PhiliPPine Journal of otolaryngology-head and neck Surgery                                                       Vol. 23 no. 2 July – december 2008

UNDER THE MICROSCOPE

PhiliPPine Journal of otolaryngology-head and neck Surgery  51

This 52-year-old male underwent fine needle aspiration biopsy of a 2-cm diameter parotid 
mass that was firm, well-delineated and vaguely moveable,

The mass was not painful and was noted for about a year.  The aspiration biopsy smear was 
quite cellular and showed fragments of spindle-shaped cells with cigar shaped nuclei and scanty 
to indistinct cytoplasms.  Nuclei were vesicular and Verocay-like bodies were identified by cell 
patterns.  The biopsy was read as a benign spindle cell tumor, probably a schwannoma.   

Excision of the mass revealed a typical schwannoma by histopathology.
Schwannomas of the parotid gland are rare1 and arise from the intraparotid branches of 

the facial nerve. Clues to the cytologic diagnosis include the cellular but benign spindly cell 
population clustered into Verocay body patterns and evidence of cyst degeneration in the form of 
histiocytes and even lymphocytes.2  Main differential diagnoses include the predominant spindle 
cell myoepitheliomas3 and some of the low grade sarcomas that may arise from the parotid gland.   
The even rarer schwannomalike mixed tumor of the parotid4 gland must be also considered.

Jose Ma. C. Avila, M.D.
Department of Pathology
College of Medicine
University of the Philippines Manila

Fine Needle Aspiration Cytology 
of Schwannoma of the Parotid Gland

Correspondence: Jose Ma. C. Avila, M.D.
University of the Philippines Manila
College of Medicine
Department of Pathology
547 Pedro Gil St. Ermita, Manila, 1000
Phone (632) 526 4550
Fax (632) 400 3638 Philipp J Otolaryngol Head Neck Surg 2008; 23 (2): 51 c  Philippine Society of Otolaryngology – Head and Neck Surgery, Inc.

ReFeReNCeS:
1. Falconi M, Russo A, Taibah A, Sanna M.  Facial nerve tumors.  Otol Neurotol.  2003 Nov; 24(6):942-7
2. Maly B, Maly A, Doviner V, Reinhartz T, Sherman Y.  Fine needle aspiration biopsy of intraparotid 

schwannoma-a case report.   Acta Cytol.  2003 Nov-Dec;47(6):1131-4.
3. Siddaraju N, Badhe BAhe BA, Fonrepanavar  M, Mishra MM.  Preoperative fine needle aspiration 

cytology diagnosis of spindle cell myoepithelioma of the a parotid gland: a case report.   Acta Cytol.  
2008 May-Jul; 53(4):495-9. 

4. Kajor M, Gierek T, Markowski J, Pajak J.  Schwannomalike mixed tumor of the parotid gland: a case 
report.  Acta Cytol.  2006 Sep-Oct; 50(5):529-30.

400x, Diff-Quik Stain