Diagnosis Of Granular Cell Tumor Research Articles

A rare case malignant granular cell tumor of the thigh with radiological imaging likely rhabdomyosarcoma: A case report

Granular cell tumors (GCTs) are uncommon soft tissue tumors characterized by the cytoplasmic granular appearance of the neoplastic cells. Malignant GCTs are rare neural tumors, intensely aggressive. Both the rare occurrence of malignant GCTs and its similarities in features with their benign lesions make the diagnosis of this malignancy difficult. Malignant GCTs comprise less than 2% of GCTs and are mostly found in the subcutaneous soft tissues of the lower extremities, especially the thighs. This article presents a case of a large malignant GCTs in the left thigh of a 46-year-old woman. Plain radiograph of the left thigh demonstrated a soft tissue mass without bone involvement. MRI images showed a malignant solid mass 7.8 x 5.2 x 21.6 cm, with ill-defined border, irregular edges, and suspected rhabdomyosarcoma. Incisional biopsy of the mass lesion revealed mixed epithelioid and spindle tumors, suspected malignant GCTs. Histological examination performed by a musculoskeletal pathologist, demonstrated nests and sheets of epithelioid to polygonal cells with hyperchromatic, intensely eosinophilic granular cytoplasm, prominent nucleoli, increased mitotic activity, necrosis, areas of spindling with significant atypia, and positive for S100 by immunohistochemistry. In conclusion, this patient with malignant soft tissue tumor demonstrated polygonal and spindle cells with eosinophilic granular cytoplasm, which need to be considered diagnosed as Malignant GCTs. This case stresses the importance of thorough histological examination in the diagnosis of malignant GCTs.

Granular Cell Tumor of the Breast: Understanding the Cancer Mimic through a Series of Three Cases

AbstractGranular cell tumors of breast are rare neoplasms, majority of which are benign. Their imaging appearances are often indistinguishable from breast cancer. They may demonstrate a few differentiating features and unlike breast cancer, typically follow a benign course. Histopathology and immunochemistry form the cornerstone of diagnosis of granular cell tumor. In this article, we presented a series of three cases of granular cell tumors with variable presentations. Our goal is to increase familiarity for these neoplasms and for the readers to be able to distinguish them from the more common entity of breast cancer, as their prognosis and management differ.

Suprasellar granular cell tumor: A rare case report

Granular cell tumor (GCT) originating from the sellar and suprasellar regions, specifically from the neurohypophysis, is a rare neoplasm. Symptomatic GCT of the neurohypophysis is exceedingly rare, being <70 cases described so far. GCTs predominantly exhibit benign behavior, while the malignancy rate remains at 2%. Imaging is quite unspecific and diagnosis is difficult to establish preoperatively. Histopathology and immunohistochemistry serve as the definitive diagnostic approach for GCTs and help in distinguishing GCT from other pituitary tumors, including pituitary adenoma, pituicytoma, and spindle cell oncocytoma. These tumors are resistant to radiotherapy and chemotherapy, necessitating surgical resection as the primary treatment modality. Due to the potential absence of distinct tumor masses and local tissue infiltration by tumor cells, complete excision is crucial, with resection extent extending beyond areas of infiltration. Here, we present a rare case of GCT originating from the posterior pituitary in the suprasellar region. On immunohistochemistry, tumor cells expressed diffusely thyroid transcription factor-1, S-100 protein, and vimentin confirming the diagnosis of supra-sellar GCT. The reported case is noteworthy for the rarity of the clinicopathological entity.

A Rare Case of Granular Cell Tumour of Tongue in a 13-year-old Girl

Granular Cell Tumour (GCT) is a rare benign tumour that usually affects adults in the third to sixth decades, with females being more commonly affected. Here, a rare case of GCT occurring in a 13-year-old child is presented. A young girl presented with a painless swelling on the right-side of her tongue. Her past medical history was unremarkable. Upon examination, a firm, well-defined, non pulsatile, non tender lesion measuring 1×0.8 cm was noted, involving the right lateral border of the tongue. The lesion was excised and sent for histopathological examination. Gross examination revealed a 1×0.8×0.6 cm mass with a grey-white cut surface. Microscopy showed hyperplastic stratified squamous epithelium overlaying a submucosal tumour composed of polygonal cells arranged in sheets. The tumour cells had central small round nuclei with abundant granular eosinophilic cytoplasm and intervening skeletal muscle fibres. No necrosis, atypia, or increased mitosis were observed. Immunohistochemistry showed strong nuclear positivity and bright granular cytoplasmic positivity for S-100, confirming the diagnosis of GCT. The patient was followed-up for 14 months after surgery and reported no recurrences. GCTs typically manifest in older individuals, with the highest prevalence in the fifth and sixth decades of life. However, this case deviates from the norm, being noted in a 13-year-old child. This exceptionally unusual presentation should prompt the inclusion of GCT in the differential diagnosis of tongue neoplasms in paediatric patients as well. Periodic follow-up of these patients is recommended to detect malignant transformations and late recurrences at early stages.

Granular cell tumor: A rare presentation as intraconal orbital space occupying lesion

Granular cell tumor (GCT) is a rare benign soft tissue tumor. They have been reported in several regions of the body but mostly in the skin and subcutaneous tissue of head and neck. It may involve the orbit, periocular skin, lacrimal sac, optic nerve, ciliary body, conjunctiva and caruncle. Here we present a rare case of intraconal GCT in a 45 year old woman who presented with unilateral proptosis. She presented with forward protrusion of right eye for the past 3 months,MRI orbit revealed a well defined T1/T2/FLAIR hypointense lesion in the inferolateral aspect of intraconal compartment of right orbit. Transconjunctival excision of the lesion was done. Histopathological Examination (HPE) and immunohistochemistry confirmed the diagnosis of Granular cell Tumor.

Is Docetaxel the Main Therapy for Lung Metastasis in Granular Cell Tumors?

Introduction: A granular cell tumor is a rare neoplasm originating from mesenchymal tissue. Malignant granular cell tumors have a poor prognosis. The lung is one of the target organs for metastatic malignant granular cell tumors. The number of rare cases makes managing metastatic malignant granular cell tumors unknown. Case: A 19-year-old male complained of shortness of breath for two months. A liver nodule biopsy revealed poorly differentiated carcinoma metastases. Histopathology of the left manus and frontal masses found granular cell tumors—negative immunohistochemistry on S-100 and myogenin. Ki-67 obtained a value of 5%. An X-ray and contrast multislice computerized tomography (MSCT) scan showed multiple metastatic nodules. Right bronchial biopsy forceps revealed a metastatic granular cell tumor. The patient was given docetaxel for six cycles. During the post-administration of docetaxel, the patient experienced clinical and radiological improvement. Conclusion: Until 2016, only three case reports of S-100 negative granular cell tumors existed. A negative S-100 test does not rule out the diagnosis of granular cell tumors. Malignant lesions are more common in males, as in this case. The number of rare cases means that management cannot be determined. Reports of similar cases show patients surviving up to 11 years with docetaxel administration. The patient in this study has survived for one year and is complaint-free.

Abrikossoff’s skin tumor: Report of two cases

Abrikossoff’s tumor, also known as granular cell tumor, is a rare tumor first described on the tongue by Ivanovich Abrikossoff in 1926. It is mainly located in the head and neck regions with preferential mucosal involvement and may occur at any age and in both sexes, although with a female predominance. Herein, we report two cases: the case of a nodule under the left breast in a 47-year-old female with a history of breast cancer and of a subcutaneous lesion on the right thigh in a 46-year-old female. The diagnosis of granular cell tumor was reached by biopsy with immunohistochemical staining, then treatment was completed by a large surgical excision. Key words: Abrikossoff; Skin; Granular cell tumor

Abrikosoff’s Tumor: A Case Repor

A 68-year-old patient had, for about 7 months, in the right buttock, a nodule of about 2 cm in diameter, rosy colour, centrally ulcerated, of hard consistency, asymptomatic. Histological examination and immunohistochemical investigations deposed for the diagnosis of granular cell tumour (Abrikosoff tumour). Granular cell tumour is a neoplasm in most cases benign, characterised by voluminous cells with eosinophilic cytoplasm and grainy appearance, with the granules corresponding to lysosomes. It is currently considered a variant of schwannoma, although cases with different histogenesis have been described. This tumour, most frequently localised on the dorsal surface of the tongue, very rarely affects the skin

Granular Cell Tumor of the Deep Lobe of the Parotid Gland Presenting With Respiratory Obstruction: Clinicopathologic Report of a Rare Presentation

Background Granular cell tumor (GCT) is a very rare, slow-growing, benign neoplasm with a controversial etiology, recently believed to be derived from Schwann cells. Hardly grows large and is also infrequently seen in children. Seventy percent of this tumor is seen in the head and neck with 1/3 in other parts of the body. Seldom occurs in the parotid gland and more so, the deep lobe of the parotid, where it may initially be asymptomatic but when large, it may result in respiratory obstruction. Case report : An 8-year-old female presented with a large right lateral upper neck-facial swelling of 3 months duration with a change in voice, difficulty swallowing, and respiratory distress. We reported an uncommon case of GCT of the deep lobe of parotid in a child with respiratory distress due to tumor obstruction of the airway. Tumor excision with preservation of the facial nerve was successfully performed. The histopathological report confirms the diagnosis of GCT. The child recovered to full general health with no signs of recurrence. Conclusion Granular cell tumor is a rare neoplasm, treatment is local surgical excision. Recurrence is uncommon, even if the lesion is not entirely removed. Microscopically this tumor may mimic a malignancy because of pseudoepitheliomatous hyperplasia of the overlying epithelium. The pathologist should be aware of this possibility to avoid a mistaken diagnosis of cancer.

Granular cell tumors of the breast: an unusual case of multifocality—a case report

: A 39-year-old female with no prior cancer diagnosis presented with a right breast lump that increased in pain with menstruation over the past 4 years. Imaging demonstrated two masses in the right breast and one mass in the left breast and image-guided core needle biopsy was consistent with bilateral granular cell tumors (GCTs) of the breasts. Based on the multifocal nature of the patient’s breast masses and associated pain, diagnosis of GCT did not clinically correlate with the patient’s presentation. However initial pathology on core biopsy showing positive staining for S100 and CD68, classic for GCTs, guided our treatment of this patient. Our patient was managed surgically with excisional biopsy yielding two masses in the right breast and one mass in the left breast. Final pathology confirmed the initial diagnosis of GCTs of the breasts, and the patient has had an uncomplicated postoperative course. Although GCTs of the breast typically present as solitary and painless masses, multifocal presentation and pain are possible. It is also important to rule out malignancy with excisional biopsy of the masses and take into account the possibility of upstaging. Furthermore, it may be warranted to explore underlying genetic conditions such as LEOPARD syndrome if patient presents with additional findings.

Malignant granular cell tumor of the arm – case report

Abstract Granular cell tumor (GCT) is a rare form of soft tissue cancer that is usually benign. Its malignant evolution is encountered in less than 2% of cases, having a more rapid and unfavorable evolution. Clinical presentation betraying malignant features could be increased tumor size, rapid growth, deep localization, and female gender. This paper presents the case of a 52-year-old patient with a hard, rapidly evolving tumor in the left arm. The diagnosis of granular cell tumor was made based on histopathological examination using the Fanburg and Smith criteria to differentiate the formation as malignant, but with certainty this was subsequently confirmed by the existence of a metastasis. Surgical excision was performed and the evolution was favorable. Evolution and treatment differ depending on the benign or malignant form, but surgical treatment with wide local excision is recommended. This may be followed by chemotherapy or radiotherapy, and follow-up of patients for the rest of their lives is mandatory.

