Granular Cell Tumor

颗粒细胞肿瘤
  • 文章类型: Journal Article
    背景:颗粒细胞瘤(GCT)是一种罕见的口腔良性病变,其发病机制尚不清楚。由于其罕见发生且与其他口腔病变相似,在最初的临床诊断中,它们经常被遗忘。因此,了解其普遍性,临床和病理特征对于准确诊断和适当管理至关重要。
    方法:对6个巴西和阿根廷口腔诊断中心诊断为GCT的所有病例进行HE染色重新评估,临床,人口统计学,收集和评估组织病理学数据。
    结果:该系列包括45名女性(73.8%)和16名男性(26.2%),男女比例为2.8:1,平均年龄为35.3±16.9岁(范围:7-77岁)。大多数病例发生在舌头上(n=49;81.6%),临床上表现为无症状的丘疹或结节(n=50;89.3%),具有正常变色(n=25;45.5%)或淡黄色(n=11;20.0%)着色,大小范围为0.2至3.0cm(平均±SD:1.40±0.75cm)。形态学上,大多数肿瘤的特征是有限的增殖(n=52;88.1%)细胞通常圆形到多边形,嗜酸性粒细胞,细颗粒状细胞质。在所有病变中均发现了Milian的卵形体(n=61;100%)。骨骼肌横纹肌(n=44;72.1%)和神经纤维(n=42;68.9%)的捕获是常见的发现。23例(39.0%)出现假性上皮瘤增生(PEH)。在仅27.7%的病例(n=13)中,临床和组织病理学诊断之间存在一致性。结果信息来自16例患者(26.2%),临床随访4-36个月(平均13.3个月),没有发生局部复发。
    结论:GCT的临床和组织病理学特征与先前研究中描述的一致。总的来说,这些病变对成年女性的舌头外侧区域有好感。在口腔黄色或正常色斑丘疹和结节的鉴别诊断中,必须考虑GCT。组织病理学评估对于明确诊断至关重要,预后良好。
    BACKGROUND: Granular Cell Tumor (GCT) is an uncommon benign lesion in the oral cavity whose pathogenesis remains poorly understood. Due to their infrequent occurrence and similarity to other oral lesions, they are often forgotten during the initial clinical diagnosis. Therefore, understanding its prevalence, clinical and pathological characteristics is crucial for an accurate diagnosis and adequate management.
    METHODS: All cases diagnosed as GCTs in six Brazilian and Argentinian oral diagnostic centers were re-evaluated by HE staining, and clinical, demographic, and histopathological data were collected and evaluated.
    RESULTS: The series comprised 45 female (73.8%) and 16 male (26.2%), with a 2.8:1 female-to-male ratio and a mean age of 35.3 ± 16.9 years (range: 7-77 years). Most cases occurred on the tongue (n = 49; 81.6%) and presented clinically as asymptomatic papules or nodules (n = 50; 89.3%) with a normochromic (n = 25; 45.5%) or yellowish (n = 11; 20.0%) coloration and sizes ranging from 0.2 to 3.0 cm (mean ± SD: 1.40 ± 0.75 cm). Morphologically, most tumors were characterized by a poorly delimited proliferation (n = 52; 88.1%) of cells typically rounded to polygonal containing abundant, eosinophilic, finely granular cytoplasm. Pustulo-ovoid bodies of Milian were identified in all lesions (n = 61; 100%). Entrapment of skeletal striated muscle (n = 44; 72.1%) and nerve fibers (n = 42; 68.9%) were common findings. Pseudoepitheliomatous hyperplasia (PEH) was observed in 23 cases (39.0%). In only 27.7% of cases (n = 13) there was agreement between the clinical and histopathological diagnosis. Outcome information was available from 16 patients (26.2%), with clinical follow-up ranging from 4 to 36 months (mean 13.3 months), and none developed local recurrence.
    CONCLUSIONS: The clinical and histopathological features of GCTs were consistent with those described in previous studies. In general, these lesions have a predilection for the lateral region of the tongue in adult women. It is essential to consider GCTs in the differential diagnosis of yellow or normochromic papules and nodules in the oral cavity. Histopathological evaluation is essential for the definitive diagnosis and the prognosis is excellent.
