Case 82

Clinical history

49 year old woman. Sudden hearing loss of the left side.

Primary image

Cerebellopontine angle. Low magnification. H&E stain.

Intermediate magnification
Intermediate magnification. H&E stain.

High magnification
High magnification. H&E stain.

Differential diagnosis

Differential diagnosis
meningioma, malignant peripheral nerve sheath tumor

Additional tests

More history

More history
There is dizziness/loss of balance.

Ask a friend

Ask a friend
It looks like a benign nerve sheath tumor.

Stains

Alcian blue/PAS to Bilirubin Test Result Alcian blue/PAS I'm sorry but this is of no help. Alican blue pH 1.0 I'm sorry but this is of no help. Alcian blue pH 2.5 I'm sorry but this is of no help. Auramine I'm sorry but this is of no help. Bielchowsky I'm sorry but this is of no help. Bilirubin I'm sorry but this is of no help.	Colloidal iron to Fontana-Masson Test Result Colloidal iron I'm sorry but this is of no help. Congo red I'm sorry but this is of no help. Cresyl violet I'm sorry but this is of no help. Dieterle I'm sorry but this is of no help. Diff Quik I'm sorry but this is of no help. Fontana-Masson I'm sorry but this is of no help.	Gallyas to Gremelius Test Result Gallyas I'm sorry but this is of no help. Giemsa I'm sorry but this is of no help. GMS I'm sorry but this is of no help. Gomori's trichrome I'm sorry but this is of no help. Gram I'm sorry but this is of no help. Gremelius I'm sorry but this is of no help.	JMS to Mucicarmine Test Result JMS I'm sorry but this is of no help. Jones I'm sorry but this is of no help. Kinyoun I'm sorry but this is of no help. Luxol fast blue I'm sorry but this is of no help. Masson trichrome I'm sorry but this is of no help. M-MAS I'm sorry but this is of no help. Movat I'm sorry but this is of no help. Mucicarmine I'm sorry but this is of no help.	Oil red O to Prussian blue Test Result Oil red O I'm sorry but this is of no help. Orecein I'm sorry but this is of no help. PAS I'm sorry but this is of no help. PASD I'm sorry but this is of no help. PASF I'm sorry but this is of no help. PTAH I'm sorry but this is of no help. Prussian blue I'm sorry but this is of no help.	Reticulin to Ziehl-Neelsen Test Result Reticulin Sudan black B I'm sorry but this is of no help. Toluidine blue I'm sorry but this is of no help. Verhoeff I'm sorry but this is of no help. Von Kossa I'm sorry but this is of no help. Warthin-Starry I'm sorry but this is of no help. Ziehl-Neeslen I'm sorry but this is of no help.

