John R. Goldblum, MD, Thomas W. Rice, MD, Gregory Zuccaro, MD, Joel E

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Presentation transcript:

Granular Cell Tumors of the Esophagus: A Clinical and Pathologic Study of 13 Cases John R. Goldblum, MD, Thomas W. Rice, MD, Gregory Zuccaro, MD, Joel E. Richter, MD The Annals of Thoracic Surgery Volume 62, Issue 3, Pages 860-865 (August 1996) DOI: 10.1016/S0003-4975(96)00443-2 Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 1 Endoscopic appearance of the “malignant” esophageal granular cell tumor (patient 11). The lesion is located just proximal to the gastroesophageal junction, and the overlying mucosa is endoscopically normal. The Annals of Thoracic Surgery 1996 62, 860-865DOI: (10.1016/S0003-4975(96)00443-2) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 2 Endosonographic image from the distal esophagus from patient 11. The granular cell tumor (black arrow) arises in the third ultrasound layer (submucosa) and is in proximity to the aorta. The fourth ultrasound layer (muscularis propria) is markedly thickened and irregular (white arrows). This may reflect the pathologic finding of tumor infiltration through the esophageal wall into the para-esophageal soft tissues. The Annals of Thoracic Surgery 1996 62, 860-865DOI: (10.1016/S0003-4975(96)00443-2) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 3 Benign esophageal granular cell tumor. The neoplastic cells are arranged into distinct nests by collagenous septae. The cells have uniform small pyknotic nuclei and abundant eosinophilic granular cytoplasm. (Hematoxylin and eosin stain; ×10 before 29% reduction.) The Annals of Thoracic Surgery 1996 62, 860-865DOI: (10.1016/S0003-4975(96)00443-2) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 4 Benign esophageal granular cell tumor with pseudoepithelio-matous hyperplasia of the overlying squamous mucosa. Unless one recognizes the underlying granular cell tumor, this change can be misinterpreted as an invasive squamous cell carcinoma. (Hematoxylin and eosin stain; ×10 before 29% reduction.) The Annals of Thoracic Surgery 1996 62, 860-865DOI: (10.1016/S0003-4975(96)00443-2) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 5 Immunohistochemical stain for S-100 protein, which outlines nests of neoplastic cells (arrow), which are infiltrating in and around the muscularis propria. Although the tumor in this case was grossly well-circumscribed (patient 11), there was transesophageal tumor infiltration. (Immunohistochemical stain; ×10 before 29% reduction.) The Annals of Thoracic Surgery 1996 62, 860-865DOI: (10.1016/S0003-4975(96)00443-2) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 6 “Malignant” esophageal granular cell tumor (patient 11) showing neoplastic cells with increased nuclear pleomorphism, macronucleoli, and a mitotic figure (arrow). (Hematoxylin and eosin stain; ×20 before 29% reduction.) The Annals of Thoracic Surgery 1996 62, 860-865DOI: (10.1016/S0003-4975(96)00443-2) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 7 Immunohistochemical stain for S-100 protein in a benign esophageal granular cell tumor. The darkly stained nests of tumor cells are seen immediately beneath the squamous mucosa and are thus frequently present in an endoscopic biopsy specimen. (Immunohistochemical stain; ×10 before 29% reduction.) The Annals of Thoracic Surgery 1996 62, 860-865DOI: (10.1016/S0003-4975(96)00443-2) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions