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Shaheen M, Wilkins BJ, Shenoy A, Byrnes K, Zhang XT, González IA. Gastrointestinal Tract Granular Cell Tumor in the Pediatric Population: A Multicenter Experience. Pediatr Dev Pathol 2024; 27:211-217. [PMID: 38179814 DOI: 10.1177/10935266231220472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
BACKGROUND Pediatric granular cell tumors (GCT) involving the gastrointestinal tract (GIT) are rare with limited case report/series reported to date. METHODS Multicenter retrospective study of pediatric GIT GCT. RESULTS A total of 10 cases were included in the study with a median age of 13.5 years (range: 7-18 years) and were predominantly female patients (60%). In half of the patients no significant medical history was present with the remaining 5 having Crohn disease (10%), eosinophilic esophagitis (EoE) (10%), Crohn disease and EoE (10%), growth hormone deficiency (10%), and aplasia cutis congenita (10%). The GCT median size was 1.3 cm (range: 1-1.6 cm) and were more commonly located in the esophagus (70%) followed by the stomach (20%) and rectum (10%). Most of the cases showed round/polygonal tumor cells with abundant granular cytoplasm, and none of the cases had nuclear atypia, increased mitotic activity, or tumor cell necrosis. None of our cases received specific therapy for GCT other than clinical follow-up, and none of the patients had evidence of local recurrence or metastatic disease. CONCLUSION We present our multicenter experience with GIT GCT, all cases had a benign course. Interestingly, 4 of the esophageal GCT cases (including 2 patients with EoE) showed an eosinophil-rich esophagitis in the underlying mucosa.
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Affiliation(s)
- Muhammad Shaheen
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Benjamin J Wilkins
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Archana Shenoy
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH, USA
| | - Kathleen Byrnes
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Xiaoyi Tina Zhang
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Iván A González
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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2
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Chaudhary A, Raza SS, Haque R. Transcriptional factors targeting in cancer stem cells for tumor modulation. Semin Cancer Biol 2023; 88:123-137. [PMID: 36603792 DOI: 10.1016/j.semcancer.2022.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023]
Abstract
Cancer Stem Cells (CSCs) are now considered the primary "seeds" for the onset, development, metastasis, and recurrence of tumors. Despite therapeutic breakthroughs, cancer remains the leading cause of death worldwide. This is because the tumor microenvironment contains a key population of cells known as CSCs, which promote tumor aggression. CSCs are self-renewing cells that aid tumor recurrence by promoting tumor growth and persisting in patients after many traditional cancer treatments. According to reports, numerous transcription factors (TF) play a key role in maintaining CSC pluripotency and its self-renewal property. The understanding of the functions, structures, and interactional dynamics of these transcription factors with DNA has modified the hypothesis, paving the way for novel transcription factor-targeted therapies. These TFs, which are crucial and are required by cancer cells, play a vital function in the etiology of human cancer. Such CSC TFs will help with gene expression profiling, which provides crucial data for predicting the prognosis of patients. To overcome anti-cancer medication resistance and completely eradicate cancer, a potent therapy combining TFs-based CSC targets with traditional chemotherapy may be developed. In order to develop therapies that could eliminate CSCs, we here concentrated on the effect of TFs and other components of signalling pathways on cancer stemness.
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Affiliation(s)
- Archana Chaudhary
- Department of Biotechnology, School of Earth Biological and Environmental Sciences, Central University of South Bihar, Gaya, Bihar, India
| | - Syed Shadab Raza
- Laboratory for Stem Cell & Restorative Neurology, Era's Lucknow Medical College and Hospital, Era University, Lucknow, India
| | - Rizwanul Haque
- Department of Biotechnology, School of Earth Biological and Environmental Sciences, Central University of South Bihar, Gaya, Bihar, India.
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3
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Fok KY, P’Ng CH, Mahajan H, Gosselink MP, El-Khoury T. Multiple caecal granular cell tumours-a case report. J Surg Case Rep 2021; 2021:rjab396. [PMID: 34567515 PMCID: PMC8458031 DOI: 10.1093/jscr/rjab396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/13/2021] [Accepted: 08/16/2021] [Indexed: 11/17/2022] Open
Abstract
Granular cell tumours (GCTs) are generally benign neoplasms, which are believed to be of neural origin. They are uncommon in the gastrointestinal tract. They are rarely found in the colon and even more rarely found to be multiple. We present a case of a man who underwent a right hemicolectomy for a submucosal lesion and polyps and was found to have multiple nodules diagnosed as caecal GCTs with cellular atypia. While uncommon, this case shows it remains an important differential due to implications for patient management, given the often benign nature of disease.
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Affiliation(s)
- Kar Yin Fok
- Correspondence address. Tel: +61-410-323-653; E-mail:
| | - Chow Heok P’Ng
- Department of Pathology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Hema Mahajan
- Department of Pathology, Westmead Hospital, Westmead, New South Wales, Australia
| | | | - Toufic El-Khoury
- Department of Colorectal Surgery, Westmead Hospital, Westmead, New South Wales, Australia
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4
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Sivasubramaniam P, Tiegs-Heiden CA, Sturgis CD, Hagen CE, Hartley CP, Thangaiah JJ. Malignant gastrointestinal neuroectodermal tumor: Cytologic, histologic, immunohistochemical, and molecular pitfalls. Ann Diagn Pathol 2021; 55:151813. [PMID: 34509898 DOI: 10.1016/j.anndiagpath.2021.151813] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 12/28/2022]
Abstract
Malignant gastrointestinal neuroectodermal tumor (GNET) is a rare malignant primary gastrointestinal mesenchymal tumor which can be diagnosed via fine-needle aspiration (FNA) cytology. In the context of FNA, the diagnosis requires a cell block and the use of significant resources including immunohistochemical stains and molecular testing. The differential diagnosis of GNET includes clear cell sarcoma (CCS), gastrointestinal stromal tumor (GIST), gastric schwannoma, metastatic melanoma, malignant perivascular epithelioid cell tumor (PEComa) and granular cell tumor, among others. Here we describe a case which was initially diagnosed as malignant granular cell tumor by FNA which was later revised to GNET following the finding of an EWSR1-ATF1 fusion gene rearrangement.
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Affiliation(s)
| | | | - Charles D Sturgis
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Catherine E Hagen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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5
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Reddi D, Chandler C, Cardona D, Schild M, Westerhoff M, McMullen E, Tomizawa Y, Clinton L, Swanson PE. Esophageal granular cell tumor and eosinophils: a multicenter experience. Diagn Pathol 2021; 16:49. [PMID: 34103065 PMCID: PMC8185915 DOI: 10.1186/s13000-021-01113-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/28/2021] [Indexed: 01/07/2023] Open
Abstract
Background Esophageal granular cell tumor (eGCT) is rare, and the recent literature suggests a link between eosinophilic esophagitis (EoE) and eGCT. The aim of our study was to determine if EoE or other disorders associated with eosinophilia are consistently associated with eGCT. Methods We retrospectively searched pathology databases of three academic institutions from 1999 to 2018 for eGCTs. The archived slides and medical records were reviewed. Results From 294,855 esophagogastroduodenoscopy procedures, 45 patients (17 males and 28 females) with eGCTs were identified. The patients (30–73 years in age, median 50) had eGCT 0.2–2.0 cm in size (average 0.71). Thirteen had a history of gastroesophageal reflux disease, 5 had Barrett esophagus/goblet cell metaplasia and 1 had EoE. Thirty-four eGCTs had intralesional eosinophils (14 with peak > 10 eosinophils/400x hpf); of these, 21 also had eosinophils in lamina propria (9 with peak > 10 eosinophils/hpf). eGCT with atypical features (including nuclear enlargement and prominent nucleoli) were more likely to have increased eosinophils in non-epithelial compartments than those without atypia. Pleomorphism and spindled cells were seen in 3 eGCT cases (mean peak intralesional eosinophils: 43 per hpf); 2 of these had goblet cell metaplasia. We found no association between EoE and eGCT, p = 0.5966, (95% C.I. 0.0276, 6.5389, Fisher’s exact test). Instead, most patients had gastroesophageal reflux disease or Barrett esophagus. Conclusion Eosinophilia, common in eGCT and adjacent stroma, likely drives atypical/reactive histologic features, but a pathogenic relationship between eosinophil rich inflammatory conditions and eGCT has not yet been established.
