2021 Volume 43 Issue 2 Pages 168-174
Background. Schwannoma originates from the Schwann cells and can occur in any part of the peripheral nerve. Schwannomas of the lungs, trachea, bronchi, and mediastinum are rare. We report 2 cases of schwannoma that were diagnosed by bronchoscopy. Case Descriptions. Case 1: A 69-year-old man was referred to our hospital due to an abnormal shadow in the chest. Chest computed tomography (CT) revealed the presence of a 41-mm tumor, which was adjacent to the left tracheal margin in the upper mediastinum. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed. A pathological examination demonstrated the presence of spindle cells with a palisading pattern. Immunohistochemical staining was positive for anti-S-100 antibodies. The patient was therefore diagnosed with mediastinal schwannoma. We performed tumor resection because the trachea was displaced. Case 2: The patient was a 48-year-old man who was being treated for another disease. Chest CT for screening revealed the presence of a 10-mm tumor in the membranous portion of the trachea. We performed a transbronchial biopsy. A pathological examination revealed the presence of spindle cells proliferating in a wave-like pattern. Immunohistochemical staining was positive for anti-S-100 antibodies. The patient was therefore diagnosed with tracheal schwannoma. Since the tumor was small and the patient had no airway obstruction symptoms, careful follow-up was performed based on the patient's wishes. Conclusion. Intrathoracic schwannomas were previously histopathologically diagnosed using surgical specimens. In some cases, they can now be diagnosed by appropriate bronchoscopy.
