Cytological features of the cystic fluid of pancreatic schwannoma with cystic degeneration. A case report.
BACKGROUND
Schwannomas are benign neoplasms arising from peripheral nerve tissue. Pancreatic schwannoma is a very rare condition. We present the histological and cytological features of a pancreatic schwannoma with cystic degeneration.


METHODS
A 51-year-old male was diagnosed with a cystic tumor measuring approximately 6 cm in the tail of the pancreas. Distal pancreatectomy and splenectomy were performed. Cystic fluid from the tumor was obtained intraoperatively by fine-needle aspiration, and it showed scattered spindle tumor cells against a background of hemosiderin-laden histiocytes. During the operation, we informed the surgeon that the tumor consisted of "atypical spindle cells". Histologically, the tumor was diagnosed as a schwannoma with cystic degeneration which had originated in the pancreas. The diagnosis was confirmed by positive immunostaining of the tumor cells in both histological and cytological materials for S-100 protein.


CONCLUSIONS
Problems occasionally arise with the use of fine-needle aspiration in the diagnosis of cystic diseases of the pancreas because of the difficulty in obtaining adequate specimens. Nevertheless, it should be emphasized that intraoperative fine-needle aspiration is as informative as a frozen section diagnosis, when appropriately performed.
Hirabayashi
Kenichi
K
Department of Pathology, Tokai University School of Medicine. Kanagawa, Japan.
Yasuda
Masanori
M
Umemura
Shinobu
S
Itoh
Hitoshi
H
Itoh
Johbu
J
Yazawa
Naoki
N
Imaizumi
Toshihide
T
Osamura
Robert Yoshiyuki
RY
D020420:Cyst Fluid / Q000166:cytology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology*; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*