PDF(Pubmed)
Abstract：
Granular cell tumors are extremely uncommon soft tissue neoplasms that mostly occur in the head and neck regions. Granular cell tumors are generally benign, asymptomatic, and rarely involve the median nerve. Due to the lack of awareness about granular cell tumors, they are easily misdiagnosed and mistreated in primary hospitals. Here, we report a giant atypical granular cell tumor located on the median nerve, approximately 12 cm in size, with unusual symptoms of median nerve damage. Magnetic resonance imaging revealed a fusiform mass that was hyperintense on T2-weighted images and iso-hypointense on T1-weighted images. The mass was subsequently biopsied and found to be a granular cell tumor. The tumor was resected, and a pathological examination was performed. Pathological examination revealed necrotic foci, abundant eosinophilic granules, pustular ovoid bodies, and multiple mitoses. Immunohistochemical staining revealed that the tumor cells were positive for S-100, CD68, SMA, SOX-10, Calretinin, and TFE3. The integrated diagnosis was an atypical granular cell tumor. To the best of our knowledge, this is the first report of an atypical granular cell tumor involving the median nerve. Furthermore, we comprehensively reviewed the existing literature to provide a concise summary of the diagnostic criteria, imaging findings, and pathological features of granular cell tumors. Given the high recurrence and metastasis rates of this disease, granular cell tumors of the median nerve should be considered when a patient presents with symptoms of median nerve impairment. The diagnosis of atypical granular cell tumors relies on pathological examination. In addition, extensive resection and long-term follow-up are necessary to improve prognosis.
摘要：
颗粒细胞瘤是极其罕见的软组织肿瘤，主要发生在头颈部。颗粒细胞瘤通常是良性的，无症状，很少涉及正中神经。由于对颗粒细胞瘤的认识不足,他们在基层医院很容易被误诊和虐待。这里,我们报道了一个位于正中神经的巨大非典型颗粒细胞瘤,大约12厘米大小，有异常的正中神经损伤症状.磁共振成像显示纺锤状肿块，在T2加权图像上为高强度，在T1加权图像上为等信号。随后对肿块进行活检，发现是颗粒细胞瘤。肿瘤被切除了,并进行了病理检查。病理检查显示坏死灶，丰富的嗜酸性粒细胞，脓疱状卵圆形体,和多个有丝分裂。免疫组化染色显示肿瘤细胞S-100、CD68、SMA、SOX-10,Calretinin,TFE3综合诊断为非典型颗粒细胞瘤。据我们所知,这是首次报道累及正中神经的非典型颗粒细胞瘤。此外，我们全面回顾了现有文献，以提供诊断标准的简明总结，影像学发现，颗粒细胞瘤的病理特征。鉴于这种疾病的高复发率和转移率，当患者出现正中神经损伤症状时，应考虑正中神经的颗粒细胞瘤。非典型颗粒细胞瘤的诊断依赖于病理检查。此外,广泛切除和长期随访是改善预后的必要条件。
