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Bronchial granular cell tumor in a child: impact of diagnostic delay
on the type of surgical resection. J
Pediatr Surg. 2006;41(7):1326-8.
Bronchial
granular cell tumor is an uncommon tumor in young children. Recurrent
pneumonia in the same site should raise suspicion of an obstructing
granular cell tumor of the bronchus. We present a 10-year-old girl
with an 18-month history of recurrent pneumonia caused by obstruction
of the main lingular bronchus by this type of tumor. In our patient,
an upper left lobectomy was only technically feasible instead of a
lingulectomy alone because of the spread pulmonary inflammation and
the depth of bronchial wall invasion by the tumor. Delayed diagnosis
resulted in a more extensive pulmonary resection.
Granular cell
tumor--a rare, benign respiratory tract neoplasm in the material of
the Institute of Tuberculosis and Lung Diseases .Pneumonol
Alergol Pol. 2004;72(5-6):187-91.
The
granular cell tumor (GCT) is a nodule that arises most commonly in the
skin, the breast or the tongue. The vast majority are benign.
Approximately 6-10% of granular cell tumors have been reported in the
lower respiratory tract. The clinical, pathological and
immunohistochemical findings of eleven cases are described in our
material consisted of 6 males and 5 females aged from 35 to 58 years
(median, 46 years). The GCT were solitary lesions in all our patients.
The tumors were located in trachea (6 cases) and in bronchus (5
cases). They were found during bronchoscopy performed because of
symptoms of pneumonia, lung cancer and hemoptysis or dyspnea alone.
Diameter of the tumors ranged from 0.2-2.5 cm (median 1.2 cm). Six
tumors were surgically excised and 5 were endoscopically removed.
Pulmonary GCT behave in a benign fashion. It was observed that tumors
of less than 8 mm were more amenable to endoscopic removal and larger
tumors were more likely to infiltrate through the bronchial wall.
Histologically, the GCT showed submucosal infiltrates of round or oval
cells with abundant granular cytoplasm. The tumors cells were positive
for S-100 protein, neuron specific enolase, CD68 and vimentin. Our
immunohistochemical results are consistent with this concept.
Granular
cell tumor of the bronchus.Pediatr
Pulmonol. 2000;30(5):425-8.
Persistent
atelectasis and recurrent pneumonia in the same location should raise
suspicion of congenital anomalies or obstructing lesions of the
bronchus leading to the affected area. We present an 8-year-old black
female with a history of recurrent fever, cough, atelectasis of the
right middle and lower lobes, and weight loss for several months.
Flexible bronchoscopy revealed a polypoid mass obstructing the
bronchus intermedius. Biopsy of the neoplasm demonstrated a granular
cell tumor (GCT). The patient had a lobectomy of the right lower and
middle lobes. She had no recurrence of the tumor after several years
of follow-up.
Granular cell tumours of the lower respiratory
tract.Histopathology.1995 Sep;27(3):257-62.
Granular cell
tumours rarely involve the lower respiratory tract. We report eight
cases surgically resected at our institution. There were four females
and four males, aged between 18 to 56 years (mean 40). One tumour
associated with a peripheral lung adenocarcinoma was asymptomatic. The
other lesions presented with obstructive pneumonitis (3 cases),
haemoptysis (2), dyspnea (1) or cough (1). These tumours were tracheal
(1) or bronchial (6) and one case was located in the lung parenchyma.
Four cases were multicentric with associated lesions located in a
bronchus (2), the oesophagus (1) or a mediastinal lymph node (1). All
tumours, with the largest diameter ranging from 0.5-4.5 cm, were
histologically invasive. The tumours were positive for S-100 protein,
neuron specific enolase, KP1 (CD68) and vimentin. No tumour expressed
desmin, keratin or p53 oncoprotein. Our study demonstrates that, in
spite of marked anatomical and clinical polymorphism, the rare
granular cell tumours of the lower respiratory tract have a constant
histological appearance. Our observations confirm that large tumours
(> 8-10 mm) usually extend beyond the tracheo-bronchial cartilages
and, therefore, only surgical treatment may avoid recurrence.
Granular cell tumors of
the lung. Clinicopathologic study of 20 cases. Am
J Surg Pathol. 1995;19(6):627-35.
Granular cell
tumor (GCT) of the lung is a rare neoplasm comprising 6-10% of all GCT.
Since it was first described in the bronchus by Kramer in 1939, less
than 80 cases have been reported. We present the clinicopathologic
features of 23 GCT from 20 patients. The patients ranged in age from
20 to 57 years (median, 45 years) and included 10 males and 10
females. Of the 19 patients with available histories, nine (47%) were
incidental findigns and 10 (53%) had obstructive symptoms [pneumonia,
7 (37%); atelectasis, 3 (16%)]. Three (16%) had hemoptysis, and one
(5%) had weight loss. The GCT were solitary in 15 patients (75%) and
multiple in five others (25%). One patient had three endobronchial
lesions, and another had one endobronchial and one peripheral
pulmonary lesion. Three of the patients had multiple cutaneous GCT
(15%). Grossly, they were polypoid or nodular, tan-yellow, and firm.
