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Novel Diagnosis and Treatment of Esophageal Granular Cell Tumor: Report of 14 Cases and Review of the Literature  Wen-shu Chen, MD, Xiao-ling Zheng, MD,

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Presentation on theme: "Novel Diagnosis and Treatment of Esophageal Granular Cell Tumor: Report of 14 Cases and Review of the Literature  Wen-shu Chen, MD, Xiao-ling Zheng, MD,"— Presentation transcript:

1 Novel Diagnosis and Treatment of Esophageal Granular Cell Tumor: Report of 14 Cases and Review of the Literature  Wen-shu Chen, MD, Xiao-ling Zheng, MD, Long Jin, MD, Xiao-jie Pan, MD, Ming-fan Ye, MD  The Annals of Thoracic Surgery  Volume 97, Issue 1, Pages (January 2014) DOI: /j.athoracsur Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Operational flow charts of submucosal tunnel endoscopic resection. (A) Submucosal tunneling: a submucosal tunnel 5 cm above the tumor is created by endoscopic mucosectomy. Epinephrine or similar solution is injected into submucosa to separate the superficial mucosa from muscularis propria and create a submucosal cavity. (B) Tumor separation and resection: the submucosal tumor is separated from surrounding tissue and dissected from muscularis propria and mucosal. (C) Removal of the submucosal tumor: the submucosal tumor is totally extracted and carefully removed with an insulated-tip knife through the submucosal tunnel. (D) Closure of the mucosal entry orifice: after complete hemostasis in the submucosal tunnel, the mucosal entry orifice is tightly closed with hemostatic tips. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Endoscopic images of esophageal granular cell tumor. (A) A yellowish colored neoplasm. (B) A white colored neoplasm. (C) A convex reddish neoplasm with an ulcer in the center. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Typical endoscopic ultrasonography images of esophageal granular cell tumor, showing hypoechoic, homogenous, and smooth-edged lesions confined to (A) mucosal layers and (B) submucosal layers. (C) A tumor confined to muscularis propria (arrow). (D) A tumor originating from muscularis propria and invading the adventitia (arrow). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Endoscopic images of an esophageal granular cell tumor of 2.0 cm in diameter confined to submucosa (A) before and (B) after endoscopic mucosal resection. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 The classical histologic characteristics of esophageal granular cell tumor. (A) Histopathologic examination revealed sheets or nests of plump, round or polygonal cells with eosinophilic granular cytoplasm and small, round, pyknotic, central, uniform nuclei. The cells were often separated by collagen fiber bundles (hematoxylin and eosin staining, original magnification ×200). (B) Both the cytoplasm and nuclei of the tumor cells showed positive immunohistochemical staining for S100 protein (original magnification ×200). (C) The cytoplasm of the tumor cells showed positive immunohistochemical staining for neuron-specific enolase (original magnification ×200). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2014 The Society of Thoracic Surgeons Terms and Conditions

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