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Kim A, Hong SN, Chang DK, Kim YH, Kim JE, Kim ER. Clinicopathologic and Endosonographic Characteristics of Colon Subepithelial Tumors Discovered Incidentally. Diagnostics (Basel) 2024; 14:551. [PMID: 38473024 DOI: 10.3390/diagnostics14050551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/07/2024] [Accepted: 03/02/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND/AIMS Colonoscopy is commonly used for colorectal cancer screening; therefore, the detection of colon subepithelial tumors (SETs) has also increased. Several research studies have been undertaken to diagnose and treat stomach and rectal SETs. The purpose of this study was to determine a diagnostic point for colon SETs by comparing histological findings with the endoscopic characteristics of colon SETs discovered by chance. METHODS A total 194 patients underwent an endoscopic ultrasound (EUS) for suspicious colon SETs during a colonoscopy from May 2014 to December 2021. A total of 105 colon SETs, which were histologically diagnosed, were finally included. Fisher's exact test was used to determine the factors associated with malignant SETs. RESULTS Colon SETs were predominantly present in the right colon (n = 73, 69.5%), particularly in the transverse colon (n = 32, 30.5%). The majority were smaller than 10 mm (n = 88, 83.8%), and they had hard consistencies (n = 84, 80%) and exhibited no surface changes (n = 96, 91.4%). Most of them were found in the submucosal layers (n = 54, 51.4%) and had a hypoechoic pattern (n = 56, 53.3%) in the EUS. Of the histologically confirmed cases, only three (3/105, 2.9%) were malignant. Most benign lesions were lipomas, suspected parasitic infections, or lesions caused by various inflammatory reactions, including fibrous/fibrocalcific lesions and necrotic nodules. All soft lesions were benign. Two of the three malignant lesions were adenocarcinomas, and the other was lymphoma. For the malignant SETs, there was a statistically significant alteration in the surface of the tumors (p < 0.001), and they were located where the muscularis mucosa layer was included (p = 0.008). The potential malignant SETs, granular cell tumors, and neuroendocrine tumors (NETs) had similar features, such as yellowish hypoechoic masses. Colon NETs were only found in the rectosigmoid junction. Parasitic infections and lesions, resulting in various inflammatory reactions, were observed as pale and hard SETs and mostly revealed as mixed echogenic masses located in the muscularis mucosa, submucosa, or multi-layers in the EUS. CONCLUSION This study showed that small colon SETs were mostly benign lesions. Despite its rarity, pathological confirmation is crucial in cases where the SET has surface changes and has been located in a position where the muscularis mucosa layer was included on the EUS, due to the risk of malignancy.
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Affiliation(s)
- Aryoung Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Sung Noh Hong
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Dong Kyung Chang
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Young-Ho Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Ji Eun Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
| | - Eun Ran Kim
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Republic of Korea
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Kim IK, Ju YT, Kim HG, Lee JK, Kim DC, Kim JM, Cho JK, Park JH, Kim JY, Jeong CY, Hong SC, Kwag SJ. Experience of surgical treatment in a granular cell tumor in the ascending colon: a case report. Ann Coloproctol 2023; 39:275-279. [PMID: 34228911 PMCID: PMC10338165 DOI: 10.3393/ac.2020.00836.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 05/06/2021] [Accepted: 05/08/2021] [Indexed: 10/20/2022] Open
Abstract
We report a case about successful surgical treatment of a granular cell tumor in the ascending colon. A 36-year-old man underwent screening colonoscopy. An endoscopic examination revealed a 10-mm yellowish and hemispheric mass in the ascending colon, and lower endoscopic ultrasonography revealed a hypoechoic-to-isoechoic mass invaded the submucosal layer. The mass was suspected to be a colonic carcinoid tumor. Based on the preoperative evaluation, endoscopic complete resection was considered difficult. Therefore, the lesion was removed via laparoscopic right hemicolectomy. Histological examination revealed that the tumor consisted of nests of polygonal cells with abundant granular eosinophilic cytoplasm. Immunohistochemical staining revealed diffuse positivity for S100 and CD68. Therefore, the tumor was diagnosed as a granular cell tumor. We suggest that surgical resection should be considered if it is located in the thin-walled ascending colon prone to perforation, difficult to rule out malignant tumor due to submucosal invasion, or to remove endoscopically.
