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Schwannoma (Neurilemmoma)...Explained by a Soft Tissue Pathologist
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- Опубліковано 15 сер 2024
- A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/pos... (dermpath) & kikoxp.com/pos... (bone/soft tissue sarcoma pathology).
This video covers the pathology findings in schwannoma...beyond the Verocay bodies! Knowing all of the clues can help you recognize schwannoma even when Verocay bodies are scarce or absent. Many thanks to Dr. Maryna Slisarenko from Ukraine for typing up the English transcript so that this video has better closed captions/subtitles! You can download the transcript here: www.dropbox.co...
Other videos that may be helpful:
- Neurofibroma, Neurofibromatosis-1, and Low Grade MPNST: • Neurofibroma, Neurofib...
- MPNST: • Malignant Peripheral N...
- PHAT: Pleomorphic Hyalinizing Angiectatic Tumor: • PHAT: Pleomorphic Hyal...
Additional reading:
- Epithelioid Schwannoma:
www.ncbi.nlm.n...
- Psammomatous melanotic schwannoma (malignant melanotic schwannian tumor):
www.ncbi.nlm.n...
Please check out my Soft Tissue Pathology & Dermatopathology survival guide textbooks: bit.ly/2Te2haB
This video is geared towards medical students, pathology or dermatology residents, or practicing pathologists or dermatologists. Of course, this video is for educational purposes only and is not formal medical advice or consultation.
Presented by Jerad M. Gardner, MD. Please subscribe to my channel to be notified of new pathology teaching videos.
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A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: kikoxp.com/posts/5084 (dermpath) & kikoxp.com/posts/5083 (bone/soft tissue sarcoma pathology).
InstaBlaster.
Its amazing how something 99.9% of people have never heard of could have such an impact on ones life. It's amazing how much pain you can become accustomed to when it starts as mild and gradually gets worse.
After it got bad enough, sought chiropractic Care, when it didn't produce lasting relief, finally went to a neurologist. Had am MRI about a week later and everything went into full chaos after that. Despite already having an appointment in a week to discuss the results of the MRI, I was told to immediately go to the Drs officer right after the MRI, and that the Dr would be there despite the office having closed over an hour before.
He was going to send me a to a local surgeon, then changed his mind and wanted me to go to The University of Miami, in of all places, Miami. This was due to the severity of the condition being above what most local Drs have lots of experience with.
So yeah, 2 days later Im in Miami meeting with the Dr, who is a professor of Neurological Surgery at The University of Miami Medical School. We set up the surgery, I had 14 days to get all sorts of pre-op testing done, and 14 days after first going, I was admitted for Surgery. The surgery was a lot more complicated than they originally thought, ended up down there a Month, not the 3-5 days they originally estimated. A week or two after Im out they call me with the pathology that it was a Schwannoma. Never heard the term before then, now I had a name for the condition that caused me so much pain for so long. The surgery was in 2013 and I still have complications but the pain is so much better.
You are a genius.
God bless you and bless your golden brain.
fabulous video as usual
Never seen such a classic section. Thank you.
Best explanation of schwannoma histopathology, very helpful. Thank you sir
Another classic from the Master. Thank you for the links to the collections.
Fascinating, I had a 2cm schwannoma removed from my spinal canal T6/T7 two years ago at The Walton Centre in Liverpool, England, they said it had been probably slowly growing for years. I feel so much better now, 3rd checkup in September.
Thankfully these are benign non-cancerous tumors, although they can certainly be painful when they press on nerves! Congrats on your recovery!
@@JMGardnerMD do they reccur after surgically REMOVED.. or can I get Homoeopathic Medicine for this.. Homoeopathy can dilute all tumours in some months..
@@saiumashiva6388 do you know any homeopathic medicine name
It was awesome!!! I hope you are able to show videos from different systems to learn Pathology in an smart and fancy way!!! Thanks a lot
Dr. Gardner. I just found out I have a schwannoma!! So of course, I have been researching as much as possible to help understand my diagnosis. As a nurse AND a patient, I am so intrigued yet perplexed by these tumors. Mine is dorsal ramus nerve at L5S1. Your teaching method is commendable and your descriptions are on point. Thanks for posting and sharing your experience and vast knowledge!!
Stay positive and Hopeful ☝️
Dr. Gardner thank you for your wonderful teaching! I learned a lot ;)
Really helpful Dr. Gardner thanks 🙏🏻
My wife has a schwanoma removed 6 months ago, but the surgeon said it was a lymph node. Damage to the brachial plexus left her left hand useless and we are still trying to sort this out. No pre-operation information about a tumour. Tests are being done and hopefully she may get the use of her hand returned, but it may be a long time yet. Doctors, hospital and surgeon will be sued but not until we know if the problem can be resolved. Hospital and doctors have admitted they were wrong, and have stated that they are sorry, but that doesn't help.
Hi ... Thank you for the videos
I have small nerve fiber neuropathy, and schwannomas are popping up all over my body. Tangled in my tendons and nerves. What a mess. Thanks for the awesome video.
Dr Gardner, when I was 15 years of age, I had a malignant Schwannoma. It was located in the cervical area. I did receive radiation treatment.
Thank you for your information.
Well explained Dr Gardner, Thanks.
I had a schwannoma removed from the lumbar spine in 2013. When my neurologist saw the MRI he immediately got in contact with the best neurosurgeons within 1000 miles at The University of Miami.
I had 2 weeks to get all the necessary pre op appointments done. The game plan was I would be admitted early in the morning, have an endoscopy procedure for about an hour to give the Dr an idea of what they were dealing with to formulate a plan for the operation, before the endoscopy he had said the actual removal surgery would take maybe 5-7 hours, and I'd be in the hospital at least 3 days but shouldn't have been longer than 5 days.
