Esophagus
Benign tumors
Granular cell tumor
Author: Elliot Weisenberg, M.D.
Last author update: 1 January 2013
Last staff update: 1 April 2024 (update in progress)
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Granular cell tumor
Table of Contents
Definition / general | Clinical features | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Electron microscopy descriptionCite this page: Weisenberg E. Granular cell tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/esophagusgct.html. Accessed April 26th, 2024.
Definition / general
- Also called Abrikosoff tumor, myoblastoma
- Most common site in GI tract for these tumors
- #2 most common stromal tumor of esophagus after leiomyoma
Clinical features
- Usually incidental, in lower esophagus, 90% solitary (Ann Thorac Surg 1996;62:860)
- May cause obstruction if large
- Almost all cases of Schwannian origin
- Relatively more common in women in 40s, African Americans
- May be underdiagnosed on superficial biopsies that lack lamina propria
- Endoscopy: sessile, yellowish white, firm, intact epithelium
- 1 - 3% are malignant (locally recur)
- Associated with rapid growth, > 4 cm, tumor necrosis, increased cellularity, atypia, > 2 mitotic figures/HPF
Case reports
- 39 year old man with coexisting esophageal leiomyomas (Dig Liver Dis 2004;36:292)
- 40 year old woman with coexisting squamous cell carcinoma (Dis Esophagus 2002;15:88)
- 53 year old man with multiple tumors (J Gastroenterol 2003;38:776)
- 59 year old Japanese man with esophageal tumor 7 years after bronchial tumor (APMIS 2006;114:659)
Treatment
- Local excision
Gross description
- Intramural nodule(s), poorly circumscribed, up to 2 cm
Microscopic (histologic) description
- Identical to granular cell tumors elsewhere; sheets or packets of uniform epithelioid cells with abundant eosinophilic granular cytoplasm and small nuclei that interdigitate with overlying epithelium
- Often pseudoepitheliomatous hyperplasia, which may mimic squamous cell carcinoma on small biopsies (J Surg Oncol 1980;13:301)
- Often involves superficial lamina propria
- May extend into muscularis propria
Microscopic (histologic) images
Contributed by Dr. Oleksandr Grygoruk, AFIP and @RaulSGonzalezMD on Twitter
Abrikossoff esophagus
Tumor fills lamina propria
Granular cell tumor
Positive stains
Electron microscopy description
- Myelin-like tubules, cytoplasmic processes surrounded by basal lamina in layers reminiscent of Schwann cells