Case report sustained by literature review on the major approaches of the granular esophageal cell tumor

Background: Granular Cell Tumors (GCT) are rare benign neoplasms with an estimated prevalence of 0,4% in retrospective series. About 8% of GCT are located in the gastrointestinal tract, having the esophagus as the main affected area. Malignancy was reported in 2-4% of cases and there are no well established treatment protocols. Case summary: It was present an oligo-symptomatic female patient with diagnosis of GCT presented on the endoscopy. Complementary investigation was based on endoscopic ultrasound (EUS). The treatment consisted of mucosectomy and endoscopic variceal ligation, evolving with a favorable outcome. Conclusion: Despite disagreement on protocols for treatment of GCT, mucosectomy appears to be an effective option.

Pulmonar Granular Cell Tumor in a Horse

Background: The occurrence of neoplasms in horses is relatively low. Granular cell tumor is a seldom diagnosed neoplasm, usually benign, of mesenchymal origin. Controversies exist regarding its origin, which is possibly from Schwann cells or cells with neuroendocrine differentiation. Despite being one of the main primary neoplasms in the lungs of horses, the number of cases is low in comparison to that of secondary lung tumors. Thus, this study proposes to report the anatomopathological aspects in a horse with granular cell tumor of primary pulmonary origin. Case: An 11-year-old female Quarter Horse breed underwent exploratory right lateral thoracotomy after presenting with chronic respiratory changes. During the operation, tumor masses were found in the right and left caudal pulmonary lobes. Due to the severity of clinical respiratory signs and the extent of the lesions, the animal was subjected to euthanasia and anatomopathological examination. Upon necroscopic examination, a tumor mass was found in the middle third of the left caudal lobe, rounded to flattened, measuring 10.0 × 8.0 cm in height and length, white in color, of firm consistency, smooth and regular surface and rising to the lung surface. When sectioned, the mass showed to be composed of multiple firm and dense circular lobes, separated by a thin layer of connective tissue. The tumor invaded the lumen of nearby segmental and subsegmental bronchi, which were partially or totally obstructed by the mass. In the right lung, multiple similar nodules were observed, accompanied by peritumoral hemorrhage. Histopathological analysis of the new formation revealed a dense cluster of cells that expanded over the lung parenchyma. The neoplastic cells were pleomorphic, moderately cohesive, without defined borders, with abundant cytoplasm, densely eosinophilic and finely granular. Intracytoplasmic granules were well evidenced by periodic acid Schiff staining (PAS). The cell nucleus was rounded to oval, excentric, markedly basophilic and with dense chromatin. There was moderate anisocytosis and mild anisokaryosis, with rare mitotic figures. Immunohistochemical analysis revealed positive staining for anti-vimentin and anti-S100 antibodies, confirming the diagnosis of granular cell tumor.Discussion: Granular cell tumors have no predisposition as to breed, sex or age. However, most of the described cases are reported in female horses aged around 13 years. The advanced age of the diagnosed animals may be related to late definitive diagnosis, since the clinical signs are nonspecific and treated palliatively like other respiratory diseases. Macroscopically, this tumor is more common in the multinodular form and, as observed in this case, it has a greater capacity for infiltration. Histologically, the visualization of large, polygonal cells, with a wide cytoplasm containing eosinophilic granules leads to the diagnosis of granular cell tumor. However, PAS staining and immunohistochemical tests were essential for the diagnostic conclusion in this report, confirming the presence of cytoplasmic granules and the mesenchymal and neuroectodermal origin of this neoplasm, respectively. Thus, considering the low occurrence of pulmonary granular cell tumor, the description of this case contributes to the basis of the knowledge of medical-veterinary professionals about this tumor in its clinical and diagnostic aspects.Keywords: Schwann cells, immunohistochemistry, neoplasia, lung.Descritores: células de Schwann, imuno-histoquímica, neoplasia, pulmão.Título: Tumor de células granulares pulmonar em um equino

Atypical cytological presentation of granular cell tumour: Tumour-associated fibrosis may affect fine-needle aspiration cytology accuracy.

