舌の両側に発生したか粒細胞しゅの１例

Abstract

The granular cell tumor is a circumscribed nodular lesion arising from the dermis or subdermal or submucosal tissue. Histlogically, the tumor is abenign lesion and it contains characteristic granules within the cytoplasm. Although the lesion occurs in various parts of the body, the oral cavity, paticularly the tongue, appears to be the most common location. Usually it occurs singly, but multiple lesion can be seen occasionallyOn March 17, 1980, a 38-year-old woman came to our clinic, complaining of a nodule in the tongue. The lesion had been presented for about 4 months and had not caused any pain and discomfort.She had received a resection of fibroma in the left breast in 1976.Family history was negative and she was in appearently good health.Clinical examination of the oral cavity revealed the presence of 2 nodules. One was flat, about 10×8×2 mm in diameter, located slightly left of the midline of dorsum of the tongue. The covering epithelium appeared granulous and slightly red in color. Palpation revealed that the nodule was clear in border, pedunculated and hard with elasticity.On the right lateral border of the tongue, the other was palpated with hard-elastic nodule. It was rhombic, flat and yellow in color about 10×5 mm in diameter and has slightly diffused swelling. It has indistinct border and adhered to muscle layer.On April 25, the nodule on the left side of the dorsum of the tongue was excised with the surrounding tissue under local anesthesia and the lesion on the right lateral border of the tongue was excised on May. 20. To this date, we can not find tendency of recurrence. Histopathologically, the tumor showed marked proliferation of granutlar cells. Neoplastic cells proliferated in the subepithelial layer and partially extended to muscular layer.In the covering epithelium pseudoepitheliomatous hyperplasia was remarkable. Cytoplasmic granules stained with PAS reaction were not decolored by diastase. From the examination of the specimen stained with Bodian method, definte axon was occasionally found in the cytoplasm. Electron microscopically, groups of granular cells were surrounded by basal lamina. Numerous cytoplasmic granules were supported by a limiting membrane and had the lysosome-like structure. Myofibrils were not found in the cytoplasm. The pathological diagnosis of the two nodules was granular cell tumor. The tumor cells were suspected to be a neurogenic orign.