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Affiliation(s)
- Deepti Reddi
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Box 356100, 1959 NE Pacific St, Seattle, WA, 98195, USA.
| | - Christropher Chandler
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Box 356100, 1959 NE Pacific St, Seattle, WA, 98195, USA
| | - Diana Cardona
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Michael Schild
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Maria Westerhoff
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109-2800, USA
| | - Emily McMullen
- Department of Pathology, University of Michigan, Ann Arbor, MI, 48109-2800, USA
| | - Yutaka Tomizawa
- Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, WA, 98195-6420, USA
| | - Lani Clinton
- Department of Pathology, Duke University Medical Center, Durham, NC, 27710, USA
| | - Paul E Swanson
- Department of Laboratory Medicine and Pathology, University of Washington Medical Center, Box 356100, 1959 NE Pacific St, Seattle, WA, 98195, USA.,Department of Medicine, Division of Gastroenterology, University of Washington, Seattle, WA, 98195-6420, USA
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6
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Taban SM, Barna RA, Dema ALC, Ratiu IM, Popa O, Plopeanu AD. Unexpected diagnosis for a gastric polyp: Granular cell tumor: Case report and review of the literature. Exp Ther Med 2021; 21:536. [PMID: 33815609 PMCID: PMC8014985 DOI: 10.3892/etm.2021.9968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/03/2021] [Indexed: 11/30/2022] Open
Abstract
A granular cell tumor (GCT) is a rare neoplasia that originates from Schwann cells. It usually appears in the skin or soft tissues, but it may occur anywhere in the body. The gastrointestinal tract is an unusual developmental site for a GCT, the esophagus being the most common site of origin for this tumor. The stomach is one of the most unique sites of origin for GCT, with less than 80 cases being mentioned in the literature. Histologically, GCTs consist of fusiform and polygonal cells, with granular cytoplasm, arranged in compact ‘nests’. Immunohistochemically, these tumors show positivity for S100 protein, CD68, CD56 and, in a smaller percentage, they are positive for other antibodies, most notably inhibin alpha. We report the case of a 52-year-old woman with a solitary GCT that had developed in the gastric cardia, discovered on a routine gastroscopy and successfully treated by endoscopic submucosal dissection.
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Affiliation(s)
- Sorina Maria Taban
- Department of Microscopic Morphology-Morphopathology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Robert Alexandru Barna
- Department of Internal Medicine II, Discipline of Gastroenterology and Hepatology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania.,Anatomic Pathology Service, 'Pius Brînzeu' County Emergency Clinical Hospital, 300723 Timisoara, Romania
| | - Alis Liliana Carmen Dema
- Department of Microscopic Morphology-Morphopathology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Iulia Maria Ratiu
- Department of Internal Medicine II, Discipline of Gastroenterology and Hepatology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Oana Popa
- Department of Microscopic Morphology-Morphopathology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania.,Endocrinology Clinic, 'Pius Brînzeu' County Emergency Clinical Hospital, 300723 Timisoara, Romania
| | - Andrei Dorel Plopeanu
- Anatomic Pathology Service, 'Pius Brînzeu' County Emergency Clinical Hospital, 300723 Timisoara, Romania
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Granular Data: A Rare Submucosal Tumor of the Colon-Case Report and Review of the Literature. Dig Dis Sci 2021; 66:714-722. [PMID: 33433808 DOI: 10.1007/s10620-020-06753-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2020] [Indexed: 12/09/2022]
Abstract
INTRODUCTION Granular cellular tumors are unusual lesions that can occur in the gastrointestinal tract, where they localize most commonly to the esophagus followed by the colon. AREAS COVERED We report a case of a young man with a sub-epithelial lesion of the ascending colon, removed by endoscopic submucosal dissection. Histological examination revealed a granular cellular tumor without features of malignancy. We present a systematic review of the English literature evaluating granular cellular tumors of lower gastrointestinal tract. EXPERT COMMENTARY These tumors are usually asymptomatic and discovered incidentally during endoscopy performed for other reasons. Though their histological behavior is usually benign, 1-2% are malignant. Therefore, it is important that these lesions are excised and adequately pathologically characterized.
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8
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Mobarki M, Dumollard JM, Dal Col P, Camy F, Peoc'h M, Karpathiou G. Granular cell tumor a study of 42 cases and systemic review of the literature. Pathol Res Pract 2020; 216:152865. [PMID: 32089415 DOI: 10.1016/j.prp.2020.152865] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/30/2020] [Accepted: 02/10/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Granular cell tumor (GCT) remains a diagnostic clinicopathologic problem because the exact frequency of its detailed morphological and clinical characteristics is unknown as most observations are collected from small series or isolated cases. Herein, our aim is to highlight the frequency of all clinicopathological characteristics of this rare tumor based in our series and the available medical (PubMed) literature. MATERIAL AND METHODS 42 cases were evaluated for: tissue layers involved by the tumor (in skin and mucosae), growth pattern, nuclear pleomorphism, mitotic index, necrosis, spindling, calcification, hyalinization, and pustule-ovoid bodies of Milian, as well as perineural and vascular invasion, and the presence of adjacent epithelium changes, and lymphocytes and eosinophils infiltration., Follow-up was analyzed. The tumors were subclassified into benign, atypical and malignant according to Fanburg-Smith criteria and into benign or GCT of uncertain malignant potential according to Nasser criteria. The same characteristics were analyzed for 1499 cases reviewed according to PRISMA guidelines. RESULTS In the current series, the mean age at diagnosis was 45.8 years (range 6-69 years). Most patients were females (60 %) and the involved organs were by descending frequency: skin and subcutaneous tissue, bronchus, esophagus, breast, tongue, larynx, pharynx, gingiva, trachea, right colon, vulva, and hypopharynx. No recurrence or progression was seen, despite 32 cases were incompletely excised, with the exception of one malignant tumor. The growth pattern was either infiltrative (85.71 %) or well limited (7.14 %). Sixteen tumors had vesicular nuclei. Mitotic activity was found in two tumors. Lymphocytic infiltration was found in 14 tumors. Eosinophils were present in 6 cases. One GCT of the right colon showed extensive calcification and hyalinization. Perineural invasion was noted in 6 lesions. No vascular invasion was found. One tumor was clinically malignant and the patient died 2 years after diagnosis. Medical literature review showed similar results in terms of frequency of the reported clinical and morphological features. Among cases with available follow up, almost 20 % showed positive margins and of those 20 % developed local recurrence. According to the Fanburg-Smith criteria, 72 % would be benign, 17 % atypical and 11 % malignant tumors, while according to those of Nasser, 93 % would be benign and 7% of uncertain malignant potential. However, true malignancy, as affirmed by metastasis of GCT is found in almost 2.5 % of the cases. CONCLUSION GCT is a usually benign tumor, affecting any anatomic location. Necrosis and mitotic activity seem to be the most effective histologic criteria for detecting aggressive tumors, but the presence of metastasis (2.5 % of the cases) remains the most accepted definitive criterion for diagnosis of malignant GCT.
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Affiliation(s)
- Mousa Mobarki
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France; Department of Pathology, Facutly of Medicine, Jazan University, Jazan, Saudi Arabia.
| | - Jean Marc Dumollard
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
| | - Pierre Dal Col
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
| | - Florian Camy
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
| | - Michel Peoc'h
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
| | - Georgia Karpathiou
- Department of Pathology, North Hospital, University Hospital of St-Etienne, France
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A Rare Granular Cell Tumor with a Center Ulcer of the Rectum. Case Rep Gastrointest Med 2020; 2020:8563718. [PMID: 32395357 PMCID: PMC7201473 DOI: 10.1155/2020/8563718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 12/11/2019] [Indexed: 11/18/2022] Open
Abstract
We report a very rare case of granular cell tumor with a center ulcer of the rectum, which was detected in a 47-year-old man during screening colonoscopy. It is difficult to distinguish granular cell tumor from other subepithelial tumors. However, our case had a center ulcer unlike previous cases. We confirmed the diagnosis using histological and immunohistochemical examinations. In addition to our case report, we discuss the morphology, size, layer of invasion, and treatment of rectal granular cell tumors based on a literature review.
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Evaluation and Management of Premalignant Conditions of the Esophagus: A Systematic Survey of International Guidelines. J Clin Gastroenterol 2019; 53:627-634. [PMID: 31403982 DOI: 10.1097/mcg.0000000000001247] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Esophageal cancer represents one of the most lethal forms of malignancy. The growing incidence of esophageal adenocarcinoma represents an emerging public health concern. This review article summarizes current diagnostic, management, and therapeutic practices of premalignant conditions of the esophagus including Barrett's esophagus, tylosis, granular cell tumors, achalasia, and the ingestion of caustic substances. Our report provides clinicians and academics with a global clinical perspective regarding presentation, surveillance guidelines, and therapeutic management of these esophageal conditions.