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  • 文章类型: Multicenter Study
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  • 文章类型: Review
    目的:颗粒细胞瘤(GCT)通常出现在皮下组织和头颈部,在胃肠道中并不常见。在儿科人群中使用食道GCT的经验有限,文献中只有7例报道,3伴嗜酸性粒细胞性食管炎(EoE)。
    方法:检索了11例食管GCT患儿的病例资料。H&E和免疫组织化学切片进行了临床回顾,内窥镜,和所有患者的随访数据。
    结果:总计,包括7名男性和4名女性患者,年龄从3到14岁不等。食管胃十二指肠镜检查(EGD)的适应症包括EoE(n=3),克罗恩病的随访,和其他非特定投诉。内窥镜检查,所有患者都有单一的粘膜下,伸入管腔的坚固物质,粘膜正常。在所有情况下,都通过内窥镜将多个碎片中的结节切除。组织学上,肿瘤显示细胞的片状和小梁含有温和的细胞核,不显眼的核仁,和丰富的粉红色颗粒细胞质,无非典型特征。所有肿瘤对S100、CD68和SOX10均具有免疫反应性。随访显示所有患者均无病(中位数,2年)。
    结论:我们报告了与EoE有巧合关联的最大系列小儿食管GCT。这些EGD发现是有特点的,活检切除是诊断和治疗。
    Granular cell tumor (GCT) commonly presents in the subcutaneous tissue and head and neck region, and it is uncommon in the gastrointestinal tract. Experience with esophageal GCTs in the pediatric population is limited, with only 7 cases reported in the literature, 3 with eosinophilic esophagitis (EoE).
    Case information from 11 pediatric patients with GCTs of the esophagus was retrieved. H&E and immunohistochemical slides were reviewed with clinical, endoscopic, and follow-up data from all patients.
    In total, 7 male and 4 female patients were included, with ages ranging from 3 to 14 years. Indications for esophagogastroduodenoscopy (EGD) included EoE (n = 3), follow-up for Crohn disease, and other nonspecific complaints. Endoscopically, all patients had a single submucosal, firm mass protruding into the lumen, with normal overlying mucosa. The nodules were removed endoscopically in multiple fragments in all cases. Histologically, the tumors showed sheets and trabeculae of cells containing bland nuclei, inconspicuous nucleoli, and abundant pink granular cytoplasm without atypical features. All tumors were immunoreactive for S100, CD68, and SOX10. Follow-up showed that all patients were disease-free (median, 2 years).
    We report the largest series of pediatric esophageal GCTs with coincidental association with EoE. These EGD findings are characteristic, and removal by biopsy is both diagnostic and therapeutic.
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  • 文章类型: Case Reports
    未经授权:报告1例颈气管颗粒细胞瘤(CTGCT),并对其临床表现进行讨论。诊断,CTGCT的治疗。还讨论了气管膜中肿瘤的其他病例。提出了一种简单可行的气管重建方法。研究设计涉及病例报告和文献综述。
    UNASSIGNED:确定了24例宫颈GCT病例报告,临床资料完整,特别关注涉及颈气管膜肿瘤手术治疗的病例。
    UNASSIGNED:确定了28例颈部气管GCT报告和6例颈部气管膜肿瘤报告。还讨论了患有宫颈GCT的中年亚洲女性的临床资料。
    未经证实:宫颈GCT是一种罕见的疾病,气管切除术是治疗颈气管GCT的合理方法。所提出的程序是使用双蒂带状肌筋膜皮瓣重建颈气管膜缺损的简单可行的方法。
    UNASSIGNED: A case of cervical tracheal granular cell tumor (CTGCT) is reported together with a discussion on the clinical manifestation, diagnosis, and treatment of CTGCT. Additional cases of tumors in the tracheal membrane are also discussed. A simple and viable tracheal reconstruction method was proposed. The research design involves a case report and literature review.
    UNASSIGNED: Twenty-four case reports on cervical GCT with complete clinical data were identified, with a specific focus on cases involving surgical treatment of tumors in the cervical tracheal membrane.
    UNASSIGNED: Twenty-eight reports of GCT in the cervical trachea and six reports on cervical tracheal membrane tumors were identified. The clinical data of a middle-aged Asian woman with a cervical GCT was also discussed.
    UNASSIGNED: Cervical GCT is a rare disease, and tracheal resection is a reasonable treatment for cervical tracheal GCT. The proposed procedure is a simple and feasible method for reconstruction of the cervical tracheal membrane defect using a double-pedicled banded myofascial flap.