After the endoscopy the Dr seemed positive about what he saw and he even revised the length of surgery time down from 5-7 hours to 3-5 hours.
Not sure what went wrong, you know doctors are often intentionally vague. When I came to in the ICU, I was basically swarmed with Drs, and that I had a day of missing time. I was told the surgery ended up taking over 18 hours, the Dr said was the longest he's ever done. I ended up being down there almost a month.
I still have several Neurological complications, but the pain is so much better. Before the surgery I was in pain almost 24/7, I was choking down OTC pain pills all day long, taking acetaminophen, ibuprofen, aspirin and naproxen all together at the same time just to be able to get through the day.
What kind of complications are you having?
Amazing explanation thanks a lot
Dr. G. your work & teaching style are greatly appreciated, especially by someone like me, living w "stable" residual Vestibular Schwanomma. Post 9 1/2 hr. retrosigmoid crani, hiding inside the nerve @ cerebellopontine angle.~>💌 to the Incomparable Brain Lab Team(s) UCSD & Drs. Quyen T Nguyen, M.D. & Bob S. Carter M.D. The tumor suppressor gene that went awry is called "merlin"? Someone had a good sense of humor. Thanks Dr. G🙌🏻
Thank you for sharing your story and for the kind words. The support of patients is always so very meaningful to me. It is because of all of you that I teach in the first place, in the hopes that someone somewhere will get more accurate diagnosis and better patient care because of it. Best wishes to you for many long years of good health ahead!
Thank you
Excellent presentation.
a perfect example of how youtube can be used for good 🌟
Excellent
Ty. 🙂
Great
Thanks again.
the hyalinization of the vessel wall looks like the collagen trapped between the palisading cells in a verocay body
Thank you for this information. I had a biopsy in 10/19 . Its located under my left arm pit . So happy it's not cancer ☝️☝️. Making an appt. Is the next step and praying, doesn't comeback . 😋
Congrats! Great news. Schwannoma rarely grows back in my experience. I hope yours causes no further issues! Best wishes for health and happiness! -Jerad
@@JMGardnerMD thank you responding: due to Covid craziness I scheduled 8/21/2020 for check up . I'm really positive about review n removable 👐☝️
Thanks
Watching from Pakistan . Medical student Robbins pathology
Sir you are from which country
USA
Dear dr. Gardner, will you still make an in depth video on the more nuanced , in detail? I am especially interested in the melanocytic schwannoma.
@Jerad Gardner, MD .... I had a Schwannoma removed from my index finger back in 2014, and it start to reappear in 2017. Should this worry me, and would like to know if the can spread ?
Schwannoma can rarely recur but it doesn’t spread or behave aggressively. I would recommend you see your doctor so they can examine you and decide what should be done if anything (which is what I would recommend pretty much any time a lesion grows back after it has been surgically removed). But in the meantime I wouldn’t worry too much about it. Hope that helps. Best wishes for good health.
Brilliant 👋👋👋
Very nice
wonderful! thank you. Epithelioid Schwannoma almost looks nevoid on scanner ?!
Absolutely. It can get confused with melanocytic neoplasms
Thank u sir!
Thanku🙏🏻
Thank you so much for your wonderful teaching! I want to ask how to distinguish plexiform schwannoma and plexiform neurofibroma in HE? Sometimes it makes me confused,like plexiform schwannoma can be non-encapsulated wheras the ordinary type is usually encapsulated. Plexifrom neurofibroma can contain verocay body like structure. Thanks again!
Check out my video on neurofibroma: ua-cam.com/video/13bLhmg0TIc/v-deo.html
Amazing video ..melanotic schwannoma was an eye treat..just a query ...so how do we differentiate melanotic schwannoma or a Mets melanoma ..without molecular?
Clinical scenario mostly. Large deep tumor arising in nerve root. No history of melanoma. That would favor melanotic schwannoma. If psammoma bodies are present, then that also helps.
Great video! One question, I've read on my textbook that in schwannomas one important aspect is the lack of IHC staining for neural differentiation markers, such as neurono-specific enolasys and neurofilaments, because of the fact that the growth of schwann cells kind of "pushes" the nerve bundles periferally... I was wondering if that would really be the case and if this feature would have any differential value in regards to other nerve sheath tumors. Thanks in advance, keep up the awesome work!
yes indeed. That is my understanding, as well. I think in some cases staining for neurofilament can be helpful in distinguishing neurofibroma from schwannoma. But usually the H&E features are enough to sort out the diagnosis. But NSE is such a non-specific stain that I essentially never use it in my practice.
@@JMGardnerMD ok I'll keep that in mind, thank you so much for your answer, makes perfect sense.
You got yourself a new subscriber by the way, please keep posting, I really enjoy your videos and I honestly think no on could argue that this is top quality content right here. Where I come from we don't have teachers as committed as you are. Best regards from Italy!
Is it true ther bigger it gets the higher % chance of damaging nerves?
A doctor told me that if its asymptomatic and doesn't grow it can be left there. Nevertheless it is actually growing but very slowly... like a mm or less per year. Now it's 3cm located on ther neck.
I’m not sure actually. I have seen really big schwannomas before (10cm or more). I know they can cause pain and sometimes push against the nerve and cause nerve symptoms but don’t recall hearing about a significant risk of serious or permanent nerve damage from them. Your doctor is the best person to ask for your particular case because they will be most familiar with the specific details.
@@JMGardnerMD thank you very much for the reply 🙇🏻♂️
My request sir . please add gross picture if possible
Will try to do that in some future lectures
theek hota Hai kya