Review of Literature
- PDF / 1,224,586 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 33 Downloads / 180 Views
CLINICAL CONUNDRUM
Swelling of Tongue Diagnosed by Fine Needle Aspiration Cytology: A Case Report and Short Review of Literature Anju Khairwa1 Received: 24 February 2020 / Accepted: 19 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Background Schwannoma synonyms neurilemmoma, neurolemmoma, and Schwann cell tumors. It is a benign tumor, slow growing, encapsulated tumor and arising from Schwan cells which composed of myelin sheaths encircle peripheral nerves [1]. Schwannomas comprising 25%- 48% of all tumors of head and neck region, development of this tumor in oral cavity is quite uncommon representing only 1% of all head and neck region tumors [2]. Schwannoma occurs different locations included intracranially (mostly cerebellar pontine Angle) in peripheral soft tissues, tongue, palate, floor of the mouth, oral mucosa, and mandible [3]. Schwannoma occurs in any age group but mostly seen in 30–40 years age group [4]. Here, we present unsuspected case of Schwannoma of tongue diagnosed by FNAC (fine needle aspiration cytology). There is paucity of articles in literatures; Schwannoma diagnosed by FNAC is enforced us to write the manuscript.
Case Report A 33-year-old male presented to us FNAC clinic with 1-year history of slow-growing lesion on left lateral side of tongue with clinical diagnosis was soft tissue tumor. Patients also have history of dysphagia, i.e., difficulty to chew and speak. On physical examination, a well-circumscribed pedunculated mass measuring 4 × 3 cm, soft to firm, mobile , and non-tender on lateral side of tongue (Fig. 1a). There was no mucosal ulceration. We performed FNA cytology in the FNA clinic from this superficial swelling with a 22-gauge needle, a 10-cm syringe, and pistol handle. FNA material was blood mixed particulate aspirated. Both airdried and * Anju Khairwa [email protected] 1
Department of Pathology, ESIC Model Hospital, Gurugram, Haryana, India
alcohol-fixed smears were made for Giemsa and hematoxylin and eosin stains. The smears were cellular with small and large cohesive tissue fragments, which were composed of hyper and hypocellular areas along with elongated cells, pointed ends, wavy nuclei, and scant cytoplasm (Fig. 1b, c). Focally showed nuclear palisading with amorphous substance interspersed in between nuclei (verocay bodies) (Fig. 1d, e) along with hyper (Antony A) and hypocellular (Antony B) areas (Fig. 1d). The elongated cells are embedded in fibrillary texture matrix (Fig. 1f, g).
What is the Diagnosis? Answer Cytologically reported as suggestive Benign Mesenchymal tumor or Schwannoma of tongue. Further, patient was operated and specimen processed for histology. Histopathologically confirmed as Schwannoma, histologically described as encapsulated tumor and showing the presence of both Antoni type A and Antoni type B areas, spindle-shaped cells having elongated nuclei, bland nuclear chromatin, and pointed ends, verocay bodies which consist of morphology of Schwannoma (Fig. 2a, b, c).
Discussion with Short Review of Lite
Data Loading...