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Affiliation(s)
- In-Kyeong Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Young-Tae Ju
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Han-Gil Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jin-Kwon Lee
- Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Korea
| | - Dong-Chul Kim
- Department of Pathology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jae-Myung Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Jin Kyu Cho
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Ji-Ho Park
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Ju-Yeon Kim
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Chi-Young Jeong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Soon-Chan Hong
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Seung-Jin Kwag
- Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
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Dhruv S, Atodaria KP, Gurala D, El Imad T, Abergel J. Granular Cell Tumor of the Ascending Colon. Case Rep Gastroenterol 2023; 17:104-108. [PMID: 36820070 PMCID: PMC9938395 DOI: 10.1159/000529170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/09/2023] [Indexed: 02/24/2023] Open
Abstract
Granular cell tumor (GCT) was first described by Abrikossoff in 1926. It is a mostly benign tumor with rare malignant transformation. It is defined as a soft tissue neoplasm with abundant eosinophilic cytoplasm. The mean age of diagnosis for GCT is around 45 years. It is rare for GCT to be found in the gastrointestinal (GI) tract. Within the subset of GI tract, the colon is an extremely rare site for it to be found. Franburg-Smith histopathology criteria are used to differentiate a benign from a malignant GCT. The malignant form is aggressive with high recurrence rates after resection. Histopathology and immunohistochemical stains are used to make a definitive diagnosis. Herein, we present a rare case of an ascending colon polyp that was resected and found to be a benign GCT.
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Affiliation(s)
- Samyak Dhruv
- Hospitalist doctor of Internal Medicine at MedStar St. Mary’s Hospital, Leonardtown, MD, USA
| | | | - Dhineshreddy Gurala
- Gastroenterology Fellow at Staten Island University Hospital, Staten Island, New York, NY, USA
| | - Talal El Imad
- Gastroenterologist with Advantage Care Physicians, New York, NY, USA
| | - Jeffrey Abergel
- Gastroenterologist at New York, Presbyterian Medical Group Hudson Valley, New York, NY, USA
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Aichouni N, Amane Y, Kamaoui I, Nasri S, Skiker I. Imaging of perianal granular cell tumor with lung metastasis: A case report and literature review. Radiol Case Rep 2021; 17:314-319. [PMID: 34876957 PMCID: PMC8633828 DOI: 10.1016/j.radcr.2021.10.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/01/2022] Open
Abstract
The granular cell tumor or Abrikossoff's tumor is a rare tumor, most often benign in evolution. Malignant forms are exceptional. We report, here, a very rare case of granular cell tumor, localized in the perianal region, in a 54-year-old woman with lung metastases. CT and MRI with contrast showed a locally advanced tumor process in the right para-anal region associated with multiple "balloon release" lung lesions. The diagnosis was confirmed by immunostaining after surgical biopsy. Very few cases of malignant granular cell tumors with lung metastasis have been reported in the literature.
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5
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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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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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7
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Schreiner P, Valli P, Marques Maggio E, Bauerfeind P. Simultaneous endoscopic full-thickness resection of two synchronous colonic granular cell tumours. BMJ Case Rep 2018; 2018:bcr-2017-222223. [PMID: 29391355 PMCID: PMC5812385 DOI: 10.1136/bcr-2017-222223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2018] [Indexed: 12/20/2022] Open
Abstract
Granular cell tumours (GCTs) are rare soft tissue tumours originating from Schwann cells. Due to potential malignant transformation, complete endoscopic resection should be aimed for. We report on a 49-year-old patient with two synchronous GCTs found in the caecum and the ascending colon, respectively. Synchronous endoscopic full-thickness resection (EFTR) using an all-in-one full-thickness resection device (FTRD) was performed under propofol sedation. Completeness of resection was proven histologically. No adverse events occurred. We report safe and complete simultaneous EFTR of two synchronous colonic GCTs.
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Affiliation(s)
- Philipp Schreiner
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | - Piero Valli
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
| | | | - Peter Bauerfeind
- Department of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland
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8
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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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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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10
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Yang SY, Min BS, Kim WR. A Granular Cell Tumor of the Rectum: A Case Report and Review of the Literature. Ann Coloproctol 2017; 33:245-248. [PMID: 29354608 PMCID: PMC5768480 DOI: 10.3393/ac.2017.33.6.245] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 10/02/2017] [Indexed: 01/20/2023] Open
Abstract
A granular cell tumor (GCT) is an uncommon mesenchymal lesion that rarely occurs in the colon and the rectum. We describe the case of 51-year-old man with a 2-cm-sized rectal GCT 10 cm above the anal verge that was incidentally detected after a screening colonoscopy. Preoperative radiologic studies demonstrated a suspicious submucosal rectal mass with mesorectal fat infiltration, but without circumferential resection margin threatening, extramural vessel invasion, and regional lymph-node enlargement. The tumor was resected by using a transanal endoscopic operation (TEO) without immediate postoperative complications. The final pathology revealed that the tumor consisted of a GCT that had invaded the subserosa with clear margins. It had no other risk factors for malignancy according to Fanburg-Smith criteria. We systematically reviewed the English literature by using PubMed and Google Scholar. This report may be the first documented case in the literature to describe a TEO for a GCT that had invaded the subserosa in the rectum.
