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Vol.40 No.3 contents | Japanese/English |
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- Case Report -
A Case Report of Granular Cell Tumor of the Bronchus with a Review of Clinicopathologic Findings of 33 Cases Reported in Japan
Shinya Okada, Motoshige Kudo, Yoshiro Ebihara, Dilinur Payzulla, Hisashi Oshiro and Masatoshi Kakihana*Departments of Pathology and Surgery*, Tokyo Medical University
Background: We encountered a case of granular cell tumor (GCT) arising in the left B1+2c. GCT, first described in the bronchus by Kramer in 1939. This type of case is still rare and only about 33 cases have been reported so far in Japan. Clinicopathological aspects of GCT arising in the lung so far reported in Japan are reviewed. Case: An abnormal shadow was detected by chest x-ray in the left upper lung field of a 39-year-old man. Bronchoscopy disclosed a polypoid, yellowish-tan submucosal tumor, obstructing the lumen of left B1+2c. Brushing smear and post-brushing lavage fluid cytologic preparations obtained numerous tumor cell clusters composed of cells with small round nuclei and abundant granular cytoplasm, often possessing intracytoplasmic inclusion bodies. Left upper lobectomy was performed and the 1.2×1.2×1.2 cm tumor was histologically shown to be GCT, consisting of round to oval cells with abundant oxyphilic granular cytoplasm with diastase-resistant PAS-positive intracytoplasmic bodies. Hyalinized thickening of the subepithelial basement membrane was seen, and the overlying epithelium showed squamous metaplasia or ulceration. Immunohistochemically, tumor cells were positive for S-100 and NSE. p53 oncoprotein was also strongly positive (79%). Ultrastructurally, angulate body-like lysosomes, myelin structures, desmosome-like apparatus, and basal lamina were observed. DNA image cytometry demonstrated DNA diploidy. No tumor recurrence or metastasis has been noted in the four years since surgery. Conclusion: Our case supports the concept of a peripheral nerve sheath origin of GCT.
key words: Granular cell tumor, Lung, Angulate body, Schwann cell, S-100 protein
Received: January 7, 2000
Accepted: March 8, 2000
JJLC 40 (3): 223-229, 2000
