Lung tumor
Benign tumors
Granular cell tumor

Author: Roseann Wu, M.D. (see Authors page)

Revised: 20 December 2016, last major update July 2015

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Granular cell tumor [title] lung
Cite this page: Granular cell tumor. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lungtumorgranularcelltumor.html. Accessed May 23rd, 2017.
Definition / general
  • Sessile polypoid endobronchial neoplasm
  • May rarely form mass in the lung, mimicking carcinoma
  • Similar to granular cell tumors at other sites
Terminology
  • Also known as Abrikossoff tumor
  • Granular cell myoblastoma, granular cell nerve sheath tumor, granular cell schwannoma
Epidemiology
  • All ages, with peak in middle age (4th-6th decades)
  • Slight female predominance (3:2)
  • May be more common in black persons
Sites
Pathophysiology
  • Neoplastic, typically solitary, small (< 5 cm)
  • Typically benign, but rare reports of malignant cases
  • Coexistent malignancy may occur
Etiology
  • Controversial histogenesis, but appears neural / schwannian
Clinical features
  • Incidental finding or may present as obstructive intrabronchial mass with intact overlying mucosa
Radiology description
  • Intrabronchial mass that may show infiltration
  • Peripheral lung parenchymal mass may show spiculated borders, mimicking malignancy
Prognostic factors
  • Incomplete resection could lead to recurrence
Case reports
Treatment
  • Conservative therapy, with surgery as needed
Clinical images

Images hosted on other servers:

Images courtesy of Dr. Roseann Wu, University of Pennsylvania (USA):

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Bronchoscopy

Gross description
  • White-tan, ill-defined mass with gritty cut surface
  • Necrosis and hemorrhage are uncommon
  • Typically small (< 5 cm)
Microscopic (histologic) description
  • Pushing or irregular, infiltrative border
  • Polygonal cells with abundant, eosinophilic, coarsely granular cytoplasm and small, hyperchromatic, oval to slightly irregular nuclei with indistinct nucleoli
  • May form targetoid cytoplasmic inclusions resembling Michaelis-Gutman bodies
  • No / rare mitoses, no necrosis, no vascular invasion
  • May show overlying pseudoepitheliomatous hyperplasia
Microscopic (histologic) images

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S100

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Moderate atypia



Images courtesy of Dr. Roseann Wu, University of Pennsylvania (USA):

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Overlying pseudoepitheliomatous hyperplasia

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S100

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H&E of tracheal granular cell tumor

Cytology description
  • Variably cohesive, moderate cellularity
  • Monotonous population of rounded epithelioid cells with abundant, granular, foamy cytoplasm best appreciated on Romanowky-stained preparations
  • Indistinct cytoplasmic borders
  • Small, bland nuclei with fine chromatin; nuclei may be eccentric, imparting plasmacytoid and oncocytic appearance
  • Naked nuclei may be seen due to smearing of delicate cytoplasm
Microscopic (histologic) images

Images hosted on other servers:

Images courtesy of Dr. Roseann Wu, University of Pennsylvania (USA):

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ThinPrep, esophageal wall

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Pap, esophageal wall

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Labial granular cell tumor, DiffQuik

Positive stains
Electron microscopy description
  • Numerous secondary and tertiary cytoplasmic lysosomes
Molecular / cytogenetics description
Differential diagnosis
  • Acinic cell carcinoma
  • Carcinoid with oncocytic cells: positive for chromogranin and synaptophysin
  • Carcinomas and smooth muscle tumors with granular cells