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Saoud C, McGowan M, Johnson J, Ali SZ. Benign mesenchymal tumours of the tongue: A report of adult-type rhabdomyoma and granular cell tumour with a review of the literature. Cytopathology 2023; 34:388-394. [PMID: 37009646 DOI: 10.1111/cyt.13230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/13/2023] [Accepted: 02/28/2023] [Indexed: 04/04/2023]
Abstract
The cytomorphological features of benign mesenchymal tumours of the tongue have rarely been reported. Herein, we present the cytomorphological features of adult-type rhabdomyoma, which occurred in the tongue of a female patient, and granular cell tumour (GCT), which occurred in the tongue of a male patient; both patients were in their mid-50s. The cytological features of the adult-type rhabdomyoma case included large polygonal to ovoid cells with abundant and granular cytoplasm with predominantly peripherally located, uniform, round to oval nuclei and small nucleoli. Cross-striation and crystalline intracytoplasmic structures were not seen. The cytological features of the GCT case included large cells with abundant granular pale cytoplasm, small round nuclei and small distinct nucleoli. The cytological differential diagnoses of these tumours overlap; thus, the cytological findings of the different entities included in their differential diagnoses are discussed.
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Affiliation(s)
- Carla Saoud
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Molly McGowan
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jeremy Johnson
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Syed Z Ali
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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2
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Enomoto A, Terasaki M, Murase Y, Kitagawa Y, Shimizu A, Ohashi R, Terasaki Y. Malignant granular cell tumors: Combining cytological and pathological findings for a definitive diagnosis. Diagn Cytopathol 2022; 50:E217-E222. [PMID: 35470985 DOI: 10.1002/dc.24970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/30/2022] [Accepted: 04/14/2022] [Indexed: 11/09/2022]
Abstract
Malignant granular cell tumors (GCTs) account for less than 2% of all GCTs and mainly occur in the deep soft tissue of the thigh or trunk. Malignant GCTs are highly aggressive tumors with high rates of recurrence and metastasis. In this brief report, we describe a rare case of malignant GCT in a 64-year-old Japanese man who presented with a 14 × 20 cm mass in the left inguinal region. The cytologic findings of fine-needle aspiration (FNA) revealed atypical epithelial-like granular cells with granular substance in the background, which was difficult to differentiate from apocrine carcinoma or melanoma. The immunohistochemistry (IHC) findings of the needle biopsy revealed that the tumor cells were positive for S-100 and lysosomal marker CD68 which was suggestive of a GCT. However, the presence of crush artifacts made it challenging to identify cellular atypia, which is a characteristic of malignant tumor. Taken together, the FNA and needle biopsy results were suggestive of malignant GCT. The importance of preoperative diagnosis of malignant GCT is well known, but few reports have described its cytological findings. In our brief report, we show that combining cytological FNA and biopsy findings with IHC findings achieves an accurate diagnosis of malignant GCT.
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Affiliation(s)
- Atsumi Enomoto
- Division of Pathology, Nippon Medical School Hospital, Tokyo, Japan
| | - Mika Terasaki
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan
| | - Yukihiro Murase
- Division of Pathology, Nippon Medical School Hospital, Tokyo, Japan
| | - Yasuyuki Kitagawa
- Department of Orthopaedic Surgery, Nippon Medical School Hospital, Tokyo, Japan
| | - Akira Shimizu
- Department of Analytic Human Pathology, Nippon Medical School, Tokyo, Japan
| | - Ryuji Ohashi
- Department of Integrated Diagnostic Pathology, Nippon Medical School, Tokyo, Japan
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3
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Malignant Granular Cell Tumor of the Lower Extremity in an Adolescent Male. J Pediatr Hematol Oncol 2021; 43:e529-e531. [PMID: 32769557 DOI: 10.1097/mph.0000000000001886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 05/13/2020] [Indexed: 11/26/2022]
Abstract
Granular cell tumors (GCTs) are extremely rare soft tissue tumors, with only 2% of tumors being malignant. Malignant GCTs are more often seen in women between the ages 40 and 60. There has been no case reported of a malignant GCT in a pediatric patient. We present a case of a 14-year-old male who presented with a large mass in his left lower extremity. After being biopsied, the mass was diagnosed as a malignant GCT. The tumor was completely excised with wide margins and close follow-up with the patient continued.