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  • 文章类型: Journal Article
    颗粒细胞肿瘤(GCTs)的特征是大量的嗜酸性粒细胞胞浆颗粒。基于假设犬颅内GCT是脑膜瘤的一种亚型,其细胞质颗粒是通过自噬过程形成的,对7例犬颅内GCT和15例常规脑膜瘤的活检标本进行组织病理学和免疫组织化学检查。组织病理学,7/7例GCT累及脑膜;3/7例可见脑膜上皮样细胞灶;2/7例可见脑浸润。免疫组织化学,肿瘤细胞的GCTs是E-cadherin阳性和阴性的S100,细胞角蛋白,7/7例患者中CD204和β-catenin。15/15脑膜瘤的肿瘤细胞E-cadherin阳性,S100和CD204阴性。在6/15例和8/15例中观察到脑膜瘤对细胞角蛋白和β-catenin的免疫反应性。分别。GCT的细胞质颗粒泛素阳性(5/7),P62(5/7),和LC3(7/7)。与GCT相比,脑膜瘤中泛素(6/15)和p62(3/15)阳性病例的比率较低,15/15例LC3阴性。这些发现表明,GCT的生物学性质包括解剖位置,E-cadherin的组织病理学特征和免疫反应性与脑膜瘤几乎一致。自噬相关分子的免疫反应性可能提示自噬可能参与犬颅内GCT的细胞质颗粒形成。
    Granular cell tumors (GCTs) are characterized by abundant eosinophilic cytoplasmic granules. Based on the hypothesis that canine intracranial GCT is a subtype of meningioma and its cytoplasmic granules are formed through autophagy processes, histopathological and immunohistochemical examination were performed on biopsy samples from 7 cases of canine intracranial GCTs and 15 cases of conventional meningiomas. Histopathologically, 7/7 cases of GCTs involved the meninges; foci of meningothelial-like cells were observed in 3/7 cases; brain invasion was observed in 2/7 cases. Immunohistochemically, neoplastic cells of GCTs were positive for E-cadherin and negative for S100, cytokeratin, CD204, and β-catenin in 7/7 cases. Neoplastic cells of 15/15 cases of meningiomas were positive for E-cadherin, and negative for S100 and CD204. Immunoreactivity of meningiomas for cytokeratin and β-catenin was observed in 6/15 cases and 8/15 cases, respectively. Cytoplasmic granules of GCTs were positive for ubiquitin (5/7), p62 (5/7), and LC3 (7/7). Compared to GCTs, the ratios of ubiquitin (6/15) and p62 (3/15) positive cases were lower in meningiomas, and 15/15 cases were negative for LC3. These findings indicate that the biological natures of GCTs including anatomical location, histopathological features and immunoreactivity for E-cadherin are almost in conformity with those of meningiomas. The immunoreactivity for autophagy associated molecules may suggest the possible involvement of autophagy in cytoplasmic granule formation of canine intracranial GCTs.
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  • 文章类型: Journal Article
    BACKGROUND: Although a granular cell tumor (GCT) usually develops on the skin or oral mucosa, it has been described in many other organs. GCT typically presents as a solitary tumor, but multiple lesions can occur. It has also been described in association with other diseases.
    OBJECTIVE: To describe the clinical characteristics of cutaneous and oral mucosal GCTs and explore potential associations with other diseases.
    METHODS: Retrospective study of patients diagnosed with GCT at our hospital between 1995 and 2019. The following information was collected from the patients\' medical records: age, sex, number of GCTs, location, diameter, time to diagnosis, tentative clinical diagnosis, surgical margin status, recurrence, follow-up time, and associated diseases.
    RESULTS: We detected 89 cutaneous or oral mucosal GCTs in 81 patients (43 women, 38 men) with a mean age of 40.21 years. The mean tumor diameter was 1.34cm. Five of the 81 patients (6.2%) had multiple GCTs, including noncutaneous tumors. Patients with multiple GCTs were on average younger than those with a single tumor (P=.004). There was only a single case of local recurrence and no cases of distant metastasis. None of the patients had associated diseases.
    CONCLUSIONS: Most GCTs are benign and local recurrence is uncommon, even in patients with positive margins. Nevertheless, the possibility of multiple tumors affecting the skin, oral mucosa, or internal organs should be borne in mind, especially in young patients.
