Multiple cauda equina schwannomas in neurofibromatosis type 2
Previous acoustic schwannoma.
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The cauda equina demonstrate innumerable enhancing nodules along its entire length, the largest of which is located behind L4 and is vividly enhancing, consistent with a schwannoma. It occupies the vast majority of the canal at this level, compressing the nerve roots around its periphery.
The patient, who has an established diagnosis of NF2, went on to have surgery for the largest L4 level lesion.
MICROSCOPIC DESCRIPTION: Paraffin sections show fragments of a moderately hypercellular neurilemmoma (Schwannoma). This is composed of predominantly of Antoni A type tissue in which there are occasional poorly formed Verocay bodies. Tumour cells show mild nuclear pleomorphism. No mitotic figures, densely hypercellular areas or areas of necrosis are identified.
FINAL DIAGNOSIS: Spinal schwannoma