Two cases of Endobronchial Neurilemmoma and Review of the Literature in Korea
- Affiliations
-
- 1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wjkoh@smc.samsung.co.kr
- 2Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 3Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 4Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- KMID: 2114600
- DOI: http://doi.org/10.4046/trd.2007.62.2.129
Abstract
- Neurilemmomas are benign tumors that originate from Schwann cells. These tumors rarely occur in the trachea or bronchus. Although small peripheral lesions cause no symptoms, they usually cause dyspnea, cough, wheeze, and atelectasis. We encountered two cases of endobronchial neurilemmoma, and reviewed 10 cases previously reported in Korea in order to clarify the characteristics of this disease, and to determine the appropriate treatment. The median age of the 12 patients reviewed were 36.5 (range 16-75). Cough and dyspnea were the most common initial symptoms (40%), and two cases had no symptoms. Regarding the diagnostic methods, bronchoscopic biopsy was found to be inadequate for diagnosis in two cases. A review of the cases revealed the following teatments: bronchoscopic removal in two cases, surgery in six cases, and combined bronchoscopic removal and surgery in one case.
Keyword
MeSH Terms
Figure
-
Figure 1 (A) Enhanced chest CT scan (5.0 mm section thickness) obtained at the level of the main bronchi shows homogeneous endobronchial nodule (arrows) obliterating right upper lobar bronchus. (B) Bronchoscopic finding showes a round hypervascular mass with smooth surface in the right main bronchus. (C) Photomicrography of endobronchial neurilemmoma consists of elongated bipolar cells disposed in fascicles (H&E, ×100). (D) Tumor cells are uniformly reactive for S-100 protein (ABC method, ×100).
Figure 2 (A, B) Mediastinal- (A) and lung-window (B) images of unenhanced CT scan (5.0-mm section thickness) obtained at the ventricular level shows a homogeneous nodule in left lower lobe. (C) Bronchoscopic finding showed a obstructing mass with hypervascular surface in the posterobasal segmental bronchus of the left lower lobe. (D) Photomicrography of endobronchial neurilemmoma shows prominent rows of cells with nuclear palisading (H&E, ×100). (E) Tumor cells are uniformly reactive for S-100 protein (ABC method, ×200).
Reference
-
1. Das Gupta TK, Brasfield RD, Strong EW, Hajdu SI. Benign solitary Schwannomas (neurilemomas). Cancer. 1969. 24:355–366.2. Kasahara K, Fukuoka K, Konishi M, Hamada K, Maeda K, Mikasa K, et al. Two cases of endobronchial neurilemmoma and review of the literature in Japan. Intern Med. 2003. 42:1215–1218.3. Horovitz AG, Khalil KG, Verani RR, Guthrie AM, Cowan DF. Primary intratracheal neurilemoma. J Thorac Cardiovasc Surg. 1983. 85:313–317.4. Park CS, Ahn JH, Shin WS, Lee SJ, Suh BJ, Kwon SS, et al. A case of tracheal neurilemmoma which was completely removed by bronchoscopic laser therapy. Tuberc Respir Dis. 1997. 44:942–948.5. Park YH, Noh YW, Hong JM. Primary neurilemmoma of the trachea. Korean J Thorac Cardiovasc Surg. 1996. 29:1166–1169.6. Baek JC, Meong JI, Kang HS, Kim YR, Lee S, Kim W, et al. A case of benign solitary endobronchial neurilemmoma. Korean J Med. 1997. 53:244–249.7. Moon CY, Lee HB, Lee YC, Rhee YK. A case report of neurilemmoma in the bronchial wall. Tuberc Respir Dis. 1998. 45:619–623.8. Kim JH, Song TS, Kim DK, Park SI, Sohn KH. Primary neurofibroma of trachea. Korean J Thorac Cardiovasc Surg. 1998. 31:82–85.9. Park SM, Kim KT. Clinical experience of tracheal resection after laser ablation in a patient having tracheal neurilemmoma with tracheal stenosis. Korean J Thorac Cardiovasc Surg. 1999. 32:947–950.10. Ahn CM, Lee HB, Lee YC, Rhee YK. Two cases of intrabronchial neurilemmoma. Tuberc Respir Dis. 2000. 49:225–230.11. Hong SC, Park IK, Kim DJ, Chung KY. Primary Schwannoma of bronchus. KoreanJ Thorac Cardiovasc Surg. 2004. 37:1036–1039.12. Kumar V, Abbas AK, Fausto N. Robbins and Cotran: pathologic basis of disease. 2005. 7th ed. Philadelpia: Saunders;1411.