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Sharma NR, Linke CS, Zelt C. Endoscopic Mucosal Resection of Granular Cell Tumors in the Esophagus: a Study of Four Cases and Brief Literature Review. J Gastrointest Cancer 2019; 49:532-537. [PMID: 28477072 DOI: 10.1007/s12029-017-9947-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Neil R Sharma
- Parkview Cancer Institute, Advanced Interventional Endoscopy & Endoscopic Oncology, GI Oncology Program, 11104 Parkview Circle, Suite 310, Fort Wayne, IN, 46845, USA
| | - Colin S Linke
- Loyola University Medical Center, 2160 S 1st Ste 3312, Maywood, IL, 60153, USA
| | - Christina Zelt
- Parkview Research Center, 3602 New Vision Drive, Fort Wayne, IN, 46845, USA.
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12
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Knoop RF, Schmidt A, Kayser G, Thimme R, Fischer A. Endoscopic submucosal dissection of an esophageal granular cell tumor. VideoGIE 2019; 4:58-61. [PMID: 30766943 PMCID: PMC6363592 DOI: 10.1016/j.vgie.2018.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Richard F Knoop
- Department of Gastroenterology and Gastrointestinal Oncology, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Arthur Schmidt
- Faculty of Medicine, Department of Medicine II, University Hospital Freiburg, University of Freiburg, Freiburg, Germany
| | - Gian Kayser
- Faculty of Medicine, Institute for Surgical Pathology, University Hospital Freiburg, University of Freiburg, Freiburg, Germany
| | - Robert Thimme
- Faculty of Medicine, Department of Medicine II, University Hospital Freiburg, University of Freiburg, Freiburg, Germany
| | - Andreas Fischer
- Faculty of Medicine, Department of Medicine II, University Hospital Freiburg, University of Freiburg, Freiburg, Germany
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Erinanç H, Göktürk HS, Kanat Ünler G, Karagülle E. Utility of Nestin immunohistochemistry in the diagnosis of granular cell tumor. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2018. [DOI: 10.25000/acem.436429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Chen Y, Chen Y, Chen X, Chen L, Liang W. Colonic granular cell tumor: Report of 11 cases and management with review of the literature. Oncol Lett 2018; 16:1419-1424. [PMID: 30008819 PMCID: PMC6036509 DOI: 10.3892/ol.2018.8811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/24/2018] [Indexed: 01/27/2023] Open
Abstract
Colonic granular cell tumors (GCTs) are rare and benign, but have malignant potential. The recent progress in endoscopic procedures and technology facilitate the diagnosis and treatment of GCTs. The present study described 11 cases of colonic GCTs diagnosed between March 2010 and April 2015, including patient clinical and histopathological features. Patients were generally asymptomatic. The most common symptoms were hematoquezia and abdominal pain. The male/female ratio was 7:4; age range was 40–67 years. Colonoscopy revealed a yellowish or white, solid and well-circumscribed tumor covered by normal mucosa. Endoscopic ultrasonography (EUS) showed a homogenous, or granular-type heterogeneous, hypoechoic solid tumor originating from the submucosal layer (8 cases) or muscularis mucosae (3 cases), with maximum diameters 0.3–3.0 cm. All patients underwent endoscopic submucosal dissection or endoscopic submucosal excavation without complication. All tumors were block removed. The mean operative time was 38 min (range, 31–50 min). Immunohistochemical analysis of all specimens confirmed the diagnosis of GCT by positive staining of S-100 protein. No recurrence or metastasis was observed during follow-up periods of 11 months to 5 years. In conclusion, colonoscopy, EUS and immunohistological examination increase the accuracy of diagnosis of GCTs. Endoscopic management is feasible and safe for GCT treatment.
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Affiliation(s)
- Yahua Chen
- Department of Gastroenterology, Affiliated Hospital of Putian University, and Affiliated Putian Hospital of Southern Medical University, Putian, Fujian 351100, P.R. China
| | - Yangyang Chen
- Department of Gastrointestinal Endoscopy, Fujian Provincial Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Xiaoqiong Chen
- Department of Gastrointestinal Endoscopy, Fujian Provincial Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Liang Chen
- Department of Gastrointestinal Endoscopy, Fujian Provincial Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Wei Liang
- Department of Gastrointestinal Endoscopy, Fujian Provincial Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
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Barakat M, Kar AA, Pourshahid S, Ainechi S, Lee HJ, Othman M, Tadros M. Gastrointestinal and biliary granular cell tumor: diagnosis and management. Ann Gastroenterol 2018; 31:439-447. [PMID: 29991888 PMCID: PMC6033765 DOI: 10.20524/aog.2018.0275] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/26/2018] [Indexed: 12/14/2022] Open
Abstract
Granular cell tumors (GCTs) are generally thought to be of Schwann cell origin and are typically S-100 positive. Up to 11% of these tumors affect the gastrointestinal tract, most commonly the esophagus, colon, and stomach. While GCTs are mostly benign, malignant and metastatic GCTs have been reported. GCTs are usually found incidentally during esophagogastroduodenoscopy, colonoscopy, imaging studies or during the evaluation of non-specific symptoms. Endoscopically, they are typically yellow in appearance with intact mucosa. On endoscopic ultrasound, they usually are hypoechoic, homogenous, smooth-edged lesions that appear to originate from the submucosal layer, although other endoscopic and ultrasound appearances have been described. There is no consensus on how to treat GCT. Surgical and conservative approaches have been described in the literature. GCTs can also affect the biliary tract, where patients may be misdiagnosed with cholangiocarcinoma. We explore the epidemiology, histology, clinical presentation, diagnosis and treatment of these tumors in the gastrointestinal tract, including the pharynx, esophagus, stomach, small intestine, large intestine and the perianal region. In addition, GCTs in the biliary tract are reviewed.
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Affiliation(s)
- Mohamed Barakat
- Department of Internal Medicine, Icahn School of Medicine - Queens Hospital Center, NY (Mohamed Barakat)
| | - Abdullah Abu Kar
- Department of Internal Medicine, Albany Medical Center, Albany, NY (Abdullah Abu Kar)
| | - Seyedmohammad Pourshahid
- Department of Internal Medicine, Icahn School of Medicine - Queens Hospital Center, NY (Seyedmohammad Pourshahid)
| | - Sanaz Ainechi
- Department of Pathology, Albany Medical Center, Albany, NY (Sanaz Ainechi, Hwa Jeong Lee)
| | - Hwa Jeong Lee
- Department of Pathology, Albany Medical Center, Albany, NY (Sanaz Ainechi, Hwa Jeong Lee)
| | - Mohamed Othman
- Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine, Houston, TX (Mohamed Othman)
| | - Micheal Tadros
- Department of Internal Medicine, Division of Gastroenterology, Albany Medical Center, Albany, NY (Micheal Tadros), USA
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16
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Gapp J, Gross J, Chintalacheruvu L, Reddymasu S. Coexisting Granular Cell Tumor and Tubular Adenoma of the Ileocecal Valve. Case Rep Gastroenterol 2018. [PMID: 29515339 PMCID: PMC5836207 DOI: 10.1159/000479496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Granular cell tumors (GCTs) have been described as neoplasms of Schwann cell origin. They are often benign and notably uncommon in the gastrointestinal tract. Recently, their incidence has become more common, likely as a result of increased colonoscopy screenings. Very few data exist regarding their potential for malignancy, but malignant GCTs have been reported. Here, we report the case of a young female patient who was diagnosed with an atypical GCT on the ileocecal valve with an overlying tubular adenoma which was found incidentally on colonoscopy. This represents the first known report of a GCT with atypical features on the ileocecal valve, as well as a rare case of overlying adenomatous changes. Due to the paucity of cases, there is no clear modus operandi for their management. Furthermore, it is not clear whether surgical or endoscopic interventions or simple observation may be most appropriate. Further studies are needed to evaluate the potential for malignancy of this tumor, as well as its management.
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Affiliation(s)
- Jonathan Gapp
- Creighton University Medical Center, Omaha, Nebraska, USA
| | - John Gross
- Creighton University Medical Center, Omaha, Nebraska, USA
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Mistrangelo M, Cassoni P, Scozzari G, Castellano I, Gavello G, Corno F, Morino M. Perianal Granular Cell Tumor: Report of a Case and Review of the Literature. TUMORI JOURNAL 2018; 95:538-41. [DOI: 10.1177/030089160909500424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Granular cell tumor was first described by Abrikossoff in 1926. Over the years several cases of this neoplasm have been reported, with a variety of localizations. We here report a case of perianal granular cell tumor and discuss its histogenesis and its relevance to clinical practice. Methods The clinical course and histopathology of the case are reviewed, and a literature search for other reported cases has been performed. Results A 46-year-old woman presented with a perianal nodular lesion. Pathological examination revealed a granular cell tumor. A literature search produced only 25 other cases of anal and perianal granular cell tumors. Conclusions Granular cell tumors are rarely observed in the perianal region. Their existence must always be borne in mind in the differential diagnosis of perianal neoplasms. In most cases surgical excision is curative, but potential malignant transformation must be considered during therapeutic procedures and follow-up.