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Layfield LJ. Soft tissue tumor diagnosis: A three prong approach utilizing pattern analysis, immunocytochemistry, and molecular diagnostics. Diagn Cytopathol 2019; 48:265-284. [PMID: 31868988 DOI: 10.1002/dc.24355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 12/28/2022]
Abstract
Tissue diagnosis of a soft tissue neoplasm is of paramount importance for the development of an appropriate treatment plan. Biopsy technique including approach and biopsy method is important to the success of diagnosis and subsequent treatment. Histologic and cytologic diagnoses are difficult and complicated by the large number of soft tissue lesions described, distinctly different biopotential for morphologically similar lesions, often small biopsy specimen size, and the generally limited experience many pathologists have in the diagnosis of soft tissue neoplasms. While utilized less frequently than core-needle biopsies, fine-needle aspiration is a valuable initial approach for the classification of soft tissue neoplasms. The combination of pattern based morphologic analysis, immunohistochemistry, and molecular diagnostics represents a utilitarian and generally successful approach for the diagnosis of soft tissue lesions.
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Affiliation(s)
- Lester J Layfield
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri
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Metastasizing Malignant Granular Cell Tumor (Abrikossoff Tumor) of the Anterior Abdominal Wall, with Prolonged Survival. Case Rep Pathol 2019; 2019:9576487. [PMID: 31080684 PMCID: PMC6475540 DOI: 10.1155/2019/9576487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/11/2019] [Indexed: 11/18/2022] Open
Abstract
Malignant granular cell tumor (MGCT) is a rare high-grade mesenchymal tumor of Schwann cell origin. MGCTs commonly affect thigh, extremity, and trunk; however, involvement of the abdominal wall is quite rare. It has poor prognosis with 39% mortality rate in 3-year interval. We report a 50-year-old female who had MGCT arising in the anterior abdominal wall and developed massive metastatic deposits in both lungs and in the right inguinal lymph nodes, with prolonged survival for 11 years. A brief review of the literature is presented.
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6
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Malignant granular cell tumor of the median nerve: a case report with a literature review of 157 cases. Skeletal Radiol 2019; 48:307-316. [PMID: 29980826 DOI: 10.1007/s00256-018-3017-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 06/15/2018] [Accepted: 06/18/2018] [Indexed: 02/02/2023]
Abstract
Malignant granular cell tumors are an extremely rare, high-grade sarcoma with a schwannian phenotype and are composed of malignant granular cells with cytoplasmic lysosomal inclusion. To date, 157 cases of malignant granular cell tumors have been reported. We report the first case of a malignant granular cell tumor arising from the digital nerve to the median nerve in the palm, and we review the 157 previously reported cases and summarize the clinical profile, treatment, and outcome of this tumor. The median age, tumor size, and follow-up periods were 51 years, 6 cm, and 24 months respectively. With respect to the oncological result, 53 patients (33.8%) had no evidence for disease, 31 (19.7%) were alive with the disease, and 51 (32.5%) died because of the disease. Our case report indicates that rare malignant tumors can arise from the digital nerve to the median nerve in the palm, an anatomical site that is usually affected by benign lesions. Exhaustive discussions between surgeons and pathologists are necessary for the treatment of this rare malignant tumor.
