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Lumbar schwannoma

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Back pain

Patient Data

Age: 30 years
mri

Behind L5 a circumscribed enhancing intra-thecal lesion is present with cystic change. It is of high T2 signal. No obvious flow voids or hemorrhage. 

Case Discussion

The patient went on to have a resection. 

Histology

MICROSCOPIC DESCRIPTION:  The sections show a moderately cellular schwannoma. It contains Antoni A areas with fascicles of spindle cells with palisading. Verocay bodies are present. Antoni B areas with microcystic change are also seen. Entrapped ependymal canals are identified. The tumor cells show no significant nuclear pleomorphism. Mitoses are inconspicuous. Thick-walled blood vessels and hemosiderin deposits are seen in the background. There is no evidence of necrosis. No evidence of malignancy is identified. The tumor cells are S-100 positive. They are EMA and GFAP negative.

DIAGNOSIS: spinal schwannoma.

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