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Affiliation(s)
| | - Paola Cassoni
- Department of Biomedical Sciences and Human Oncology, University of Turin, Italy
| | - Gitana Scozzari
- Department of Surgery and Center of Minimal Invasive Surgery, University of Turin, Italy
| | - Isabella Castellano
- Department of Biomedical Sciences and Human Oncology, University of Turin, Italy
| | - Giorgia Gavello
- Department of Surgery and Center of Minimal Invasive Surgery, University of Turin, Italy
| | - Franco Corno
- Department of Surgery and Center of Minimal Invasive Surgery, University of Turin, Italy
| | - Mario Morino
- Department of Surgery and Center of Minimal Invasive Surgery, University of Turin, Italy
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18
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Ofori E, Ramai D, Lui YX, Reddy M. Esophageal Granular Cell Tumor: A Case and Review of the Literature. Gastroenterology Res 2018; 10:372-375. [PMID: 29317947 PMCID: PMC5755641 DOI: 10.14740/gr898w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 09/28/2017] [Indexed: 01/15/2023] Open
Abstract
Granular cell tumors (GCTs) are rare and benign tumors that can occur at any anatomical site. GCTs are thought to originate from nerve cells, particularly Schwann cells. Their name derives from the fact that an accumulation of cytoplasmic lysosomes imparts the tumor with a granular appearance. They are most commonly observed in the oral cavity, skin and subcutaneous tissue, breast, and respiratory tract. GCTs rarely affect the gastrointestinal tract. We report a 56-year-old female with a medical history of human immunodeficiency virus, hepatitis C, and cholelithiasis, who presented with abdominal pain. Upper endoscopy revealed a 1 - 2 cm solitary yellowish appearing nodule just distal to the GE junction. Biopsy of the nodule followed by histopathology was positive for S100, but negative for pancytokeratin immunostains. PAS staining highlighted cytoplasmic granules, further supporting the diagnosis of gastrointestinal GCT.
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Affiliation(s)
- Emmanuel Ofori
- Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
| | - Daryl Ramai
- Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.,Department of Anatomical Sciences, St. George's University School of Medicine, True Blue, Grenada, WI
| | - Ying X Lui
- Department of Pathology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
| | - Madhavi Reddy
- Department of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Academic Affiliate of The Icahn School of Medicine at Mount Sinai, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA
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19
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Ramai D, Lai J, Changela K, Anand S. Colonic Granular Cell Tumor: An Endoscopic and Histopathologic Review with Case Illustration. Cureus 2018. [PMID: 29531868 PMCID: PMC5837324 DOI: 10.7759/cureus.2015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Granular cell tumors (GCTs) are rare and benign tumors that can occur at any anatomical site. GCTs are thought to originate from nerve cells, particularly Schwann cells. Their name derives from the fact that an accumulation of cytoplasmic lysosomes imparts the tumor with a granular appearance. They are most commonly observed in the oral cavity, skin and subcutaneous tissue, breast, and respiratory tract. Granular cell tumors rarely affect the gastrointestinal tract. We report a 58-year-old female with a past medical history of hypertension, mitral valve prolapse, and depression who presented for surveillance colonoscopy. A single firm sessile polypoid lesion, with overlying pale tan color mucosa, measuring approximately 1 to 1.5 cm, was found in the ascending colon. Biopsy of the nodule followed by histopathology was positive for S100 and CD68, but negative for AE1/AE3, CD117, smooth muscle actin, and desmin, consistent with the diagnosis of GCT. We review the clinicopathologic features of GCTs.
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Affiliation(s)
- Daryl Ramai
- Division of Gastroenterology and Hepatology, Academic Affiliate of the Icahn School of Medicine, Clinical Affiliate of the Mount Sinai Hospital
| | - Jonathan Lai
- School of Medicine, St. George's University, Grenada, West Indies
| | - Kinesh Changela
- Division of Gastroenterology and Hepatology, Academic Affiliate of the Icahn School of Medicine, Clinical Affiliate of the Mount Sinai Hospital
| | - Sury Anand
- Division of Gastroenterology, NYU Langone Hospital, 150 55th St Brooklyn, Ny, 11220
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20
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Qiao YY, Chu P. Expression of nestin in embryonic tissues and its effects on clinicopathological characteristics of patients with placenta previa. J Cell Biochem 2017; 119:2061-2072. [PMID: 28833496 DOI: 10.1002/jcb.26368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 08/17/2017] [Indexed: 01/19/2023]
Abstract
In this study, we examined expression of nestin in the spinal cord, lung, kidney, stomach, colon, and intestine tissues at different stages of embryos in patients with placenta previa. Fetuses of 75 patients with placenta previa were assigned to case group and 80 fetuses from healthy pregnant women with normal placenta who voluntarily terminated pregnancy to control group. Clinical data of pregnant women were collected at the time of admission. Blood from elbow vein was collected to determine expression of serum nestin. Tissues from spinal cord, lung, kidney, stomach, colon, and intestine in 3-7 months fetuses of the two groups were extracted. Expression of nestin in tissues was detected by immunohistochemistry, Western blotting and RT-qPCR. The mRNA expression of nestin in the case group was increased. Nestin expression was correlated with the gestational age, age of foetus, and type of placenta previa in patients with placenta previa. Positive nestin expression was detected in the spinal cord, lung, kidney, stomach, intestine, and colon tissues in normal and placenta previa embryo at Stage I. The positive cell density and nestin expression decreased at Stage II, and further decreased at Stage III. The case group had higher nestin mRNA and protein levels throughout human fetal development. Findings of this study suggested that, nestin, as a specific marker of neural precursor cells, was expressed in various tissues of the embryo in patients with placenta previa and nestin expression was lower with increased maturation of the embryo.
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Affiliation(s)
- Yan-Yan Qiao
- Department of Obstetrics and Gynecology, School of Clinical Medicine, Jining Medical University, Jining, China
| | - Ping Chu
- Department of Obstetrics and Gynecology, Jining No.1 People's Hospital, Jining, China
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21
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Rajagopal MD, Gochhait D, Shanmugan D, Barwad AW. Granular Cell Tumor of Cecum: A Common Tumor in a Rare Site with Diagnostic Challenge. Rare Tumors 2017; 9:6420. [PMID: 28975016 PMCID: PMC5617916 DOI: 10.4081/rt.2017.6420] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/27/2016] [Accepted: 06/27/2016] [Indexed: 12/26/2022] Open
Abstract
Granular cell tumor (GCT) also known as Abrikossoff's tumor is a benign neoplasm that is usually seen in the fourth to sixth decades of life with slight female preponderance. It is most frequently seen in the oral cavity, skin, and subcutaneous tissue. Gastrointestinal tract involvement is uncommon, in which esophagus is the most commonly affected site. There are case reports of GCT in stomach, appendix, colon and rectum. In this article, we report a case of GCT involving cecum. The cell of origin in GCT is controversial. There are various pools of thoughts regarding its histogenesis, the details of which are reviewed in this article with emphasis on the diagnostic difficulties encountered in this tumor.
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Affiliation(s)
- Meyyappa Devan Rajagopal
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, India
| | - Debasis Gochhait
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, India
| | - Dasarathan Shanmugan
- Departments of Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, India
| | - Adarsh Wamanrao Barwad
- Departments of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, India
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22
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Thumallapally N, Ibrahim U, Kesavan M, Chang Q, Opitz L, Dhar M, Andrawes S. Esophageal Granular Cell Tumor: A Case Report and Review of Literature. Cureus 2016; 8:e782. [PMID: 27752408 PMCID: PMC5065346 DOI: 10.7759/cureus.782] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Granular cell tumors (GCTs) are soft tissue neoplasms that originate from Schwann cells. They occur predominantly in the oral cavity, skin, and breast tissues. Gastrointestinal GCTs are very rare, accounting for only eight percent of all GCTs, most of which are located in the esophagus. Endoscopic ultrasound has been a breakthrough in diagnosing GCTs because it provides precise information on the depth of tumor invasion, thus narrowing the differential diagnosis of subepithelial lesions in the esophagus. However, the definitive diagnosis requires histological confirmation of the lesion. Here, we report a case of esophageal GCT that was identified incidentally and removed by endoscopic mucosal resection.
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Affiliation(s)
| | - Uroosa Ibrahim
- Department of Hematology/Oncology, Staten Island University Hospital
| | | | - Qing Chang
- Department of Pathology, Staten Island University Hospital
| | - Lynne Opitz
- Department of Pathology, Staten Island University Hospital
| | - Meekoo Dhar
- Department of Hematology/Oncology, Staten Island University Hospital
| | - Sherif Andrawes
- Department of Gastroenterology, Staten Island University Hospital
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23
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Abstract
Esophageal granular cell tumor is a rare benign soft tissue tumor with malignant potential, and its histogenesis remains unclear. Since clinical manifestations lack specificity, the diagnosis depends on endoscopy, endoscopic ultrasonography, pathology and immunohistochemistry. Esophageal granular cell tumors have the potential of malignant transformation and are easily confused with leiomyoma and interstitialoma. At present, the treatment of this disease has not yet reached a consensus. This review aims to elucidate the histogenesis, clinical manifestations, diagnosis, treatment and prognosis of esophageal granular cell tumors.
