[Microcystic/reticular schwannoma occurring in cervical spine: report of a case with literature review].
OBJECTIVE
To study the morphologic characteristics, immunophenotype and differential diagnosis of a case of microcystic/reticular schwannoma occurring in cervical spine.


METHODS
The pathologic features and immunophenotypic profile of a case of microcystic/reticular schwannoma were studied. Immunohistochemistry was performed using EnVision two-step method.


RESULTS
The patient was a 35-year-old male and presented with a bump over the fifth cervical spine on radiologic check up. Grossly, the bump was gray-white in color, soft, well-circumscribed but non-encapsulated. The tumor measured 3.5 cm × 3.0 cm × 1.8 cm in size. Histologically, it was composed of two distinctive components. One component resembled the conventional schwannoma but showed focally nuclear pleomorphism, reminiscent of changes in degenerating schwannoma. The other component consisted of epithelial-like cells arranged in a reticular or lace-like pattern, amongst a myxoid matrix. Immunohistochemical study showed that the tumor cells were strongly positive for vimentin, S-100 protein, glial fibrillary acidic protein and neuron-specific enolase, focally positive for CD68, CD10 and Ki-67, and negative for pan-cytokeratin, epithelial membrane antigen, neurofilament, carcinoembryonic antigen, smooth muscle actin, estrogen receptor, progesterone receptor and p53.


CONCLUSIONS
Microcystic/reticular schwannoma is a novel variant of schwannoma, arising mainly in internal viscera but seldom in bone. Awareness of this entity is helpful in distinction from chordoma, other mucoid tumors or sarcomas.
Department of Pathology, the Second Affiliated Hospital of Zhejiang University Medical College, Hangzhou 310009, China.
Bai-zhou
BZ
Li
Jia-wei
JW
Wang
Hong-quan
HQ
Wei
D000328:Adult; D002574:Cervical Vertebrae; D002813:Chondrosarcoma / Q000378:metabolism / Q000473:pathology; D002817:Chordoma / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D006801:Humans; D008297:Male; D009442:Neurilemmoma / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D010751:Phosphopyruvate Hydratase / Q000378:metabolism; D009418:S100 Proteins / Q000378:metabolism; D012509:Sarcoma / Q000378:metabolism / Q000473:pathology; D013125:Spinal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D014746:Vimentin / Q000378:metabolism
D005904:Glial Fibrillary Acidic Protein; D009418:S100 Proteins; D014746:Vimentin; D010751:Phosphopyruvate Hydratase