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Mir F, Alnajar H, Rohra P, Naumaan A, Cheng L, Gattuso P. Metastatic granular cell tumor to the breast diagnosed by fine needle aspiration cytology: A case report with review of the literature. Diagn Cytopathol 2018; 47:226-229. [DOI: 10.1002/dc.24060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 08/01/2018] [Accepted: 08/02/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Fatima Mir
- Department of PathologyRush University Medical Center Chicago Illinois
| | - Hussein Alnajar
- Department of PathologyEvanston Hospital, NorthShore University Health System Evanston Illinois
| | - Prih Rohra
- Department of PathologyRush University Medical Center Chicago Illinois
| | - Anam Naumaan
- Department of PathologyRush University Medical Center Chicago Illinois
| | - Lin Cheng
- Department of PathologyRush University Medical Center Chicago Illinois
| | - Paolo Gattuso
- Department of PathologyRush University Medical Center Chicago Illinois
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Abstract
Soft tissue neoplasms are diagnostically challenging, although many advances in ancillary testing now enable accurate classification of fine-needle aspiration biopsies by detection of characteristic immunophenotypes (including protein correlates of molecular alterations) and molecular features. Although there are many useful diagnostic immunohistochemical markers and molecular assays, their diagnostic utility relies on correlation with clinical and morphologic features, judicious application, and appropriate interpretation because no single test is perfectly sensitive or specific. This review discusses applications of ancillary testing for commonly encountered soft tissue neoplasms in cytopathologic practice in the context of a pattern-based approach.
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Affiliation(s)
- Vickie Y Jo
- Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
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Tanwar P, Das P, Barwad A, Shukla N, Ramteke P. Aspirate from an abdominal lump in a known case of breast carcinoma. Cytopathology 2018; 29:394-395. [PMID: 29732667 DOI: 10.1111/cyt.12546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- P Tanwar
- Laboratory Oncology, Dr B.R.A., I.R.C.H., All India Institute of Medical Sciences, New Delhi, India
| | - P Das
- All India Institute of Medical Sciences, New Delhi, India
| | - A Barwad
- All India Institute of Medical Sciences, New Delhi, India
| | - N Shukla
- All India Institute of Medical Sciences, New Delhi, India
| | - P Ramteke
- All India Institute of Medical Sciences, New Delhi, India
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Choudhary Z, Gupta P, Malhotra P, Bhardwaj M, Sharma PK. Granular Cell Tumour of the Chest Wall: FNA Diagnosis with a Review of Literature and Elaboration of Cytological Mimickers. J Clin Diagn Res 2017; 11:ED01-ED03. [PMID: 28969141 DOI: 10.7860/jcdr/2017/29123.10337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 05/26/2017] [Indexed: 11/24/2022]
Abstract
Granular Cell Tumours (GCTs) are uncommon tumours which can be confused with other benign soft tissue tumours on clinical examination. Fine Needle Aspiration Cytology (FNAC) plays a significant role in their diagnosis. There are certain cytological mimickers of GCTs so a cytopathologist must be aware of its characteristic cytomorphology. These tumours can be present anywhere on the body; however, chest wall is one of the uncommon sites. We present a case of GCT present on the chest wall in an elderly male as a subcutaneous nodule. We have discussed the common cytological differential of GCTs, features of malignant GCTs along with cytomorphological and immunohistochemical features.
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Affiliation(s)
- Zeba Choudhary
- Senior Resident, Department of Pathology, Pgimer, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Prajwala Gupta
- Associate Professor, Department of Pathology, Pgimer, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Malhotra
- Specialist, Department of Pathology, Pgimer, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Minakshi Bhardwaj
- Professor, Department of Pathology, Pgimer, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Prafull Kumar Sharma
- Professor, Department of Dermatology, Pgimer, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Primary cutaneous malignant granular cell tumor: an immunohistochemical study and review of the literature. Am J Dermatopathol 2016; 37:334-40. [PMID: 25794371 DOI: 10.1097/dad.0000000000000106] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Granular cell tumors (GCTs) are uncommon soft tissue tumors characterized by cytoplasmic granular appearance of the neoplastic cells. Malignant granular cell tumors (MGCTs) comprise less than 2% of GCTs and are mostly found in the subcutaneous soft tissues of the lower extremities, especially the thighs. Very few cases have been reported in the skin. The uncommon occurrence of cutaneous MGCTs and their histopathologic similarities with their benign counterpart make difficult the diagnosis of this particular malignancy. We describe a primary cutaneous MGCT that presented as a left posterior chest wall mass in a 51-year-old woman. Local excision was performed for the primary tumor, which was first interpreted as an atypical GCT, but 3 months later a left axillary mass appeared, and subsequent axillary lymph node dissection demonstrated metastatic disease in 4 of 12 excised lymph nodes. We report the immunophenotype of this primary cutaneous MGCT, which was studied with an ample panel of antibodies and compare our results with those of the few previously reported cases in the skin and subcutaneous soft tissues.