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24
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Machado I, Cruz J, Lavernia J, Llombart-Bosch A. Solitary, multiple, benign, atypical, or malignant: the “Granular Cell Tumor” puzzle. Virchows Arch 2015; 468:527-38. [DOI: 10.1007/s00428-015-1877-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/13/2015] [Accepted: 10/22/2015] [Indexed: 12/23/2022]
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25
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Neradil J, Veselska R. Nestin as a marker of cancer stem cells. Cancer Sci 2015; 106:803-11. [PMID: 25940879 PMCID: PMC4520630 DOI: 10.1111/cas.12691] [Citation(s) in RCA: 180] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/14/2015] [Accepted: 04/27/2015] [Indexed: 12/14/2022] Open
Abstract
The crucial role of cancer stem cells (CSCs) in the pathology of malignant diseases has been extensively studied during the last decade. Nestin, a class VI intermediate filament protein, was originally detected in neural stem cells during development. Its expression has also been reported in different tissues under various pathological conditions. Specifically, nestin has been shown to be expressed in transformed cells of various human malignancies, and a correlation between its expression and the clinical course of some diseases has been proved. Furthermore, the coexpression of nestin with other stem cell markers was described as a CSC phenotype that was subsequently verified using tumorigenicity assays. The primary aim of this review is to summarize the recent findings regarding nestin expression in CSCs, its possible role in CSC phenotypes, particularly with respect to capacity for self-renewal, and its utility as a putative marker of CSCs.
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Affiliation(s)
- Jakub Neradil
- Laboratory of Tumor Biology, Department of Experimental Biology, School of Science, Masaryk University, Brno, Czech Republic.,Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Renata Veselska
- Laboratory of Tumor Biology, Department of Experimental Biology, School of Science, Masaryk University, Brno, Czech Republic.,Department of Pediatric Oncology, University Hospital Brno and School of Medicine, Masaryk University, Brno, Czech Republic
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26
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Hechtman JF, Harpaz N. Neurogenic polyps of the gastrointestinal tract: a clinicopathologic review with emphasis on differential diagnosis and syndromic associations. Arch Pathol Lab Med 2015; 139:133-9. [PMID: 25549149 DOI: 10.5858/arpa.2013-0431-rs] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Primary neurogenic gastrointestinal polyps are encountered relatively frequently in routine pathology practice. They encompass a variety of neoplastic entities with clinical, morphologic, and molecular features that reflect the diversity of neural elements within the gastrointestinal system. Although most are benign and encountered incidentally, accurate diagnosis may have important clinical implications because of the associations of certain neurogenic polyps with familial syndromes or other conditions. We review the pathology of these polyps with an emphasis on the diagnostic challenges that they pose and on newly described subtypes.
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Affiliation(s)
- Jaclyn F Hechtman
- From the Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York (Dr Hechtman); and the Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Harpaz)
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27
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An S, Jang J, Min K, Kim MS, Park H, Park YS, Kim J, Lee JH, Song HJ, Kim KJ, Yu E, Hong SM. Granular cell tumor of the gastrointestinal tract: histologic and immunohistochemical analysis of 98 cases. Hum Pathol 2015; 46:813-9. [PMID: 25882927 DOI: 10.1016/j.humpath.2015.02.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 02/11/2015] [Accepted: 02/13/2015] [Indexed: 12/24/2022]
Abstract
Granular cell tumors (GCTs) are uncommon benign neoplasms in the gastrointestinal (GI) tract, and our current understanding of GCT in GI tract is limited. A total of 98 GCTs were retrieved from 95 patients, and the clinicopathological and immunohistochemical features were compared. The male-to-female ratio was 2.2:1 and with a mean age of 49 years. The mean tumor size was 0.37 cm. Seventy-three esophageal (75%), 21 colorectal (21%), and 4 gastric (4%) GCTs were included. Gastric (mean, 0.75 cm) and colorectal (0.6 cm) GCTs were significantly larger than esophageal tumors (0.27 cm; P<.001). Colonic and gastric GCTs showed a more infiltrative growth pattern (P<.001) and peritumoral lymphoid cuffs (P<.001) than esophageal tumors. Involvement of mucosa, submucosa, and both were noted in 58 cases (59%), 11 cases (11%), and 28 cases (29%), respectively. One GCT from the sigmoid colon (1%) had infiltration to pericolic soft tissue and with lymph node metastasis. High frequency of immunolabeling for S-100 protein (81/81, 100%), CD56 (55/58, 95%), CD68 (58/61, 95%), SOX-10 (54/58, 93%), and inhibin-α (30/58, 52%) were observed. In summary, GCTs in the GI tract were observed with the following frequency: esophagus, colorectum, and stomach. Colorectal and gastric GCTs were larger and had infiltrative growth and more lymphoid cuffs than esophageal GCTs. Although invasive GCT was rare, it could be observed in the GI tract. Inhibin-α expression were more common in colonic GCTs than esophageal tumors. High S-100 protein, CD56, CD68, and SOX-10 expression rates were observed in GCTs from GI tracts.
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Affiliation(s)
- Soyeon An
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea
| | - Jaejung Jang
- Department of Pathology, Anyang Sam Hospital, Anyang, 430-733, Republic of Korea
| | - Kwangseon Min
- Department of Pathology, Anyang Sam Hospital, Anyang, 430-733, Republic of Korea
| | - Min-Sun Kim
- Asan Institute for Life Science, Asan Medical Center, Seoul, 138-736, Republic of Korea
| | - Hosub Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea
| | - Young Soo Park
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea
| | - Jihun Kim
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea
| | - Jeong Hoon Lee
- Department of Pathology, Anyang Sam Hospital, Anyang, 430-733, Republic of Korea
| | - Ho June Song
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea
| | - Kyung-Jo Kim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea
| | - Eunsil Yu
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea
| | - Seung-Mo Hong
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Republic of Korea.
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Abrikossoff cell tumor of the esophagus: case presentation of a rare endoscopic entity and review of literature. J Gastrointest Cancer 2015; 46:87-9. [PMID: 25600695 DOI: 10.1007/s12029-015-9683-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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29
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Tampaki EC, Nakopoulou L, Tampakis A, Kontzoglou K, Weber WP, Kouraklis G. Nestin involvement in tissue injury and cancer--a potential tumor marker? Cell Oncol (Dordr) 2014; 37:305-15. [PMID: 25164879 DOI: 10.1007/s13402-014-0193-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In eukaryotic cells, the cytoskeleton contains three major filamentous components: actin microfilaments, microtubules and intermediate filaments. Nestin represents one of the class VI intermediate filament proteins. Clinical and molecular analyses have revealed substantial information regarding the presence of Nestin in cells with progenitor or stem cell properties. During tissue injury Nestin is expressed in cells with progenitor cell-like properties. These cells may serve as a tissue reserve and, as such, may contribute to tissue repair. Based on currently available data, Nestin also appears to be implicated in two oncogenic processes. First, Nestin has been found to be expressed in cancer stem-like cells and poorly differentiated cancer cells and, as such, Nestin is thought to contribute to the aggressive behavior of these cells. Second, Nestin has been found to be involved in tumor angiogenesis through an interaction of cancer cells and blood vessel endothelial cells and, as such, Nestin is thought to facilitate tumor growth. CONCLUSIONS We conclude that Nestin may serve as a promising tumor marker and as a potential therapeutic target amenable to tumor suppression and angiogenesis inhibition.