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  • 文章类型: Journal Article
    背景:颗粒细胞瘤(GCT)仍然是一个诊断性的临床病理问题,因为其详细的形态学和临床特征的确切频率是未知的,因为大多数观察是从小系列或孤立病例收集的。在这里,我们的目的是根据我们的系列文章和现有的医学(PubMed)文献,强调这种罕见肿瘤的所有临床病理特征的发生频率.
    方法:42例被评估为:肿瘤累及的组织层(皮肤和粘膜),增长模式,核多态性,有丝分裂指数,坏死,纺锤,钙化,透明质化,还有米莲的脓疱卵圆形身体,以及神经周和血管侵犯,以及邻近上皮的改变,淋巴细胞和嗜酸性粒细胞浸润。,随访进行了分析。肿瘤被分为良性,根据Fanburg-Smith标准,非典型和恶性,并根据Nasser标准进入良性或恶性潜力不确定的GCT。根据PRISMA指南对1499例进行了相同的特征分析。
    结果:在当前系列中,诊断时的平均年龄为45.8岁(范围6~69岁).大多数患者是女性(60%),受累器官的频率下降:皮肤和皮下组织,支气管,食道,乳房,舌头,喉部,咽部,牙龈,气管,右结肠,外阴,和下咽。未见复发或进展,尽管32例切除不完全,除了一个恶性肿瘤。生长模式为渗透型(85.71%)或有限型(7.14%)。16个肿瘤有囊泡核。在两个肿瘤中发现有丝分裂活性。在14个肿瘤中发现淋巴细胞浸润。6例存在嗜酸性粒细胞。右结肠的一个GCT显示广泛的钙化和透明化。在6个病变中发现了神经周围浸润。未发现血管侵犯。一个肿瘤是临床上恶性的,患者在诊断后2年死亡。医学文献综述显示,在报告的临床和形态学特征的频率方面,结果相似。在有随访的病例中,近20%显示切缘阳性,20%出现局部复发.根据范堡-史密斯标准,72%是良性的,17%的非典型和11%的恶性肿瘤,而根据纳赛尔的说法,93%是良性的,7%是不确定的恶性潜力。然而,真正的恶性肿瘤,正如GCT转移所证实的那样,在近2.5%的病例中发现。
    结论:GCT通常是良性肿瘤,影响任何解剖位置。坏死和有丝分裂活动似乎是检测侵袭性肿瘤的最有效的组织学标准。但是转移的存在(占病例的2.5%)仍然是诊断恶性GCT的最公认的确定标准。
    BACKGROUND: Granular cell tumor (GCT) remains a diagnostic clinicopathologic problem because the exact frequency of its detailed morphological and clinical characteristics is unknown as most observations are collected from small series or isolated cases. Herein, our aim is to highlight the frequency of all clinicopathological characteristics of this rare tumor based in our series and the available medical (PubMed) literature.
    METHODS: 42 cases were evaluated for: tissue layers involved by the tumor (in skin and mucosae), growth pattern, nuclear pleomorphism, mitotic index, necrosis, spindling, calcification, hyalinization, and pustule-ovoid bodies of Milian, as well as perineural and vascular invasion, and the presence of adjacent epithelium changes, and lymphocytes and eosinophils infiltration., Follow-up was analyzed. The tumors were subclassified into benign, atypical and malignant according to Fanburg-Smith criteria and into benign or GCT of uncertain malignant potential according to Nasser criteria. The same characteristics were analyzed for 1499 cases reviewed according to PRISMA guidelines.
    RESULTS: In the current series, the mean age at diagnosis was 45.8 years (range 6-69 years). Most patients were females (60 %) and the involved organs were by descending frequency: skin and subcutaneous tissue, bronchus, esophagus, breast, tongue, larynx, pharynx, gingiva, trachea, right colon, vulva, and hypopharynx. No recurrence or progression was seen, despite 32 cases were incompletely excised, with the exception of one malignant tumor. The growth pattern was either infiltrative (85.71 %) or well limited (7.14 %). Sixteen tumors had vesicular nuclei. Mitotic activity was found in two tumors. Lymphocytic infiltration was found in 14 tumors. Eosinophils were present in 6 cases. One GCT of the right colon showed extensive calcification and hyalinization. Perineural invasion was noted in 6 lesions. No vascular invasion was found. One tumor was clinically malignant and the patient died 2 years after diagnosis. Medical literature review showed similar results in terms of frequency of the reported clinical and morphological features. Among cases with available follow up, almost 20 % showed positive margins and of those 20 % developed local recurrence. According to the Fanburg-Smith criteria, 72 % would be benign, 17 % atypical and 11 % malignant tumors, while according to those of Nasser, 93 % would be benign and 7% of uncertain malignant potential. However, true malignancy, as affirmed by metastasis of GCT is found in almost 2.5 % of the cases.