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12
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Use of a Recursive-Rule eXtraction algorithm with J48graft to achieve highly accurate and concise rule extraction from a large breast cancer dataset. INFORMATICS IN MEDICINE UNLOCKED 2015. [DOI: 10.1016/j.imu.2015.12.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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13
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Singh S, Gupta N, Sharma S, Azad RK. Aspiration cytology in the preoperative diagnosis of granular cell tumor of thyroid region in an 11-years-old female child. J Cytol 2013; 30:218-9. [PMID: 24130422 PMCID: PMC3793367 DOI: 10.4103/0970-9371.117639] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Suman Singh
- Department of Pathology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
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14
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Harp E, Caraway NP. FNA of thyroid granular cell tumor. Diagn Cytopathol 2012; 41:825-8. [DOI: 10.1002/dc.22851] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Accepted: 01/29/2012] [Indexed: 12/29/2022]
Affiliation(s)
- Eric Harp
- Department of Pathology; College Station Medical Center; Bryan; Texas
| | - Nancy P. Caraway
- Department of Pathology; The University of Texas MD Anderson Cancer Center; Houston; Texas
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Abstract
Malignant granular cell tumor is a rare neural tumor characterized by abundant granular-appearing tumor cells. These tumors account for <2% of all granular cell tumors. Unlike its benign counterpart, a malignant granular cell tumor presents primarily in the lower limb and is notably larger. Both the uncommon occurrence of malignant granular cell tumors and its similarities in feature with their benign counterparts make diagnosis of this particular malignancy difficult. By 1998, Fanburg-Smith et al developed a diagnostic criteria in which granular cell tumors were divided into 3 categories-benign, atypical, and malignant-based on 6 histological characteristics of the tumor: necrosis, spindling, vesicular nuclei with large nucleoli, increased mitotic activity, high nuclear-to-cytoplasmic ratio, and pleomorphism. This article presents a case of a large malignant granular cell tumor in the right thigh of a 69-year-old woman. Gross examination of the mass showed the well-demarcated, tan, white tumor measuring 18.2 cm long and 7.6 cm wide at its largest width. Histological examination of the mass, performed by an oncological pathologist, demonstrated foci of tumor necrosis, scattered apoptotic cells, prominent nucleoli, increased nuclear-to-cytoplasmic ratio, increased mitotic activity, and areas of spindling with significant atypia. To our knowledge, this is the largest reported case of malignant granular cell tumor in the lower limb diagnosed using the histological criteria established by Fanburg-Smith et al. This case stresses the importance of thorough evaluation in instances of atypical granular cell tumor presentations.