IHC

Alpha-1 AT to Cathepsin K Test Result alpha-1 AT I'm sorry but this is of no help. ACTH I'm sorry but this is of no help. AE1/AE1 NEGATIVE alpha-fetoprotein I'm sorry but this is of no help. Alk-I I'm sorry but this is of no help. AMACR I'm sorry but this is of no help. AR I'm sorry but this is of no help. ATRX I'm sorry but this is of no help. Beta2-microglobulin I'm sorry but this is of no help. B72.3 I'm sorry but this is of no help. Beta-catenin I'm sorry but this is of no help. BCL2 I'm sorry but this is of no help. BCL6 I'm sorry but this is of no help. BCLxL I'm sorry but this is of no help. C3 comp I'm sorry but this is of no help. CA9 I'm sorry but this is of no help. Calcitonin I'm sorry but this is of no help. Calponin I'm sorry but this is of no help. Calretinin NEGATIVE CAM5.2 I'm sorry but this is of no help. Cathepsin K I'm sorry but this is of no help.	CD10 to Chromogranin Test Result CD10 I'm sorry but this is of no help. CD117 I'm sorry but this is of no help. CD138 I'm sorry but this is of no help. CD15 I'm sorry but this is of no help. CD1a I'm sorry but this is of no help. CD20 I'm sorry but this is of no help. CD21 I'm sorry but this is of no help. CD23 I'm sorry but this is of no help. CD3 I'm sorry but this is of no help. CD30 I'm sorry but this is of no help. CD31 I'm sorry but this is of no help. CD34 NEGATIVE CD35 I'm sorry but this is of no help. CD4 I'm sorry but this is of no help. CD43 I'm sorry but this is of no help. CD45 (LCA) very few cells positive CD5 I'm sorry but this is of no help. CD56 I'm sorry but this is of no help. CD57 I'm sorry but this is of no help. CD68 I'm sorry but this is of no help. CD7 I'm sorry but this is of no help. CD79a I'm sorry but this is of no help. CD8 I'm sorry but this is of no help. CD99 I'm sorry but this is of no help. CDX2 I'm sorry but this is of no help. CEA-m I'm sorry but this is of no help. Chromogranin I'm sorry but this is of no help.	CK17 to Glypican 3 Test Result CK17 I'm sorry but this is of no help. CK19 I'm sorry but this is of no help. CK20 I'm sorry but this is of no help. CK34betaE12 I'm sorry but this is of no help. CK5/6 I'm sorry but this is of no help. CK7 I'm sorry but this is of no help. CMV I'm sorry but this is of no help. c-MYC I'm sorry but this is of no help. Cyclin D1 I'm sorry but this is of no help. D2-40 I'm sorry but this is of no help. Desmin I'm sorry but this is of no help. DOG1 I'm sorry but this is of no help. EBV I'm sorry but this is of no help. EMA NEGATIVE ER and PR I'm sorry but this is of no help. Factor VIII I'm sorry but this is of no help. Factor XIIIa I'm sorry but this is of no help. Fascin I'm sorry but this is of no help. FH I'm sorry but this is of no help. FSH I'm sorry but this is of no help. Gastrin I'm sorry but this is of no help. GATA3 I'm sorry but this is of no help. GCDFP-15 (BRST2) I'm sorry but this is of no help. GFAP I'm sorry but this is of no help. GH I'm sorry but this is of no help. Glucagon I'm sorry but this is of no help. Glypican-3 I'm sorry but this is of no help.	HBME-1 to IgM Test Result HBME-1 I'm sorry but this is of no help. HBV core I'm sorry but this is of no help. HBV surface I'm sorry but this is of no help. H-caldesmon I'm sorry but this is of no help. HCG I'm sorry but this is of no help. Helicobacter I'm sorry but this is of no help. Hepatocyte I'm sorry but this is of no help. HER2/neu I'm sorry but this is of no help. HHV-8 I'm sorry but this is of no help. HMB-45 I'm sorry but this is of no help. HNF1beta I'm sorry but this is of no help. HPV I'm sorry but this is of no help. HSV-I I'm sorry but this is of no help. HSV-II I'm sorry but this is of no help. IDH-1 I'm sorry but this is of no help. Inhibin I'm sorry but this is of no help. INI1 (BAF47) I'm sorry but this is of no help. Insulin I'm sorry but this is of no help. Kappa I'm sorry but this is of no help. Ki-67 Lambda I'm sorry but this is of no help. Leu 7 I'm sorry but this is of no help. IgA I'm sorry but this is of no help. IgG I'm sorry but this is of no help. IgM I'm sorry but this is of no help.	LH to PDGFR Test Result LH I'm sorry but this is of no help. LIN28 I'm sorry but this is of no help. Lysozyme I'm sorry but this is of no help. mammoglobin I'm sorry but this is of no help. MAP2 I'm sorry but this is of no help. MCV I'm sorry but this is of no help. Melanin A I'm sorry but this is of no help. MHC class I I'm sorry but this is of no help. MITF I'm sorry but this is of no help. MUM1 I'm sorry but this is of no help. Myeloperoxidase I'm sorry but this is of no help. MYO D1 I'm sorry but this is of no help. Myoglobin I'm sorry but this is of no help. Napsin I'm sorry but this is of no help. NF NKX3.1 I'm sorry but this is of no help. NSE I'm sorry but this is of no help. OCT3/4 I'm sorry but this is of no help. p16 I'm sorry but this is of no help. P501S I'm sorry but this is of no help. p53 I'm sorry but this is of no help. p57 I'm sorry but this is of no help. p63 I'm sorry but this is of no help. Pankeratin I'm sorry but this is of no help. PAX2 I'm sorry but this is of no help. PAX5 I'm sorry but this is of no help. PAX8 I'm sorry but this is of no help. PCNA I'm sorry but this is of no help. PDGFR I'm sorry but this is of no help.	PLAP to WT1 Test Result PLAP I'm sorry but this is of no help. PNL-2C I'm sorry but this is of no help. Prolactin I'm sorry but this is of no help. PSA I'm sorry but this is of no help. PSAP I'm sorry but this is of no help. RCC I'm sorry but this is of no help. S-100 SALL4 I'm sorry but this is of no help. Smooth muscle actin I'm sorry but this is of no help. Somatostatin I'm sorry but this is of no help. STAT6 I'm sorry but this is of no help. Synaptophysin I'm sorry but this is of no help. TdT I'm sorry but this is of no help. TFE3 I'm sorry but this is of no help. TFEB I'm sorry but this is of no help. Thyroglobulin I'm sorry but this is of no help. Toxoplasma I'm sorry but this is of no help. TSH I'm sorry but this is of no help. TTF-1 I'm sorry but this is of no help. Ubiquitin I'm sorry but this is of no help. UCHL1 (PGP9.5) I'm sorry but this is of no help. Ulex Europaeus I'm sorry but this is of no help. Vimentin I'm sorry but this is of no help. VIP I'm sorry but this is of no help. VZV I'm sorry but this is of no help. WT-1 I'm sorry but this is of no help.

Diagnosis

Diagnosis
Schwannoma, WHO grade I. Comment: This is the most frequent tumor of the cerebellopontine angle. Positive S-100 Immunostain and reticulin around individual tumor cells confirm the diagnosis and rule out a potential meningioma.