    CONCLUSIONS: GCT is a usually benign tumor, affecting any anatomic location. Necrosis and mitotic activity seem to be the most effective histologic criteria for detecting aggressive tumors, but the presence of metastasis (2.5 % of the cases) remains the most accepted definitive criterion for diagnosis of malignant GCT.
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  • 文章类型: Journal Article
    OBJECTIVE: Granular cell tumour (GCT) is a benign neoplasm that originates from Schwann cells. Within the oral cavity, it usually appears as a lingual nodule and especially amongst female adults. Histologically, GCT shows a proliferation of polygonal cells with eosinophilic granular cytoplasm, which can be associated with a pseudoepitheliomatous hyperplasia (PEH). In this study, we analyse the main clinicopathological data of intraoral GCT and we compare our results with previous studies.
    METHODS: We have studied a series of 56 cases of oral GCT in Spain and Brazil, and we have conducted a systematic review in PubMed, Web of Knowledge and Scopus databases, using the keywords: \"granular cell tumour\" and oral.
    RESULTS: In our series, GCT appeared as an asymptomatic benign tumour that is more frequent in women and in the tongue. PEH was observed in 32% of the lesions. In the review, we collected 282 cases of oral GCT with a similar clinical profile; seven patients had multiple lesions, and 33% of the cases presented PEH. No cases of malignant oral GCT have been described to date. GCT is an uncommon oral benign neoplasm, mainly unique and asymptomatic, derived from Schwann cells.
    CONCLUSIONS: Although the etiopathogenesis of this oral tumour is unknown, its characteristics suggest that it could have a reactive nature. Conducting a complete clinicopathological study in all intraoral GCT is fundamental in order to dismiss other entities, including oral carcinoma.
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  • 文章类型: Case Reports
    Granular cell tumors are lesions of Schwannian phenotype that most frequently arise in the skin, breast, and tongue. Pulmonary granular cell tumors (pGCTs) are exceedingly rare and only a handful of cases worldwide have been reported as malignant. We report here a series of 4 pGCTs, including an extremely rare case of a malignant pGCT which underwent next-generation sequencing to identify a novel pathogenic mutation. We are the first to report any prognostic data and response to treatment. Consistent with granular cell tumors of other primary sites, the majority of pGCTs (75%) were deemed histologically and biological benign without metastasis or recurrence after resection (mean follow-up, 750 d). pGCTs occurred predominantly in women (75%) with a mean age of 57 years (range, 49 to 66 y) and variable smoking history. Notably, 2 women also developed an associated lung carcinoma (adenocarcinoma and small cell carcinoma). We also report here an exceedingly rare case of a 51-year-old nonsmoker woman diagnosed with a malignant pGCT. She presented with a 6.4×6.1×4.4 cm infrahilar left lower lobe mass with extrinsic compression and obstruction of the left mainstem on enhanced computed tomography. Pathology of the resection specimen confirmed a pGCT composed of sheets of tumor cells with pleural, pericardial, and diaphragmatic metastases. Molecular analysis by next-generation sequencing failed to yield any driver mutations common to primary lung adenocarcinomas. Only 2 previous malignant pGCTs have been reported; our case revealed a novel pathologic ATM mutation.
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  • 文章类型: Journal Article
    Granular cell tumors (GCT) are uncommon neoplasms that may involve the larynx. Patients affected with a laryngeal GCT usually complain of dysphonia. When they involve the larynx, these tumors have predilection for the posterior half of the vocal cords. Between 2006 and 2018, we have experienced five cases of GCT involving the right true vocal cord. They were diagnosed and successfully treated with microsurgical resection. Here we present this 5-case series and a retrospective review of literature.
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