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Affiliation(s)
- John S Hwang
- Department of Orthopedic Surgery, Division of Musculosketal Oncology, New Jersey Medical School, Newark, NJ 07103, USA
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16
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Cimino-Mathews A, Illei PB, Ali SZ. Atypical granular cell tumor of the thyroid: Cytomorphologic features on fine needle aspiration. Diagn Cytopathol 2010; 39:608-11. [DOI: 10.1002/dc.21509] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 07/03/2010] [Indexed: 11/08/2022]
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Arai E, Nishida Y, Tsukushi S, Sugiura H, Ishiguro N. Intramuscular granular cell tumor in the lower extremities. Clin Orthop Relat Res 2010; 468:1384-9. [PMID: 19760336 PMCID: PMC2853648 DOI: 10.1007/s11999-009-1085-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2009] [Accepted: 08/27/2009] [Indexed: 01/31/2023]
Abstract
UNLABELLED Granular cell tumors are uncommon but typically histologically benign neoplasms that occasionally behave as malignant tumors. Differentiation of benign granular cell tumors from malignant counterparts with radiographic and/or histologic analysis is crucial for physicians. We retrospectively studied five cases of intramuscular granular cell tumors arising in the lower extremities. All tumors had been histologically diagnosed as benign and were resected with a wide surgical margin. The minimum followup was 1 year (mean, 45 months; range, 12-119 months) after surgery. Four patients had no local recurrence or distant metastasis (at a minimum of 18 months followup), whereas one patient with lymph node metastasis had a recurrence and distant metastasis 3 months after surgery resulting in death. Intramuscular granular cell tumors can be diagnosed based on their characteristic MRI features, such as peripheral high intensity on T2-weighed images, and histologic evaluation. The histologic criteria described by Fanburg-Smith et al. can differentiate malignant granular cell tumors from benign tumors. A wide resection seems suitable for most granular cell tumors in the extremities. LEVEL OF EVIDENCE Level IV, diagnostic study. See the Guidelines for Authors for a complete description of evidence.
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Affiliation(s)
- Eisuke Arai
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550 Japan
| | - Yoshihiro Nishida
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550 Japan
| | - Satoshi Tsukushi
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550 Japan
| | - Hideshi Sugiura
- Department of Orthopaedic Surgery, Aichi Cancer Center Central Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi Japan
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, Nagoya, Aichi 466-8550 Japan
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Fitzhugh VA, Maniar KP, Gurudutt VV, Rivera M, Chen H, Wu M. Fine-needle aspiration biopsy of granular cell tumor of the tongue: A technique for the aspiration of oral lesions. Diagn Cytopathol 2009; 37:839-42. [DOI: 10.1002/dc.21112] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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20
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John BK, Dang NC, Hussain SA, Yang GCH, Cham MD, Yantiss R, Joseph AS, Giashuddin SM, Lee PC, Fleming R, Somnay K. Multifocal granular cell tumor presenting as an esophageal stricture. J Gastrointest Cancer 2009; 39:107-13. [PMID: 19340612 DOI: 10.1007/s12029-009-9056-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 03/18/2009] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Granular cell tumors are uncommonly found in the gastrointestinal tract with slow progression and are usually benign though they may have propensity for malignant transformation. Initially attributed to neuronal origin through immunohistochemistry, there has been controversy with increasing reports of granular cell tumors of non-neural origin. CASE REPORT We report a case of multifocal granular cell tumor involving the esophagus and stomach in a young female with history of dysphagia for 9 years with worsening symptoms. She had been managed at another facility with repeated dilations for presumed benign peptic stricture. Radial endosonography (EUS) of the proximal end of stricture showed a posterior submucosal esophageal mass that was heterogeneous and invaded into the muscularis propria. Fine-needle aspiration (FNA) showed large cells with granular cytoplasm along with spindle nuclei. Cells were initially checked for CD117 stain alone and found to be negative. A follow-up CT-guided core needle biopsy revealed similar granular cells that were positive for S-100. She underwent a two-stage transhiatal esophagogastrectomy as the tumor circumferentially involved the cervical esophagus and was adherent to the trachea and recurrent laryngeal nerve bilaterally. At surgery, there were two additional foci palpable in the proximal stomach. DISCUSSION AND CONCLUSION As these tumors may have potential for malignant transformation and locoregional invasion, they should be considered while evaluating submucosal lesions of the esophagus even in young patients. A large number of granular cell tumors may be missed in the absence of S-100 staining, which should be requested when granular cells are seen on cytology obtained by EUS FNA as this can be a minimally invasive diagnostic modality for these tumors. Other foci should be sought at surgery as they have a propensity for locoregional spread.
