Kosin Med J.  2017 Dec;32(2):258-262. 10.7180/kmj.2017.32.2.258.

A Case of Primary Tracheal Schwannoma

• Choi SM
• You JH
• Lee SB
• Kim SH
• Kim YS

• KMID: 2400271
• DOI: http://doi.org/10.7180/kmj.2017.32.2.258

Abstract

Although benign nerve sheath tumors have been described, primary tracheal schwannomas are extremely rare. We report a case of primary tracheal schwannoma, a rare benign nerve sheath tumor in a 58-year-old man with atypical symptoms of chronic cough, sputum and dyspnea for 2 months. Chest computerized tomography showed a 1.7 cm polypoid lesion in posterior wall of mid trachea. The results of bronchoscopic biopsy and immuno-histo-chemical studies were consistent with schwannoma. A surgical treatment of tumor resection and tracheal reconstruction by end-to-end anastomosis was performed.

Keyword

Neurilemmoma; Schwannoma; Trachea

MeSH Terms

Biopsy
Cough
Dyspnea
Humans
Middle Aged
Nerve Sheath Neoplasms
Neurilemmoma*
Sputum
Thorax
Trachea

Figure

• 

  Fig. 1 Imaging studies of tracheal schwannoma. (A) Chest x-ray showed only a scar change of previous pulmonary tuberculosis in left upper lung field.(B) Computed tomography revealed a round-shaped 1.7 cmpolypoid lesion in mid trachea.(Arrow) (C) Bronchoscopic evaluation showed a polypoid endotracheal mass lesion. (D) Endoscopic trans-esophageal ultrasonography showed that this lesion was localized only in trachea without any evidence of esophageal invasion. (Arrow)

• 

  Fig. 2 Flow-volume curves of pulmonary function test (PFT) and histo-pathologic pictures of tracheal schwannoma. (A) Preoperative flow-volume curve of PFT revealed upper airway obstructive pattern with inspiratory plateau. Forced vital capacity (FVC) = 3.85 liters (L), 110% of reference. Forced expiratory volume during the first second (FEV1) = 2.27 L, 88% of reference. FEV1/FVC = 59% (B) Postoperative flow-volume curve of PFT showed normal flow-volume curve. FVC = 3.36 L, 97% of reference. FEV1 = 2.6 L, 101% of reference. FEV1/FVC = 77% (C) In hematoxylin and eosin (H&E) staining, cellular region (Antoni A)(a) and loose paucicellular region(Antoni B)(b) were documented. Verocay body(v) with palisading elongated nuclei was also seen. (Magnification, ×200)(D) Immuno-histo-chemical S-100 staining of this lesion had strong positivity. (Magnification, ×400)

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