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Granular cell tumor

Author: Roseann I. Wu, M.D., M.P.H.

Last author update: 1 July 2015

Last staff update: 11 November 2022 (update in progress)

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PubMed Search: Granular cell tumor [title] lung

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Table of Contents

Cite this page: Wu R. Granular cell tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lungtumorgranularcelltumor.html. Accessed April 2nd, 2023.

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

Many anatomic locations, but rare in trachea and lungs (6-10% of all granular cell tumors, J Surg Oncol 1980;13:301)

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

32 year old woman with pulmonary malignant granular cell tumor (World J Surg Oncol 2003;1:22)
42 year old woman with granular cell tumor of the lung (Lung 2010;188:355)
55 year old woman with coexistent pulmonary granular cell tumor and adenocarcinoma of the lung (Transl Lung Cancer Res 2014;3:262)
60 year old man with primary bronchial granular cell tumor (Korean J Thorac Cardiovasc Surg 2014;47:193)
Malignant granular cell tumor (Ann Diagn Pathol 2010;14:273)

Treatment

Conservative therapy, with surgery as needed

Clinical images

Contributed by Roseann Wu, M.D., M.P.H.

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

Contributed by Roseann Wu, M.D., M.P.H.

Overlying pseudoepitheliomatous hyperplasia

S100

H&E of tracheal granular cell tumor

Images hosted on other servers:

S100

Moderate atypia

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

Cytology images

Contributed by Roseann Wu, M.D., M.P.H.