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Affiliation(s)
- Ekaterini Christina Tampaki
- 2nd Department of Propedeutic Surgery, Athens University Medical School, Laiko General Hospital, 17 Agiou Thoma Street, 11527, Athens, Greece,
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30
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Na JI, Kim HJ, Jung JJ, Kim Y, Kim SS, Lee JH, Lee KH, Park JT. Granular cell tumours of the colorectum: histopathological and immunohistochemical evaluation of 30 cases. Histopathology 2014; 65:764-74. [DOI: 10.1111/his.12487] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 06/23/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Jong-In Na
- Department of Pathology; Chonnam National University Medical School; Gwangju Korea
| | - Hye-Jeong Kim
- Department of Pathology; Chonnam National University Medical School; Gwangju Korea
| | - Jong-Jae Jung
- Department of Pathology; Chonnam National University Medical School; Gwangju Korea
| | - Young Kim
- Department of Pathology; Chonnam National University Medical School; Gwangju Korea
| | - Sung-Sun Kim
- Department of Pathology; Chonnam National University Medical School; Gwangju Korea
| | - Jae-Hyuk Lee
- Department of Pathology; Chonnam National University Medical School; Gwangju Korea
| | - Kyung-Hwa Lee
- Department of Pathology; Chonnam National University Medical School; Gwangju Korea
| | - Jong-Tae Park
- Department of Forensic Medicine; Chonnam National University Medical School; Gwangju Korea
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31
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ZHANG MING, SUN ZEQUN, ZOU XIAOPING. Esophageal granular cell tumor: Clinical, endoscopic and histological features of 19 cases. Oncol Lett 2014; 8:551-555. [PMID: 25013469 PMCID: PMC4081371 DOI: 10.3892/ol.2014.2152] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 03/06/2014] [Indexed: 12/15/2022] Open
Abstract
Esophageal granular cell tumors (GCTs) are rare and often misdiagnosed. To demonstrate their clinicopathological features, the present study reports 19 cases and reviews the literature. There were 11 female and eight male esophageal GCT patients with a median age of 42.0 years. All the tumors were solitary. The majority of patient indications for endoscopy (89.5%) were non-specific and endoscopic therapy was performed in 17 cases with a relapse in one case after a 12-month follow-up. The endoscopic appearance of esophageal GCT was variable and the majority of tumors (80.0%) were located in the middle and lower esophageal segments. The size of the tumors ranged from 0.4 to 2 cm in diameter and the surface was white-gray, pink or yellow. Nine patients underwent an endoscopic ultrasound exam, eight of which demonstrated hypoechoic echostructures with a smooth margin and intracavity growth features. One case was derived from the muscularis propria layer with an irregular margin and intra- and extra-cavity growth features. The histological features could mimic other tumors and immunohistochemical stains are usually positive for S-100, periodic acid-Schiff, neuron-specific enolase and nestin. Three cases indicated pleomorphism and Ki-67 was locally positive. Esophageal GCTs are rare and endoscopic ultrasound features are variable. Immunohistochemical staining may aid in the diagnosis.
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Affiliation(s)
- MING ZHANG
- Gastroenterology Department, Drum Tower Hospital Affiliated Medical College of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
| | - ZE-QUN SUN
- Gastroenterology Department, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei 442008, P.R. China
| | - XIAO-PING ZOU
- Gastroenterology Department, Drum Tower Hospital Affiliated Medical College of Nanjing University, Nanjing, Jiangsu 210008, P.R. China
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32
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Chamberlain BK, McClain CM, Gonzalez RS, Coffin CM, Cates JM. Alveolar soft part sarcoma and granular cell tumor: an immunohistochemical comparison study. Hum Pathol 2014; 45:1039-44. [DOI: 10.1016/j.humpath.2013.12.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 12/24/2013] [Accepted: 12/27/2013] [Indexed: 11/29/2022]
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33
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Krishnan A, Ramakrishnan R, Menon M. Endoscopic Removal of Granular Cell Tumors of Stomach: Case Report and Review of Literature. Gastroenterology Res 2013; 6:240-243. [PMID: 27785260 PMCID: PMC5051133 DOI: 10.4021/gr588w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2013] [Indexed: 01/23/2023] Open
Abstract
Gastrointestinal granular cell tumors (GCTs), usually benign, soft-tissue tumors, are thought to arise from Schwann cells that may occur at many sites. Only 5-7% of these lesions are detected in the gastrointestinal tract. Histologically, it is composed of sheets or nests of plump round or polygonal cells having abundant slightly amphophilic granular cytoplasm with centrally located uniform pyknotic nuclei and immunohistochemical staining for S-100 protein supports the proposed derivation from Schwann cells. In this study, we reported a case of a solitary GCT of the stomach that was completely removed after endoscopic submuscosal resection.
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Affiliation(s)
| | | | - Maya Menon
- Department of Pathology, Apollo Hospitals, Chennai, India
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Chen WS, Zheng XL, Jin L, Pan XJ, Ye MF. Novel diagnosis and treatment of esophageal granular cell tumor: report of 14 cases and review of the literature. Ann Thorac Surg 2013; 97:296-302. [PMID: 24140217 DOI: 10.1016/j.athoracsur.2013.08.042] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/07/2013] [Accepted: 08/19/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Granular cell tumors (GCT), especially in the esophagus, are rare neoplasms originating from the nervous system. There is still some controversy regarding the diagnosis and treatment of esophageal GCT. METHODS We report 14 cases of esophageal GCT diagnosed and treated from January 2004 to March 2013. Their clinical manifestations, endoscopic image, endoscopic ultrasonography (EUS) appearance, pathology, immunohistochemistry, treatment, and prognosis were reviewed. RESULTS The typical images of EUS were hypoechoic, homogenous, and smooth-edged tumors restricted to deep mucosal and submucosal layers. However, there were 2 cases with tumors invading muscular layer. Endoscopic ultrasonography was valuable to assess the tumor size, location, depth of invasion, and nature. According to EUS manifestation, 11 cases with lesions 3 cm or less in diameter without muscular layer invasion underwent endoscopic resection without complication and the other 3 cases underwent surgical resection. A new technique of submucosal tunnel endoscopic resection was performed in 3 submucosal cases with lesions ranging from 2 cm to 3 cm in diameter. All of these cases were benign and histology was necessary for differential diagnosis. CONCLUSIONS Endoscopic ultrasonography plays an important guiding role in the diagnosis and treatment of esophageal GCT. Submucosal tunnel endoscopic resection is safe and effective. Further study is needed to determine whether this technique can be expanded into other applications.
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Affiliation(s)
- Wen-shu Chen
- Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Xiao-ling Zheng
- Department of Gastrointestinal Endoscopy Center, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Long Jin
- Department of Pathology, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
| | - Xiao-jie Pan
- Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
| | - Ming-fan Ye
- Department of Thoracic Surgery, Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China
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Roesch S, Dejaco M, Hauser-Kronberger C, Rasp G. Congenital granular cell tumor with uncommon clinical behavior. Laryngoscope 2013; 123:2459-62. [PMID: 23917999 DOI: 10.1002/lary.23919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVES/HYPOTHESIS Congenital granular cell tumor (CGCT), also known as congenital epulis, is a rare benign mesenchymal tumor of the oral cavity. We report of a 3 years and 7 months old female patient undergoing surgical excision of an oral tumor. Subsequent histological and immunohistological investigations within the clinical course led to the diagnosis of CGCT. However, clinical findings in this case, such as primary onset and an untypical location within the oral cavity, clearly stand in contrast to those usually found in CGCT, resulting in an exceptional case not previously described in the literature.
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Affiliation(s)
- Sebastian Roesch
- Department of Otorhinolaryngology, Head and Neck Surgery, General Hospital Salzburg, University Hospital of Paracelsus Medical University, Salzburg, Austria
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Cambruzzi E, Pruinelli R, Milani DM, Cruz RP, Cunha O, Clivatti N. Tumor esofágico de células granulares associado à carcinoma epidermoide: relato de caso. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2013; 26:156-8. [DOI: 10.1590/s0102-67202013000200020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Xu GQ, Chen HT, Xu CF, Teng XD. Esophageal granular cell tumors: Report of 9 cases and a literature review. World J Gastroenterol 2012; 18:7118-21. [PMID: 23323018 PMCID: PMC3531704 DOI: 10.3748/wjg.v18.i47.7118] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 10/13/2012] [Accepted: 10/30/2012] [Indexed: 02/06/2023] Open
Abstract
Esophageal granular cell tumors (GCTs) are rare tumors of the esophagus. We evaluated the clinical and pathologic features of 9 esophageal GCT patients (5 men and 4 women) from our institute and reviewed the related disease literature. Patient age ranged from 25 to 53 years (mean: 41 years). All the patients were asymptomatic or presented with non-specific symptoms. Most GCTs occurred in the distal esophagus and were less than 6 mm in diameter. Computational analysis showed that the average gray-scale endoscopic ultrasound images of esophageal GCTs were greater than that of esophageal leiomyomas. Eight patients were treated by endoscopic resection, and 1 patient underwent surgical excision. No post-therapy recurrence or metastasis developed during follow-up (mean: 36.4 mo, range: 1-72 mo).
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A malignant granular cell tumor excised with mohs micrographic surgery. Case Rep Oncol Med 2012; 2012:453569. [PMID: 22606454 PMCID: PMC3350294 DOI: 10.1155/2012/453569] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 11/29/2011] [Indexed: 11/17/2022] Open
Abstract
Malignant granular cell tumors are extremely rare, aggressive neoplasms displaying rapid growth and frequent associated metastatic disease. Excision and evaluation for metastatic disease are mandatory. We present a 54-year-old patient with a malignant granular cell tumor, treated with Mohs micrographic surgery. Cutaneous granular cell tumors are uncommon neoplasms, likely of perineural origin. Most follow a benign and uneventful course, with wide local excision being the treatment of choice (Enzinger, 1988). The malignant granular cell tumor is an extremely rare, aggressive variant, which provides a diagnostic challenge and management dilemma, especially with early presentation when it may be mistaken for other entities. There is also controversy regarding surgical management and follow-up of both benign and malignant granular cell tumors.
