Schwannoma Histology — MFDS Part 1 MCQ

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ModerateOral PathologySchwannoma HistologyMFDS Part 1

Histological examination of a painless submucosal nodule excised from the tongue shows a circumscribed spindle-cell tumour. There are alternating hypercellular areas with nuclear palisading and Verocay bodies and hypocellular areas with a loose myxoid stroma. The tumour cells show strong diffuse S100 positivity. What is the most likely diagnosis?

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Correct answer: C — Schwannoma (neurilemmoma)

Explanation lettering: B = shown as A · D = shown as B · A = shown as C · E = shown as D · C = shown as E

The diagnosis is **schwannoma (neurilemmoma)**. Its characteristic biphasic architecture comprises hypercellular Antoni A areas, in which palisaded nuclei may form Verocay bodies, and hypocellular Antoni B areas with loose myxoid stroma. Strong diffuse S100 expression supports Schwann-cell differentiation. Schwannomas are usually circumscribed, although tongue lesions are not invariably completely encapsulated. Neurofibroma is generally unencapsulated and contains a more heterogeneous spindle-cell population without the classic Antoni A/B architecture or Verocay bodies. A granular cell tumour contains sheets of cells with abundant granular cytoplasm rather than a biphasic spindle-cell pattern. Traumatic neuroma is a reactive, disorganised proliferation of nerve fascicles following injury. Mucoepidermoid carcinoma is an epithelial salivary malignancy composed of mucous, intermediate and epidermoid cells.

Reference: Ud Din N, et al. Schwannoma of tongue: a clinicopathologic study of 34 cases and review of published literature. Diagnostic Pathology. 2026;21:53. https://pubmed.ncbi.nlm.nih.gov/42063167/