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Affiliation(s)
- Bijo K John
- Department of Medicine, New York Hospital Queens and Weill Cornell Medical College, New York, NY, USA.
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Sidwell RU, Rouse P, Owen RA, Green JSA. Granular cell tumor of the scrotum in a child with Noonan syndrome. Pediatr Dermatol 2008; 25:341-3. [PMID: 18577039 DOI: 10.1111/j.1525-1470.2008.00678.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Granular cell tumor is a rare neoplasm thought to be of neural origin, composed of cells with distinctive granular cytoplasm. Granular cell tumors most often arise on the tongue, but can occur at any body site, and therefore initial presentation to dermatologists is common. We report a granular cell tumor of the scrotum in a child with Noonan syndrome, known to have a mutation in the PTPN11 gene. No previous reports of granular cell tumor of the scrotum in a child are found. The tumor is usually benign; however, it can have a high local recurrence rate (variable between 2% and 50% dependent on whether initial excision is complete and on the occurrence of an infiltrative growth pattern) and therefore long-term follow-up is necessary. This case highlights the occurrence of granular cell tumor, a diagnosis not to be missed by the dermatologist. In addition, we postulate the possible role of PTPN11 mutations in the development of granular cell tumor.
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Affiliation(s)
- Rachel U Sidwell
- Department of Dermatology, Chelsea and Westminster Hospital, London, UK
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Policarpio-Nicolas MLC, Le BH, Mandell JW, Lopes MBS. Granular cell tumor of the neurohypophysis: report of a case with intraoperative cytologic diagnosis. Diagn Cytopathol 2008; 36:58-63. [PMID: 18064694 DOI: 10.1002/dc.20646] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Cytological techniques including touch and smear preparations are very useful diagnostic modality in the evaluation of central nervous system (CNS) lesions and, in many instances, may be effectively used as the sole modality of tissue preparation for intraoperative consultation. Cytologic preparations offer many advantages over frozen sections for CNS specimens. These include selective examination of multiple areas from small biopsy specimens, superior preservation and details of cellular morphology, fewer artifacts, faster results, and improved cost-effectiveness. We describe the cytologic diagnosis of a granular cell tumor (GCT) of the neurohypophysis in a 33-year-old male who presented with headache and blurred vision. CT scan revealed an enlarged sella with a 2.15 x 2.0 cm pituitary lesion. Transsphenoidal resection of the mass was performed and submitted for intraoperative consultation. Smears and touch preparations were made on a portion of the mass that showed uniform polygonal cells with round to ovoid nuclei and abundant eosinophilic granular cytoplasm. An intraoperative cytological diagnosis of "favor GCT" was rendered. The histologic sections of the remaining material confirmed the diagnosis. Although GCT of the neurohypophysis is very rare, a specific intraoperative cytological diagnosis is possible. We report the clinical, cytological, and pathological findings of a GCT affecting the neurohypophysis.
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Affiliation(s)
- Maria Luisa C Policarpio-Nicolas
- Department of Pathology, Division of Cytopathology, University of Virginia Health System, Charlottesville, Virginia 22908-0214, USA
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Thacker MM, Humble SD, Mounasamy V, Temple HT, Scully SP. Case report. Granular cell tumors of extremities: comparison of benign and malignant variants. Clin Orthop Relat Res 2007; 455:267-73. [PMID: 16936589 DOI: 10.1097/01.blo.0000238786.06231.17] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Granular cell tumors are uncommon soft tissue neoplasms that arise from cells of neural origin. We present three patients with this rare tumor: one with a benign tumor, one with a malignant tumor, and one with a histologically benign tumor that later metastasized to the lung. We studied the difficulty in differentiating between the benign and malignant variants using only histology. We also compared the clinical, radiographic, and pathologic features and the criteria for malignancy, natural history, and prognosis.