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Affiliation(s)
- Seung Yoon Yang
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Soh Min
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Woo Ram Kim
- Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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11
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Kelly EF, Stein AA, Ma XC, Yeguez J. A rare case of perianal granular cell tumor: case report and literature review. J Surg Case Rep 2017; 2017:rjw186. [PMID: 28603602 PMCID: PMC5460004 DOI: 10.1093/jscr/rjw186] [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: 08/29/2016] [Accepted: 06/01/2017] [Indexed: 11/13/2022] Open
Abstract
Granular cell tumor (GCT) is a rare submucosal neoplasm most commonly localized in the oral mucosa; with one-third of all cases found in the tongue, with less than 30 cases of perianal GCT reported in the literature, making it a rare anal neoplasm. Wide local excision is the gold standard of treatment and follow-up includes annual colonoscopy due to the high incidence of reoccurrence. Here we describe a rare case of benign perianal GCT in a 29-year-old female who presented asymptomatically; however, pathology report revealed a S100 positive immunostaining pattern. GCT is an important differential to be included when evaluating a patient with an asymptomatic perianal submucosal lesion. Since GCT and Squamous Cell Carcinoma present with similar pseudoepitheliomatous hyperplasia of the epithelium it is important that a biopsy and immunohistochemical analysis be performed to allow for accurate diagnosis and appropriate treatment.
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Affiliation(s)
- Emily F Kelly
- Department of Surgery, Boca Raton Regional Hospital, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Alan A Stein
- Department of Surgery, Boca Raton Regional Hospital, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Xiaoling Charlene Ma
- Department of Surgery, Boca Raton Regional Hospital, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Jose Yeguez
- Department of Surgery, Boca Raton Regional Hospital, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
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12
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Granular Cell Tumor of Rectum: A Very Rare Entity. Case Rep Gastrointest Med 2017; 2017:3795482. [PMID: 28255473 PMCID: PMC5306986 DOI: 10.1155/2017/3795482] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 01/22/2017] [Indexed: 11/26/2022] Open
Abstract
Granular cell tumors are predominantly benign, occurring more commonly in women, with about 10% developing in the gastrointestinal tract. Rectal location of this tumor is very rare. We herein report one such case of a 61-year-old man with granular cell tumor in the rectum who underwent endoscopic curative resection.
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Erginel B, Akin M, Yildiz A, Alkim CA, Tanik C, Karadag CA, Sever N, Tokel M, Dokucu Aİ. The first endoscopic resection of a colonic granular cell tumor in a child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2016.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Judd S, Antaki F. The "pot-of-gold" sign: not always a lipoma. Gastrointest Endosc 2014; 80:743-744. [PMID: 25220516 DOI: 10.1016/j.gie.2014.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 04/16/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Stephanie Judd
- Division of Gastroenterology, Department of Internal Medicine, John D. Dingell VA Medical Center and Wayne State University School of Medicine, Detroit Medical Center, Detroit, Michigan, USA
| | - Fadi Antaki
- Division of Gastroenterology, Department of Internal Medicine, John D. Dingell VA Medical Center and Wayne State University School of Medicine, Detroit, Michigan, USA
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15
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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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Choi SM, Hong SG, Kang SM, Chae BG, Kim SJ, Park PK, Park HS. A case of malignant granular cell tumor in the sigmoid colon. Clin Endosc 2014; 47:197-200. [PMID: 24765605 PMCID: PMC3994265 DOI: 10.5946/ce.2014.47.2.197] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 06/24/2013] [Accepted: 06/28/2013] [Indexed: 11/14/2022] Open
Abstract
Granular cell tumor (GCT) is an uncommon, usually benign neoplasm; however, a malignant potential has been described. Malignant GCT is an extremely rare neoplasm showing rapid growth and invasion into adjacent muscles, lymph nodes, or vessels, or even distant metastasis. We recently experienced a case of a histologically benign or atypical but clinically malignant GCT, with invasion of the lymph nodes and vessels in the sigmoid colon, diagnosed by segmental colon resection with lymph node dissection. We also performed a review of relevant medical literature.
