Ultrastructural diagnosis of facial nerve schwannoma using fine needle aspiration

In a 14-year-old boy presenting with left facial nerve paralysis, physical examination revealed a soft, round mass in the floor of the left external auditory canal. A fine needle aspiration biopsy was performed to obtain material for light and electron microscopy. Several small groups of uniform, spindle-shaped neoplastic cells were present on the slides; a malignant mesenchymal tumor was considered, but a definite diagnosis could not be established under light microscopy. The ultrastructural examination revealed spindle-shaped and stellate cells with multiple parallel cytoplasmic processes lined with a well-developed basal lamina; these features are highly characteristic of a benign schwannoma.