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Zhong N, Katzka DA, Smyrk TC, Wang KK, Topazian M. Endoscopic diagnosis and resection of esophageal granular cell tumors. Dis Esophagus 2011; 24:538-43. [PMID: 21539675 DOI: 10.1111/j.1442-2050.2011.01197.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Granular cell tumors (GCT) are uncommon neoplasms. There is controversy regarding the endoscopic diagnosis and treatment of esophageal GCT. We studied the endoscopic diagnosis and management of esophageal GCT among 23 patients identified in a single-institution pathology database. Medical records, pathology, and endoscopic images were reviewed. All patients underwent endoscopy and endoscopic ultrasonography (EUS), and endoscopic resection was performed in 10 patients. Seven of 23 patients had more than one esophageal GCT. Only six lesions exhibited a classic yellow discoloration. Among patients with a single GCT, three, four, and nine lesions were located in the proximal, middle, and distal esophagus, respectively. EUS showed hypoechoic, smooth-edged lesions usually confined to deep mucosa and submucosa. Standard forceps biopsy was diagnostic in 19 of 23 patients (83%). Ten GCT ≤ 10 mm in diameter underwent successful endoscopic mucosal resection without complication. The endoscopic appearance, location, and number of esophageal GCT are highly variable. Histological proof is still necessary for the differential diagnosis of this rare neoplasm. Endoscopic forceps biopsy is usually diagnostic. Endoscopic resection appears safe and effective in selected cases with lesions ≤ 10 mm.
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Affiliation(s)
- N Zhong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
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40
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Znati K, Harmouch T, Benlemlih A, Elfatemi H, Chbani L, Amarti A. Solitary granular cell tumor of cecum: a case report. ISRN GASTROENTEROLOGY 2011; 2011:943804. [PMID: 21991536 PMCID: PMC3168574 DOI: 10.5402/2011/943804] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Accepted: 10/19/2010] [Indexed: 01/20/2023]
Abstract
Granular cell tumor (GCT) was first described by Abrikossof in 1926. This tumor is a benign neoplasm of unclear histogenesis that is generally believed to be of nerve sheath origin. GCT is not common and most often affects the tongue, skin, and soft tissue, although it may occur anywhere in the body. Gastrointestinal tract involvement, and especially that of the colon, is very rare. This usually benign tumor appears as a submucosal nodule, measuring less than 2 cm in diameter and is often found incidentally during colorectal examinations. We describe the case of a 27-year-old man with a GCT in the cecum that was detected after a screening colonoscopy. Endoscopic examination revealed a yellowish submucosal tumor, 0.7 cm in diameter. An endoscopic mucosal polypectomy was done for histological confirmation and treatment.
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Affiliation(s)
- Kaoutar Znati
- Department of Pathology, Hassan II University Hospital, Fez, Morocco
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Díaz-Sánchez A, Soto S, Ponferrada A, Campos R, García MO, Benito DM, Troya J, Merino B, Aldeguer M. [Granular cell tumor of the esophagus: description of an infrequent benign tumor]. GASTROENTEROLOGIA Y HEPATOLOGIA 2011; 34:454-9. [PMID: 21636174 DOI: 10.1016/j.gastrohep.2011.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2011] [Revised: 03/01/2011] [Accepted: 03/02/2011] [Indexed: 02/08/2023]
Abstract
Granular cell tumors (GCT) are infrequent tumors first described by Abrikossoff in 1926. Gastrointestinal involvement occurs in about 6% of GCT, the esophagus being the most frequent location. These tumors are usually benign and asymptomatic and are usually found incidentally when an upper gastrointestinal endoscopy is carried out for another reason, showing an isolated polyp or sessile submucosal nodule, covered by intact yellowish mucosa and with firm consistency. Endoscopic ultrasonography has significantly improved the diagnosis of these lesions. Nowadays endoscopic mucosectomy is the treatment of choice of esophageal GCT with a low frequency of complications. Histologic analysis of the surgical specimen shows specific characteristics such as positivity for S-100 protein. We present two new cases of esophageal GCT that were diagnosed recently and discuss the most relevant features of this infrequent disease.
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Affiliation(s)
- Antonio Díaz-Sánchez
- Sección de Aparato Digestivo, Hospital Universitario Infanta Leonor, Madrid, España.
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42
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Ishiwata T, Matsuda Y, Naito Z. Nestin in gastrointestinal and other cancers: Effects on cells and tumor angiogenesis. World J Gastroenterol 2011; 17:409-18. [PMID: 21274370 PMCID: PMC3027007 DOI: 10.3748/wjg.v17.i4.409] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Revised: 12/01/2010] [Accepted: 12/08/2010] [Indexed: 02/06/2023] Open
Abstract
Nestin is a class VI intermediate filament protein that was originally described as a neuronal stem cell marker during central nervous system (CNS) development, and is currently widely used in that capacity. Nestin is also expressed in non-neuronal immature or progenitor cells in normal tissues. Under pathological conditions, nestin is expressed in repair processes in the CNS, muscle, liver, and infarcted myocardium. Furthermore, increased nestin expression has been reported in various tumor cells, including CNS tumors, gastrointestinal stromal tumors, pancreatic cancer, prostate cancer, breast cancer, malignant melanoma, dermatofibrosarcoma protuberances, and thyroid tumors. Nestin is reported to correlate with aggressive growth, metastasis, and poor prognosis in some tumors; however, the roles of nestin in cancer cells have not been well characterized. Furthermore, nestin is more specifically expressed in proliferating small-sized tumor vessels in glioblastoma and gastric, colorectal, and prostate cancers than are other tumor vessel markers. These findings indicate that nestin may be a marker for newly synthesized tumor vessels and a therapeutic target for tumor angiogenesis. It has received a lot of attention recently as a cancer stem cell marker in various cancer cells including brain tumors, malignant rhabdoid tumors, and uterine, cervical, prostate, bladder, head and neck, ovarian, testicular, and pancreatic cancers. The purpose of this review is to clarify the roles of nestin in cancer cells and in tumor angiogenesis, and to examine the association between nestin and cancer stem cells. Nestin has the potential to serve as a molecular target for cancers with nestin-positive cancer cells and nestin-positive tumor vasculature.
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Lu WJ, Lan F, He Q, Lee A, Tang CZ, Dong L, Lan B, Ma X, Wu JC, Shen L. Inducible expression of stem cell associated intermediate filament nestin reveals an important role in glioblastoma carcinogenesis. Int J Cancer 2010; 128:343-51. [PMID: 20669222 DOI: 10.1002/ijc.25586] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2010] [Accepted: 07/20/2010] [Indexed: 12/17/2022]
Abstract
The intermediate filament nestin is transiently expressed in neural stem/progenitor cells during the development of central nervous system. Recently, increasing evidence has shown that upregulation of nestin is related to malignancy of several cancers, especially glioblastoma. However, the function of nestin in carcinogenesis remains unclear. In this study, we investigated the role of nestin in glioblastoma carcinogenesis by comparing subclones of rat C6 glioblastoma cells that were either high or low for nestin expression. We found that while nestin expression did not influence the in vitro proliferation of glioblastoma cells, subclones characterized by high levels of nestin formed tumors in vivo at significantly faster rates than subclones with low expression. Importantly, C6 subclones that expressed nestin at low levels in vitro were also found to give rise to tumors highly positive for the protein, suggesting that induction of nestin plays an important role in glioblastoma carcinogenesis. Derivation of nestin positive tumors from nestin negative human U87 glioblastoma cells in immunodeficient mice further confirmed that a switch to positive expression of nestin is fundamental to the course of glioblastoma development. Blocking the expression of nestin in glioblastoma tumors via intratumor injection of shRNA significantly slowed tumor growth and volume. These results demonstrated that nestin plays a crucial role in development of glioblastoma and may potentially be targeted for treatment of the disease.