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Affiliation(s)
- Mihir M Thacker
- Department of Orthopaedic Surgery, Alfred I duPont Hospital for Children, Wilmington, DE, USA
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25
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Bean SM, Eloubeidi MA, Eltoum IA, Cerfolio RJ, Jhala DN. Preoperative diagnosis of a mediastinal granular cell tumor by EUS-FNA: a case report and review of the literature. Cytojournal 2005; 2:8. [PMID: 15943858 PMCID: PMC1184093 DOI: 10.1186/1742-6413-2-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Accepted: 06/08/2005] [Indexed: 11/10/2022] Open
Abstract
We report the first case of a posterior mediastinal granular cell tumor initially diagnosed on cytologic material obtained via endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in a 51-year-old male with a prior history of colon cancer. Aspirates obtained were cellular and composed of polygonal cells with abundant granular cytoplasm and small, round dark nuclei. An immunoperoxidase stain performed on the cell block for antibodies to S-100 protein showed strong, diffuse staining of the cytoplasmic granules. Electron microscopy performed on the cell block revealed numerous cytoplasmic lysosomes. This is the first case report in the English literature of a definitive preoperative diagnosis of a mediastinal granular cell tumor utilizing material obtained via EUS-FNA.
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Affiliation(s)
- Sarah M Bean
- Department of Pathology, Division of Anatomic Pathology, the Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mohamad A Eloubeidi
- Department of Pathology, Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Isam A Eltoum
- Department of Pathology, Division of Anatomic Pathology, the Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robert J Cerfolio
- Department of Cardiothoracic Surgery at the University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Darshana N Jhala
- Department of Pathology, Division of Anatomic Pathology, the Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Loo CK, Santos LD, Killingsworth MC. Malignant oesophageal granular cell tumour: a case report. Pathology 2004; 36:506-8. [PMID: 15370125 DOI: 10.1080/00313020412331282744] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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27
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Yoshizawa A, Ota H, Sakaguchi N, Kanai S, Nakayama J, Matsuzawa K, Tsuzuki S, Takada R, Miyazawa F, Kasahara H, Katsuyama T. Malignant granular cell tumor of the esophagus. Virchows Arch 2004; 444:304-6. [PMID: 14745554 DOI: 10.1007/s00428-003-0957-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2003] [Accepted: 11/28/2003] [Indexed: 11/25/2022]
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28
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Buratti S, Savides TJ, Newbury RO, Dohil R. Granular cell tumor of the esophagus: report of a pediatric case and literature review. J Pediatr Gastroenterol Nutr 2004; 38:97-101. [PMID: 14676603 DOI: 10.1097/00005176-200401000-00021] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Silvia Buratti
- Division of Pediatric Gastroenterology and Nutrition, University of California, San Diego, and Children's Hospital San Diego, USA
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Domanski HA. Cytologic features of angioleiomyoma: cytologic-histologic study of 10 cases. Diagn Cytopathol 2002; 27:161-6. [PMID: 12203864 DOI: 10.1002/dc.10163] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Fine-needle aspiration (FNA) features in 10 angioleiomyomas (ALM) were evaluated and correlated to histological features and clinical data. The tumors developed in the skin or subcutaneous tissue of the lower extremities (eight), the shoulder (one), and the lower arm (one). Eight tumors were painful or tender. Cytological specimens showed moderate or sparse cellularity. The most frequent findings were uniform spindle cells, seen in nine smears. In eight of these, the spindle cells were admixed with smooth muscle cells and fragments of collagenous tissue in varying proportions. The occurrence of macrophages and fat cells was less specific, being present in three of nine smears. One aspirate contained some "ganglion-like" cells and a multinucleated giant cell. Smears from ALM are not sufficiently characteristic to permit a histotype diagnosis, but together with typical clinical data (painful or tender nodule) may help to exclude other skin or subcutaneous lesions.
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Affiliation(s)
- Henryk A Domanski
- Department of Pathology and Cytology, Lunds University Hospital, Lund, Sweden.
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