Granular cell tumour of the bronchus: bronchoscopic and clinical features

Granular cell tumor of the bronchus: A case report

Introduction and importance

Pulmonary granular cell tumor (GCT) is a very rare neoplasm that originates from Schwann cells.

Case presentation

Our case report describes a symptomatic benign pulmonary GCT found during follow-up CT imaging and was eventually excised with a good outcome.

Clinical discussion

GCT are mostly benign tumors. Pulmonary GCTs mostly occur in the endobronchial region and can be symptomatic or discovered incidentally.

Conclusion

Treatment options for pulmonary GCT are either conservative treatment or surgical resection depending on the size of the tumor and the presence of tracheal wall invasion.

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Pulmonary Granular cell tumor (GCT) is a very rare neoplasm that originates from Schwann cells.

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GCT is mostly a benign neoplasm; however, around 1-2% are malignant tumors.

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GCTs which are centrally locatedare usually symptomatic, however, some may be diagnosed incidentally.

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Large GCT tumors of more than 1 cm with an invasion to adjacent structures are treated by complete surgical resection.

Multifocal Pulmonary Granular Cell Tumor Presenting with Postobstructive Pneumonia

Granular cell tumor (GCT) is a neoplasm of Schwann cell origin. Its presence in the aerodigestive tract is uncommon and becomes a diagnostic challenge on initial presentation. Our case is of a 59-year-old woman who presented to the emergency department with a history of productive cough and dyspnea associated with fever and chest pain. An initial chest X-ray (CXR) showed a right middle lobe consolidation with follow-up Computed Tomography (CT) scan showing a mass in the right bronchus. Bronchoscopy revealed a polypoid, sessile granular mass in the right bronchus intermedius with multiple white lesions in trachea, left main bronchus, and right upper bronchi. Histology revealed a benign GCT. Bronchoalveolar lavage from the right middle lobe grew Streptococcus pneumoniae. Patient was treated with intravenous levofloxacin during hospital stay and discharged on a 7-day course of oral antibiotics to be followed as outpatient but was lost to follow-up. GCT can present as a polypoid tumor causing recurrent postobstructive pneumonia. Surgical resection is the most successful treatment option. The tumor is more common in third and fourth decade of life and our patient is the oldest patient, according to our knowledge, to have a GCT.

Pulmonary granular cell tumours: case presentations and literature review

Pulmonary granular cells tumours are very rare tumours, most probably originating from Schwann cells. Although rare, clinical and biological presentation is diverse. They are most commonly endobronchial masses, usually a solitary pulmonary lesion, although in up to 20% they can occur as multiple lesions and can be mistaken for malignant process. In spite of infiltrative growth, and rare direct lymph node invasion, they have a very good prognosis if completely removed. Here we present two cases from the archives of the Institute of Pathology, University of Zagreb School of Medicine, with literature review.

Benign endobronchial granular cell tumor resulting in right middle lobe collapse

Granular cell tumors (GCTs) are generally benign neoplastic tumors of neural origin that have little malignant potential. These tumors may occur in any location, including the tracheobronchial tree. Although an endobronchial location is believed to represent a small percentage of cases, GCTs should be included in the differential considerations of any endobronchial lesions leading to airway collapse.

Cytology of endobronchial granular cell tumor

Cytologic features of four cases of endobronchial granular cell tumor are presented. The diagnostic cells were found in bronchoscopically obtained material. They were arranged in smaller clusters and had finely granular cytoplasm with uniform oval or round nuclei. Frequently the cells are overlooked on regular cytologic examination owing to their benign nature. Nevertheless, there are enough cytomorphologic features that help to distinguish these cells from macrophages and bronchial epithelial cells. It is essential that the possibility of granular cell tumor is considered on cytologic examination. Final diagnosis, however, requires histologic verification.