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Affiliation(s)
- Wen Jing Lu
- Department of Cell Biology, Peking University Health Science Center, Beijing, China
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45
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Peripheral nerve sheath tumors of the gastrointestinal tract: a multicenter study of 58 patients including NF1-associated gastric schwannoma and unusual morphologic variants. Virchows Arch 2010; 456:411-22. [PMID: 20155280 DOI: 10.1007/s00428-010-0886-8] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Revised: 01/13/2010] [Accepted: 01/13/2010] [Indexed: 02/06/2023]
Abstract
The frequency and morphological spectrum of gastrointestinal peripheral nerve sheath tumors (PNSTs) from consecutive case material has not been studied in the c-KIT era. We reviewed all mesenchymal gastrointestinal (GI) lesions at our departments according to current diagnostic criteria. PNSTs formed the third commonest group of mesenchymal GI tumors with a lower frequency (< or =5%) compared to gastrointestinal stromal tumors (GISTs; approximately 50%) and smooth muscle neoplasms ( approximately 30%). Granular cell tumors (GCTs; n = 31) and schwannomas (n = 22) were the most common types of PNSTs encountered. Rare tumors included neurofibromatosis 1 (NF1)-associated PNSTs (n = 5) and gastric perineurioma (n = 1). Thirteen schwannomas (including also some recent cases) were initially diagnosed as GIST, leiomyoma, or neurofibroma. Unusual histological variants included sigmoid GCT with prominent lipomatous component (n = 1), reticular-microcystic schwannoma of small (n = 1) and large (n = 1) bowel, NF1-associated gastric schwannoma (the first case to date), and psammomatous melanotic colonic schwannoma unrelated to Carney complex (n = 1). PNSTs coexisted with GIST in four patients (three had definite NF1). In conclusion, PNSTs of the GI tract are rare uniformly benign neoplasms that may show schwannian, perineurial, fibroblastic, or mixed differentiation. Most of them (92%) occurred sporadically unassociated with NF1 or NF2. Gastrointestinal PNSTs are still underrecognized by general pathologists. Awareness of their diverse morphology will help to avoid confusing them with smooth muscle neoplasms and GIST that they may closely mimic.
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Mucosal Schwann cell "hamartoma": clinicopathologic study of 26 neural colorectal polyps distinct from neurofibromas and mucosal neuromas. Am J Surg Pathol 2009; 33:781-7. [PMID: 19065103 DOI: 10.1097/pas.0b013e31818dd6ca] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Colorectal polyps containing S-100-positive neural proliferations in the lamina propria that lack ganglion cells have been variously referred to as "neuromas" or "neurofibromas." However, these lesions have not been systematically examined, and whether they are associated with type 1 neurofibromatosis (NF1) or other inherited syndromes is unknown. The aim of this study was to evaluate the clinicopathologic and immunohistochemical features of these lesions, in comparison to colorectal neurofibromas from known NF1 patients. Morphologically similar lesions from 26 patients (mean age, 62 y; range, 46 to 88 y; male/female ratio, 10/16) were retrieved from surgical pathology and consult files. Clinical and endoscopic data were obtained, and immunohistochemistry for S-100 protein, glial fibrillary acidic protein, neurofilament protein (NFP), epithelial membrane antigen, claudin-1, CD34, smooth muscle actin, and KIT was performed. The findings were compared with those in mucosal biopsies of 5 submucosal neurofibromas from NF1 patients. All 26 polyps were sessile, ranging from 1 to 6 mm in size (mean, 2.5 mm). Most arose in the distal colon (15 rectosigmoid, 7 descending, 2 transverse, and 2 ascending), and were incidentally found at screening colonoscopy. After a mean follow-up of 6.5 years (range, 3 mo to 17.5 y), none of the patients developed other neural polyps, and none had evidence of NF1 or other inherited syndromes. Histologically, the lamina propria of the polyps contained a diffuse cellular proliferation of uniform bland spindle cells with elongated, tapering nuclei, abundant, dense eosinophilic cytoplasm, and indistinct cell borders, entrapping adjacent crypts. No nuclear atypia, pleomorphism, mitotic activity, or associated ganglion cells were observed. All showed strong staining for S-100 protein in essentially 100% of cells. NFP highlighted rare axons in 7 lesions. All other markers were negative. The 5 neurofibromas showed similar histologic features, but were generally less uniformly cellular, showed some intralesional heterogeneity, and showed less extensive staining for S-100 protein; all contained scattered NFP-positive axons. In summary, solitary colorectal polyps containing pure Schwann cell proliferations in the lamina propria are not associated with NF1. Distinguishing these lesions from NF1-associated neurofibromas is difficult based on histologic features; the presence of an underlying submucosal nodule or mass should be excluded endoscopically, and immunohistochemistry should be performed. Although their nature is uncertain, we propose the interim designation "mucosal Schwann cell 'hamartoma'" to avoid confusion with the neural lesions that have significant associations with inherited syndromes.
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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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Cha JM, Lee JI, Joo KR, Choe JW, Jung SW, Shin HP, Lim SJ. Granular cell tumor of the descending colon treated by endoscopic mucosal resection: a case report and review of the literature. J Korean Med Sci 2009; 24:337-41. [PMID: 19399282 PMCID: PMC2672140 DOI: 10.3346/jkms.2009.24.2.337] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2007] [Accepted: 01/29/2008] [Indexed: 01/02/2023] Open
Abstract
Although colorectal granular cell tumors (GCTs) are rare, their incidental finding has increased as the use of diagnostic colonoscopy has become more common. Here we describe the case of a 41-yr-old man with a GCT in the descending colon that was detected after a screening colonoscopy. Endoscopic examination revealed a yellowish submucosal tumor, 13x12 mm in diameter, in the descending colon. Endoscopic mucosal resection (EMR) followed by histological examination revealed that the tumor was composed of plump histiocyte-like cells with an abundant granular eosinophilic cytoplasm and small round nuclei. The tumor cells expressed S-100 protein and stained with periodic acid-Schiff, but were negative for desmin and cytokeratin. The resected tumor was diagnosed as a GCT. Colonoscopists should consider the possibility of GCT in the differential diagnosis of yellowish submucosal tumors of the colon. In such patients, EMR seems to be a feasible and safe approach for diagnosis and treatment.
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Affiliation(s)
- Jae Myung Cha
- Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea
| | - Joung Il Lee
- Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea
| | - Kwang Ro Joo
- Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea
| | - Jae Won Choe
- Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea
| | - Sung Won Jung
- Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea
| | - Hyun Phil Shin
- Department of Internal Medicine, Kyunghee University College of Medicine, Seoul, Korea
| | - Sung Jik Lim
- Department of Pathology, Kyunghee University College of Medicine, Seoul, Korea
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Vered M, Carpenter WM, Buchner A. Granular cell tumor of the oral cavity: updated immunohistochemical profile. J Oral Pathol Med 2008; 38:150-9. [DOI: 10.1111/j.1600-0714.2008.00725.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Veselska R, Hermanova M, Loja T, Chlapek P, Zambo I, Vesely K, Zitterbart K, Sterba J. Nestin expression in osteosarcomas and derivation of nestin/CD133 positive osteosarcoma cell lines. BMC Cancer 2008; 8:300. [PMID: 18925963 PMCID: PMC2588620 DOI: 10.1186/1471-2407-8-300] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Accepted: 10/16/2008] [Indexed: 01/08/2023] Open
Abstract
Background Nestin was originally identified as a class VI intermediate filament protein that is expressed in stem cells and progenitor cells in the mammalian CNS during development. This protein is replaced in the adult organism by other intermediate filament proteins; however, nestin may be re-expressed under certain pathological conditions such as ischemia, inflammation, brain injury, and neoplastic transformation. Nestin has been detected in many kinds of tumors, especially in tumors derived from the CNS. Co-expression of nestin and the CD133 surface molecule is considered to be a marker for cancer stem cells in neurogenic tumors. Our work was aimed at a detailed study of nestin expression in osteosarcomas and osteosarcoma-derived cell lines. Methods Using immunodetection methods, we examined nestin in tumor tissue samples from 18 patients with osteosarcomas. We also successfully established permanent cell lines from the tumor tissue of 4 patients and immunodetection of nestin and CD133 was performed on these cell lines. Results Nestin-positive tumor cells were immunohistochemically detected in all of the examined osteosarcomas, but the proportion of these cells that were positively stained as well as the intensity of staining varied. Nestin-positive cells were rarely observed in 2 tumor samples, and the remaining 16 tumor samples showed various nestin expression patterns ranging from very sporadic occurrence to an overwhelming proportion of cells with strong positive staining. Three of the established osteosarcoma cell lines were demonstrated to be nestin-positive, and only one cell line showed no expression of nestin; this finding corresponds with the rare occurrence of nestin-positive cells in the respective tumor sample. Moreover, three of these osteosarcoma cell lines were undoubtedly proven to be Nes+/CD133+. Conclusion Our results represent the first evidence of nestin expression in osteosarcomas and suggest the possible occurrence of cells with a stem-like phenotype in these tumors.
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Affiliation(s)
- Renata Veselska
- Laboratory of Tumor Biology and Genetics, Institute of Experimental Biology, School of Science, Masaryk University, Kotlarska 2, 611 37 Brno, Czech Republic.
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