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Affiliation(s)
- Sang Myung Choi
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Seung Goun Hong
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Shin Myung Kang
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Byung Gi Chae
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Sung Jin Kim
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Pyung Kang Park
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
| | - Hyun Sung Park
- Department of Internal Medicine, SAM Medical Center, Anyang, Korea
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Granular cell tumour in a patient with Crohn's disease treated with infliximab: coincidence or causal relationship? Eur J Gastroenterol Hepatol 2012; 24:857-9. [PMID: 22475791 DOI: 10.1097/meg.0b013e3283530999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Granular cell tumour (or Abrikossoff's tumour) was first described by Abrikossoff in 1926. This is a rare benign neoplasm of unclear histogenesis that is generally believed to be of nerve sheath origin. Usually, it presents as a solitary lesion, located mainly in the subcutaneous tissue of the head, or the neck, or in the oral cavity, such as a tongue lesion, although it may develop anywhere in the body. Approximately 1-2% of granular cell tumours are malignant. Granular cell tumours are extremely rare in patients with inflammatory bowel disease. To the best of our knowledge, granular cell tumours have never been reported in association either with Crohn's disease or scheduled infliximab treatment. Herein, we report a case of a granular cell tumour that presented as a subcutaneous skin nodule of the right lumbar area without any associated local or systemic symptoms in a 41-year-old woman with Crohn's disease who was receiving scheduled treatment with infliximab (5 mg/kg every 8 weeks) for 7 years.
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Zoccali M, Cipriani N, Fichera A, Turner JR, Krane M. Acute appendicitis secondary to a granular cell tumor of the appendix in a 19-year-old male. J Gastrointest Surg 2011; 15:1482-5. [PMID: 21533589 DOI: 10.1007/s11605-011-1536-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 04/04/2011] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Granular cell tumors are rare, usually benign, neoplasms presenting as solitary small nodules in the skin or subcutaneous tissue. Involvement of the gastrointestinal tract is unusual, particularly of the appendix, and it is characterized by indolent, submucosal lesions usually diagnosed as an incidental finding. CASE REPORT We describe the rare case of acute appendicitis secondary to a granular cell tumor of the appendix in a 19-year-old male.
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Affiliation(s)
- Marco Zoccali
- Department of Surgery, University of Chicago Medical Center, Chicago, IL, 60637, USA.
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Patel AJ, Jakate SM. Granular cell tumor of the biliary tract. Gastroenterol Hepatol (N Y) 2010; 6:331-6. [PMID: 20567590 PMCID: PMC2886492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Brain JG, Burt AD. Abrikosoff's Tumor and the Hepatobiliary System: A Curiosa Revisited. Gastroenterol Hepatol (N Y) 2010; 6:337-8. [PMID: 20567591 PMCID: PMC2886489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Kim YS, Ra JE, Sohn YW. Unusual colonic pedunculated polypoid mass covering with normal appearing colonic mucosa. Gastroenterology 2009; 137:e3-4. [PMID: 19879989 DOI: 10.1053/j.gastro.2009.03.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Accepted: 03/19/2009] [Indexed: 12/02/2022]
Affiliation(s)
- Yong Sung Kim
- Department of Gastroenterology, Wonkwang Digestive Disease Research Institute, Wonkwang University Sanbon Hospital, Gunpo, South Korea
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Radaelli F, Minoli G. Granular Cell Tumors of the Gastrointestinal Tract: Questions and Answers. Gastroenterol Hepatol (N Y) 2009; 5:798-800. [PMID: 37967389 PMCID: PMC2886372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
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Huaqing Ye J, Gaskins R, Stead J. Multiple Granular Cell Tumors of the Ascending Colon. Gastroenterol Hepatol (N Y) 2009; 5:795-797. [PMID: 37967414 PMCID: PMC2886368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Affiliation(s)
- Jeff Huaqing Ye
- Digestive Health Center and Southern Tennessee Internal Medicine, Winchester, Tennessee
| | - Ronald Gaskins
- Section of Digestive Diseases, Department of Internal Medicine, Morgantown, West Virginia
| | - Jeffrey Stead
- Department of Pathology, West Virginia University School of Medicine, Morgantown, West Virginia
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Hong R, Lim SC. Granular cell tumor of the cecum with extensive hyalinization and calcification: a case report. World J Gastroenterol 2009; 15:3315-8. [PMID: 19598311 PMCID: PMC2710791 DOI: 10.3748/wjg.15.3315] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A granular cell tumor (GCT) 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. We experienced a case of GCT that arose in the cecum of a 55-year-old man. The GCT was removed by laparoscopic resection. In addition to the tumor, endoscopic examination revealed the presence of a 5-mm-polyp in the descending colon and multiple tiny polyps in the sigmoid colon and rectum. Histological examination demonstrated a cecal tumor 1.5 cm x 1.0 cm x 0.7 cm with a hard consistency; in cut sections, mixed cells with yellowish and whitish portions were seen. The tumor was located between the mucosa and subserosa, and was composed of plump histiocyte-like tumor cells with abundant granular eosinophilic cytoplasm, which were immunoreactive for S-100 protein, vimentin, neuron-specific enolase, inhibin-alpha and calretinin. The tumor showed extensive hyalinization and focal dystrophic calcification. Immunohistochemical profiles did not confirm any particular cell type for the histogenetic origin of the GCT, including a nerve sheath origin. Extensive hyalinization and calcification showing involution of tumor cells suggest benign clinical behavior of GCT.
