Granular cell tumor of stomach： A case report and review of literature

Granular cell tumor (GCT) was described for the first time by Abrikosoff in 1926. It is a relatively rare neoplasm that may occur at many sites, but most commonly in the skin or soft tissues. The occurrence of GCT in the gastrointestinal tract is rare, accounting approximately for 8% of all tumors, among which the most common site is the esophagus, whereas gastric localization is very rare. Gastric GCTs can be solitary or, more frequently, associated with other gastrointestinal localization. Although GCTs are usually clinically and histologically benign, some malignant cases have been reported. Histologically, these tumors consist of polygonal and fusiform cells disposed in compact "nests" and immunohistochemical staining for S-100 protein supports the proposed derivation from Schwann cells. A correct preoperative diagnosis of this tumor can only be made in 50% of all patients and it is always based on endoscopic biopsy. Laparoscopic or conventional wedge resection represents the treatment of choice. In this study, the authors reported a case of a 49-year-old woman with a solitary granular cell tumor of the stomach with infiltrative pattern, successfully treated with surgical resection. A review of literature is also presented with emphasis on diagnostic criteria concerning the malignant form.     

Granular cell tumor of the rectum: a case report and review of the literature

A 47-year-old Japanese woman with a 5-year history of alcoholism was admitted to the Ryukyu University Hospital for the treatment of the alcoholism. For evaluation of observed changes in her bowel habits, she underwent colonoscopy, which revealed seven small polyps spread throughout the entire large intestine. Six of the polyps were in the colon; one was an adenoma and five were hyperplastic polyps. The remaining polyp, in the rectum, was an 8-mm submucosal tumor. Pathological analysis of a biopsy of the lesion in the rectum indicated a possible diagnosis of adenocarcinoma. Endoscopic ultrasonography (EUS) demonstrated a submucosal hypoechoic nodule, involving the mucosa and the muscularis propria. Subsequently, the patient underwent a radical low anterior resection of rectum. The lesion was a submucosal tumor with ulceration. The tumor consisted of granular tumor cells which were positive for S-100 protein, neuron-specific enolase, and periodic acid schiff (PAS) stain, but negative for desmin and vimentin. Granular cell tumor is rare in the gastrointestinal tract. As a result, such tumors can be misinterpreted to indicate a possible malignancy on either a biopsy or EUS. Received: July 9, 1999 / Accepted: December 17, 1999     

Granular cell myoblastoma of the esophagus

Granular cell myoblastoma, a rare, but generally benign tumor, is being encountered with increasing frequency in the digestive tract. Seventy-two cases have been described in the esophagus; we report two additional cases. A follow-up, available in 13 patients (including ours), reveals a low likelihood of malignant transformation or recurrence after surgical removal. Guidelines for the management of these tumors are presented.     

Granular cell tumor of colon： Report of a case and review of literature

Granular cell tumor (GCT) is uncommon in the colon and rectum. Here we report a case of GCT in the transverse colon. A 48-year-old male patient underwent a screening colonoscopy. A yellowish sessile lesion, about 4 mm in diameter, was found in the transverse colon. An endoscopic snare resection was performed without complication. Histological examination revealed the tumor consisted of plump neoplastic cells with abundant granular eosinophilic cytoplasm containing acidophilic periodic acid Schiff-positive, diastase-resistant granules. Immunohistochemical analysis showed the tumor cells expressed S-100 protein and neuron-specific enolase. Thus, the resected tumor was diagnosed as a GCT. Since GCTs are usually benign, endoscopic resection constitutes an easy and safe treatment. Colonoscopists should consider the possibility of GCT in the differential diagnosis of submucosal tumors of the colon.     

Granular cell tumors of the colon: report of a case and review of the literature

Granular cell tumors are uncommon, usually benign tumors that can be located anywhere in the body. They commonly occur in the oral cavity and in subcutaneous tissue. In the gastrointestinal tract, granular cell tumors are uncommon and are quite rare in the colon. To date, 55 patients diagnosed with granular cell tumors of the colon have been reported in the literature, only 15 had multiple tumors. We describe the case of a 38-year-old man with a family history of colon cancer who was diagnosed with multiple colonic granular cell tumors after a screening colonoscopy. This seems to be the first report of this type. However, in our patient, the diagnosis of colonic granular cell tumors was incidental and there is no data that correlates adenomas or colorectal cancer with granular cell tumors of the colon. Finally, since granular cell tumors are usually benign, we suggest a conservative approach to patients with multiple granular cell tumors of the colon by means of endoscopic resection and a strict endoscopic follow-up.     