The cytological features of granular cell tumour (GCT) are generally quite typical but, in some cases, the fine needle aspiration cytology (FNAC) diagnosis of GCT may be difficult or impossible because of unusual sites of onset or equivocal cytological features. In this report, two GCTs with atypical FNAC features are described in order to investigate the causes and provide possible diagnostic tips. From a series of nine histologically proven GCTs, two inconclusive FNAC cases were retrieved. Smears were poorly cellular showing isolated naked nuclei, anisonucleosis, granular chromatin and occasional small nucleoli. The background was finely granular in one case. Histological controls of these cases revealed marked fibrosis. Tumour-associated fibrosis in GCT is variable and does not seem to influence clinical behaviour but it influences the harvest and the integrity of granular cells collected by FNAC. When GCT smears are poorly cellular, attention should be paid to the granular background and to the few granular cells, if any, as they might be the only features to suggest a GCT.

Squash smear cytology of pituitary granular cell tumor: A case report and review of literature with special emphasis on cytological differential diagnosis in pituitary region

Neurohypophysis granular cell tumor (NGCT) is a rare entity and is classified under thyroid transcription factor 1 (TTF-1) expressing tumors of pituitary. It is considered as an uncommon differential during sellar and suprasellar mass evaluation. Its intraoperative squash cytology is distinct and has rarely been reported in literature. A 65-year-old female presented with reduced vision of right eye and history of seizures. Radiological findings revealed a sellar/suprasellar mass with mass effect on optic chiasma. Intraoperative squash neurocytology examination showed a spindle cell lesion with abundant granular cytoplasm in tumor cells. Subsequent histopathology and immunohistochemistry confirmed the diagnosis of granular cell tumor. Granular cell tumor remains one of the sellar/suprasellar surprises. Its intraoperative neurocytology is unique and should be considered while evaluating a sellar/suprasellar mass. A case of sellar granular cell tumor with its intraoperative squash cytology, histopathology along with a review of literature is being presented with special emphasis on cytological differential diagnosis in pituitary region.

Experience with Esophageal Granular Cell Tumors: Clinical and Endoscopic Analysis of 22 Cases.

Esophageal granular cell tumors (GCTs) are rare tumors. Differences in reports on the clinical features of GCTs in the esophagus and some controversies about the diagnostic strategy for esophageal GCTs exist. We aimed to investigate the clinical features and diagnosis of esophageal GCTs. Additionally, we sought to determine the prevalence of gastroesophageal reflux disease and reflux esophagitis in patients with esophageal GCTs. We retrospectively studied the clinical features, endoscopic features, and management of 22 patients with esophageal GCTs. Esophageal GCTs were more common in men than in women with a ratio of 1.2:1 and were predominantly found in the distal esophagus. Ten patients with esophageal GCTs had regurgitation and/or heartburn symptoms, and eight patients were confirmed to have reflux esophagitis by endoscopy. All esophageal GCTs were protuberant lesions covered by normal esophageal epithelium. The endoscopic morphology of esophageal GCTs was diverse. On endoscopic ultrasonography, these tumors appeared as homogeneous or inhomogeneous hypoechoic lesions with clear borders originating from the submucosal or mucosal layer. Eleven patients underwent endoscopic forceps biopsy at the first endoscopy, and only six patients were correctly diagnosed by pathology. Nevertheless, the 18 lesions treated with endoscopic resection were all correctly diagnosed without complications, and no patients developed recurrence during the follow-up period. The occurrence of esophageal GCTs may be related to esophageal inflammation. As a method for obtaining an accurate pathological diagnosis and for treatment, endoscopic resection should be offered as the primary option for patients with esophageal GCTs.

Granular cell tumour (Abrikossoff's tumor) in the ENT region: about two cases report