Histologically, the endobronchial GCT consisted of submucosal
infiltrates of round to oval cells with abundant granular cytoplasm.
The tumor often infiltrated into peribronchial tissue and in one case
focally infiltrated an adjacent lymph node. Hyalinized thickening of
the subepithelial basement membrane was common; the overlying
epithelium often showed squamous metaplasia or ulceration. In those
patients with available follow-up, the clinical behavior of lung GCT
was benign. Our experience supports a conservative approach to therapy
in most cases unless there has been extensive postobstructive lung
injury. Potential conservative therapeutic approaches include
bronchoscopic extirpation, laser therapy, or sleeve resection. The
histogenesis of GCT is not known, although most studies suggest a
peripheral nerve sheath origin. Our immunohistochemical results with
positive staining for antibodies to S100 (4/4), NSE (3/3), vimentin
(4/4), and actin (4/4, focal) are consistent with this concept.
Cytology
of bronchial benign granular-cell tumor. Acta
Cytol. 1991 Jul-Aug;35(4):381-4.
The cytologic
features of a case with multiple bronchial benign granular-cell tumors
are reported and compared with those of previously reported cases.
Characteristic tumor cells were found in the bronchoscopic brushing
smears and in cell block sections (but not smears) prepared from the
washing fluid. These findings were confirmed by the bronchial biopsy
and histologic study of the resected tumors. A cytologic diagnosis of
bronchial granular-cell tumor should not be difficult because the
cytologic appearance of the tumor cells is characteristic; however,
the possibility of a concomitant tumor, such as adenocarcinoma or
small-cell carcinoma, should be considered and excluded.
Bronchial
granular-cell tumor. Report of a case with preoperative cytologic
diagnosis on bronchial brushings and immunohistochemical studies.
Acta Cytol.
1991;35(4):375-80.
A 42-year-old man
presented with a polypoid endobronchial mass of the right apical
segmental bronchus. Bronchial brushing smears contained clusters of
cells exhibiting abundant diffusely granular cytoplasm with indistinct
borders. A cytologic diagnosis of granular-cell tumor was rendered.
Histologic examination of the upper right lobectomy specimen provided
confirmation. Immunohistochemically, the granular cells strongly
reacted with the S-100 protein antibody. This case demonstrates that
the cytologic diagnosis of bronchial granular-cell tumor is possible
if this lesion is considered in the differential diagnosis of lung
tumors.
Bronchopulmonary granular cell tumor. Z Erkr
Atmungsorgane. 1989; 173 (3): 242-6.
The so-called
granular cell tumors, tumors of uncertain or disputed histogenesis,
are generally rare, in the bronchial tree extremely rare. With regard
to their localization, they are able--like a bronchogenic cancer--to
cause mucus retention, bronchiectasis, recurrent pneumonias and
atelectasis. A definitive diagnosis and typing of these benign tumors
must be made before operation in the interest of an adequate therapy
and avoiding overtreatment.
Granular cell
tumour of the bronchus: bronchoscopic and clinical features.Thorax.
1986 Dec;41(12):927-31.
Granular cell
tumours are uncommon, generally benign neoplasms of uncertain origin
that occasionally affect the tracheobronchial tree. Their incidence
seems to be increasing, despite the fact that such tumours are rarely
suspected on clinical grounds or bronchoscopic appearance. Here we
describe three cases of endobronchial granular cell tumours, one of
which regressed spontaneously after biopsy, and review previous
accounts of their bronchoscopic and clinical features.
Present status of
granular cell tumors. Apropos of 8 new cases with tracheobronchial
localization.Rev
Pneumol Clin. 1985;41(6):358-64.
The authors
report 8 new cases of granular cell tumour of Abrikossoff's tumour
located in the trachea or bronchus. After briefly recalling the
generally accepted features of this disease, they report several new
aspects: the obviously under-estimated frequency, the absence of
progression, requiring therapeutic abstention and regular follow-up,
the epidemiological problems posed by the association with chronic
bronchitis or the coexistence with a malignant bronchial tumour, the
uncertainties which still surround the histogenesis, which is partly
mesenchymal and partly nervous tissue, more particularly Schwann
cells, which can be supported by ultrastructural arguments.
Cytomorphology of
granular-cell tumor of the bronchus. A case report.
Acta Cytol.
1984 Mar-Apr;28(2):129-32.
The
cytologic features of a bronchial granular-cell tumor clinically
mimicking a bronchogenic carcinoma are presented. Distinctive granular
cells similar to the main cellular components of the surgical specimen
were found in abundance in bronchial brushings and washings obtained
during bronchoscopy. Our findings and conclusions confirm previously
published studies. Granular-cell tumors of the bronchus can easily be
diagnosed on cytologic examination if the entity is considered in the
differential diagnosis of clinically suspected lung tumors.
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