Granular cell myoblastoma of the sigmoid colon

A granular cell myoblastoma of the upper sigmoid colon is reported in a 53-year-old male. The tumor was detected during investigation of abdominal pain and was removed by colonoscopic polypectomy. Colonoscopy provides a new method of treatment for these unusual colonic lesions and avoids the need for surgery. To our knowledge the tumor has not been reported previously in the sigmoid colon.     

Granular acute lymphoblastic leukemia: a case report and literature review

Authors report a rare case of granular acute lymphoblastic leukemia (ALL) in a 45-year-old woman with a history of multiple myeloma. The patient's lymphoblasts contained large numbers of distinctive cytoplasmic granules closely mimicking heavily granulated myeloblasts in acute myeloid leukemia. These blasts were completely negative for myeloperoxidase but positive for acid phosphatase and Periodic Acid-Schiff reaction by cytochemical staining. Immunophenotype analysis by immunohistochemistry clearly demonstrated precursor B-cell phenotype. Granular ALL occurs approximately 2 to 7% in childhood populations but is extremely rare in adults. Such cases may cause problematic distinction from myeloid differentiation and lead to misdiagnosis of acute myeloid leukemia. Ten cases of adult granular acute lymphoblastic leukemia described to date in the literature were also reviewed.     

Colonic squamous cell carcinoma in ulcerative colitis: Report of a case and review of the literature.

Squamous cell carcinoma (SCC) is a rare neoplasm in the colorectum. A case of SCC rising from an area of squamous metaplasia in the rectum is presented in a patient with long-standing ulcerative colitis and perianal warts. This is the first report in the literature describing the evolution of squamous metaplasia in the colonic mucosa into invasive carcinoma over time. Related literature on colorectal SCC and squamous metaplasia, and their relationships with inflammatory bowel disease and human papilloma virus, is reviewed.     

Granular-cell myoblastoma of the cecum: Report of a case

Summary A 9-mm granular-cell myoblastoma of the cecum found incidentally during appendectomy in a 17-year-old girl is reported. Electronmicroscopic findings favor origin of the granular cells from an undifferentiated mesenchymal (fibroblast-like) cell. Review of the small number of previously reported cases revealed three involving the cecum, one each in the ascending and transverse colon and two in the rectum. Four patients were asymptomatic and their lesions were found incidentally. Three lesions simulated malignancy clinically; these patients underwent right hemicolectomy.     

Isolated ileal villous atrophy: a rare cause of chronic diarrhea. Report of a case and review of the literature

Villous atrophy of the terminal ileum is usually secondary to celiac disease or other diseases. Very few cases of primary ileal villous atrophy have been reported in the literature. We report here the case of a 37-year-old man with chronic diarrhea since childhood without features of malabsorption. The macroscopic and microscopic appearance of the duodenal, ileal and colonic mucosae at endoscopy and contrast radiography of the small bowel was normal. Ileal lesions consisted of total villous atrophy. Search for antinuclear antibodies, anti-endomysium and anti-gliadin IgA and IgG and HIV serology were negative. Serum immunoglobulin level was normal. Diarrhea resolved under treatment with colestyramine.     

Granular cell myoblastoma of the common bile duct

Summary Two cases of granular cell myoblastoma of the common bile duct are reported. One tumor caused extrahepatic cholestasis and another was an incidental finding at autopsy. These are the second and third cases reported involving the common bile duct.Supported in part by US Public Health Service Research Grant FR-5590, from the Division of Research Facilities and Resources, NIH.The authors are indebted to Drs. J. Paul Decker, Frank P. Brooks, and Ralph M. Myerson for their critical review of this paper, and to Dr. P. V. Skerrett for review of the pathologic material.     

Primary squamous cell carcinoma of the stomach. Report of a case and review of literature

Primary squamous cell carcinomas of the stomach represent a rare entity. Since the first report in 1895 by R?rig et al. (1) only 80 cases have been published. These reports show a peak incidence in the sixth decade of life and preference of male gender (5:1). We report the case of a 61-year-old patient who presented with anemia and weight loss due to a large tumor of the gastric wall with adhesion to the pancreatic tail. After radical regional "en bloc" gastrectomy, splenectomy and pancreatic tail resection, the diagnosis of primary gastric squamous cell carcinoma could be confirmed, since the esophageal wall and the pancreatic tail were not infiltrated and extragastric squamous cell primaries could be excluded. After postoperative irradiation of the upper abdominal area, the patient developed a single liver metastasis in the left hepatic lobe that decreased with polychemotherapy. It was resected half a year later. Due mainly to advanced tumor stages, survival after surgical resection is poor. However, adjuvant radio and chemotherapy have resulted in survival rates of more than 3 years in reported cases, as in the present case. Five years after the diagnosis was established the patient is free of recurrence and without any complaint. Pathophysiological features, therapy and outcome are discussed by reviewing the cases reported in world literature.