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Affiliation(s)
- Ran Hong
- Department of Pathology, Chosun University School of Medicine, Gwangju 501-140, South Korea
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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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McIntire M, Jakate S, Losurdo J. Granular cell tumor in colonic polyp found on screening colonoscopy. Clin Gastroenterol Hepatol 2007; 5:e17-8. [PMID: 17428738 DOI: 10.1016/j.cgh.2007.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Maria McIntire
- Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
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Parfitt JR, McLean CA, Joseph MG, Streutker CJ, Al-Haddad S, Driman DK. Granular cell tumours of the gastrointestinal tract: expression of nestin and clinicopathological evaluation of 11 patients. Histopathology 2006; 48:424-30. [PMID: 16487364 DOI: 10.1111/j.1365-2559.2006.02352.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
AIMS Granular cell tumours (GCTs) in the gastrointestinal (GI) tract are rare, with few series reported in the literature. Nestin is a recently identified intermediate filament protein that is expressed in neuroectodermal stem cells and skeletal muscle progenitor cells and has been shown to be expressed in gastrointestinal stromal tumours (GISTs) and GI schwannomas. Herein, we describe the clinicopathological and immunohistochemical features of 11 GI GCTs, introducing nestin as an additional marker that identifies these tumours. METHODS AND RESULTS The archives of the departments of pathology at London Health Sciences Centre (London, Ontario) and St Michael's Hospital (Toronto, Ontario) were searched for GCTs occurring in the GI tract, yielding 11 cases. Histological features were assessed and immunohistochemistry was performed with S100 protein, nestin, glial fibrillary acidic protein (GFAP), CD34, desmin, CD117, and inhibin-alpha. Charts were reviewed for clinical information. Ages at diagnosis ranged from 31 to 73 years; there were six males and four females. All GCTs were solitary, six in the oesophagus, three in the caecum, one in the rectum and one perianal. Most lesions were discovered incidentally. The size of the GCTs ranged from 4 mm to 30 mm. All were submucosal, typically firm, with a white-yellow appearance. Histologically, the GCTs showed moderate cellularity, predominantly solid growth with areas of nesting. While lesional cells were mainly plump and polygonal, areas of spindling were present in several tumours, more frequently in the colorectum. Margins were circumscribed. Nuclei were round to oval, with even chromatin and small nucleoli. Mitoses were rare to absent and necrosis was absent in all cases. Staining with periodic acid-Schiff, with diastase predigestion, showed globular and diffuse positivity within the cytoplasm. Moderate to strong expression of S100 protein and nestin was observed in 11 of 11 and seven of seven tumours, respectively. GFAP, CD34, desmin, CD117 and inhibin-alpha were negative. While patients were variably managed with resection or observation, all remain clinically well, without disease progression. CONCLUSIONS Although rare, GI GCTs have characteristic clinicopathological features. Nestin may be a useful immunohistochemical marker for identifying these tumours; the presence of this persistent stem cell cytoskeletal filament within GI GCTs suggests that these lesions may arise from a multipotential stem cell in the GI tract.
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Affiliation(s)
- J R Parfitt
- Department of Pathology, London Health Sciences Centre, University of Western Ontario, London, Canada
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