Intra-parotid facial nerve schwannoma: case report of a rare entity

Intraparotid facial nerve schwannoma was first reported by Ibarz in 1927. The frequency of intra-parotid schwannomas range from 0.2% to 1.5%. Facial nerve schwannoma can occur at any point along its course from the cerebello-pontine angle to its peripheral branches. Its typical presentation is a slow growing, painless mass mimicking a pleomorphic adenoma. Because of its low prevalence and very few clinical and radiological signs associated with it, pre-operative diagnosis of intraparotid facial nerve schwannoma is generally difficult. There is great potential of misdiagnosis and mismanagement when detected intra-operatively with the worst consequences of facial nerve palsy. In this case a 58 years old male had a parotid mass with a prolonged history of sixteen years with sudden increase in size. Preoperative work up of imaging modalities and fine needle aspiration cytology was not conclusive. Intraoperatively mass couldn’t be separated from the facial nerve, so total parotidectomy for the tumor with transection of facial nerve was done resulting in postoperative facial nerve paralysis. The diagnosis of schwannoma was offered only after histopathological examination. Parotid nerve schwannomas are extremely rare and routine investigations are not very helpful in diagnosis. Whenever a facial nerve is seen involved by a clinically benign appearing lesion, intraparotid schwannoma should be thought of as a diagnostic possibility to avoid radical surgery and prevent complications like facial nerve palsy.

Study of hematological parameters in cases of splenomegaly

Background: This was a prospective study carried out in the department of pathology of a tertiary care hospital during a period of one and half years (Nov 2016- June2018). All patients presented with palpable spleen were included in study. Blood samples were collected for complete hemogram, reticulocyte count, sickling test, osmotic fragility and other haematological investigations if needed. Bone marrow examination and serum electrophoresis was done whenever necessary. Grading of splenomegaly was done by Hackett’s classification. Data collected was analysed to find out the etiology of splenomegaly and its haematological manifestations. Maximum cases were seen in the age group of 11-20 years (19.23%) with a male preponderance. Objectives: To study haematological parameters in cases of splenomegaly in all age groups. To correlate splenomegaly with various hematological parameters and to evaluate hematological and non hematological causes of splenomegaly. Results: Total 260 cases of splenomegaly were studied in this present study. Hematological causes of splenomegaly (53.85%) were more common than the non hematological causes (46.15%). Anemia (38.85%) was the most common cause of splenomegaly among the hematological disorders followed by leukemia (11.92%) where as infective etiology (30.77%) was the predominant cause among the non hematological disorders. Hackett’s grade I splenomegaly was seen in maximum number of case (38.46%). Conclusion: There was no significant correlation between degree of splenomegaly and degree of cytopenia. Increasing splenic size was significantly associated with occurrence of hypersplenism