Schwannoma, spinal

Schwannomas originate from the Schwann-cells and are always located on the posterior nerve root. This explains why schwannomas classically are extramedullary, and are responsible for spinal cord compression. Less frequently, they may be both extra- and intramedullary. In very rare instances they may be strictly intramedullary.

Pure intramedullary schwannomas are well-defined iso-intense lesions on T1WI and T2WI with homogeneous enhancement after Gadolinium injection.

Schwannomas should be considered in the differential diagnosis with metastases and hemangioblastomas.

Histology

Schwannomas are encapsulated tumors, composed of spindle shaped neoplastic Schwann cells. Two basic histological patterns are seen in most schwannomas: densely cellular areas (image 1) composed of elongated cells often associated with palisading (see arrows), and a less cellular (image 2), loosely textured pattern.

Case

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