<p class="abstract">Granular cell tumors also named Abrikossoff’s tumors, are very rare soft tissue tumors, almost always benign and can affect different organs. The head and neck location are the most common, particularly skin and the tongue. The larynx is concerned in 7 to 10% of the cervico-facial locations of this tumor (1, 2). In this article we report two cases of Abrikossoff’s tumor. The first case is of a 27 years old man, with no particular features in his medical history, who consulted for dysphonia, progressively evolving over 6 months. The nasal endoscopy found a whitish nodular lesion of almost 20 mm of diameter, involving the middle third of the right vocal cord. The tumor was removed under microlaryngoscopy. The second case is of ten days old newborn female, who presented dyspnea and dysphagia while breastfeeding, the clinical exam showed a round shaped lesion of 4 cm of diameter, implanted in the dorsal face of the tongue. The lesion was rooted out with electrocautery under general anesthesia. Anatomopathology examination with Immunohistochemistry of both patients’ surgical samples confirmed the diagnosis of granular cell tumor. The Origin of the Abrikossof’s tumors is uncertain. The recent immunohistochemical studies are orienting toward neurogenic origin. These tumors usually arise in the adult, between the ages of 20 to 60 years old, with female predominance. The symptoms are diverse and non-specific, only the anatopahtological examination permits to confirm the diagnosis. The main issues of these tumors are the compression of the adjacent structures and the high risk of recurrence, which requires long term surveillance.</p>

Granular cell tumor of the breast: correlations between imaging and pathology findings.

ObjectiveTo review the imaging features of granular cell tumors of the breast (on mammography, ultrasound, and magnetic resonance imaging), establishing a pathological correlation, in order to familiarize radiologists with this entity and make them aware of the differential diagnoses, other than malignancy, of lesions with spiculated margins.Materials and MethodsWe reviewed the medical records (from a clinical-pathology database and picture archiving and communication system) of five patients with a pathologically confirmed diagnosis of granular cell tumor of the breast, treated at the Portuguese Oncology Institute of Lisbon, in the city of Lisbon, Portugal, between January 2012 and December 2018.ResultsAll five tumors exhibited imaging features highly suggestive of malignancy (BI-RADS 5 lesions), namely spiculated margins, significant depth, and posterior acoustic shadowing (on ultrasound). One tumor showed a kinetic curve indicative of washout on magnetic resonance imaging, two were adherent to the pectoralis muscle, and one was accompanied by skin retraction. Pathology provided the definitive diagnosis in all cases.ConclusionGranular cell tumors of the breast pose a diagnostic challenge because they can present with clinical and imaging features mimicking malignancy, and the diagnosis is therefore provided by pathology. Radiologists should be familiarized with this entity, so they can be aware of the fact that breast lesions with spiculated margins can be indicative of diagnoses other than malignancy.

GRANULAR CELL TUMOR OF LOWER LIP: CASE REPORT

Granular cell tumor is a rare benign soft-tissue neoplasm with a predilection for the mouth. Its most common location is in the tongue followed by buccal mucosa. There is a predilection for the female sex, and it occurs most often between the fourth and sixth decade. It is usually normochromic, but occasionally it may present a yellow coloration. Our aim is to report a case of a 21-year-old black male patient presenting a firm yellowish sessile nodule, measuring 1 cm in the lower lip with an evolution of 3 years. The clinical diagnoses were fibrolipoma and traumatic fibroma. An excisional biopsy was performed, and in the histopathologic examination a proliferation of large and polygonal cells with abundant eosinophilic and granular cytoplasm and vesicular nuclei were observed, leading to the diagnosis of granular cell tumor. The patient has been followed up for 5 months, and no recurrence was observed.

GRANULAR CELL TUMOR: REPORT OF A CASE IN A YOUNG PATIENT

Granular cell tumors are a rare benign neoplasm of uncertain etiology and probable origin from Schwann cells that in the oral cavity affect the tongue preferentially. The nature of their cytoplasmic granularity may be a result of cell senescence due to lysosome accumulation. This work reports a case of granular cell tumor arising in the dorsum of the tongue of an 18-year-old brown woman displaying a solitary, fast-growing, painful, and sessile 2-cm-sized swelling at the presentation. After excisional biopsy, the microscopic analysis revealed a massive and poorly demarcated proliferation of plump eosinophilic and polygonal cells showing central small dark nuclei and abundant granular cytoplasm. These cells are intimately associated to skeletal muscle. Immunohistochemical evaluation demonstrated an intense positive staining to S100 protein in tumor cells, establishing the diagnosis of granular cell tumor. Since 1 year of clinical follow-up, no recurrence was identified.