Hoda Rana S, Minamiguchi Sachiko, Lewin David N, Foody William, Weselow Grace, Wildi Stephan M
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
Acta Cytol. 2005 Mar-Apr;49(2):199-203. doi: 10.1159/000326134.
Granular cell tumors (GCTs) of biliary system are rare. GCTs show a striking preponderance for young, black females, who generally present with obstructive jaundice. To our knowledge, these are the first 2 reports of GCT of biliary system identifed on endoscopic brushing cytology.
In case 1, a 24-year-old, black woman presented with a 5-month history of pruritus. Radiographic studies demonstrated a mass in the distal common bile duct. Endoscopic biopsy and bile duct brushing were diagnosed as GCT. A Whipple procedure was confirmatory of GCT. In case 2, a 38-year-old, black female presented with a 7-month history of pruritus and jaundice. Radiographic studies showed a stricture of the common hepatic duct at the hilum. Endoscopic brushing cytology of the stricture yielded only a few sheets of granular cells that were missed on initial screening. Suspicion of cholangiocarcinoma prompted surgery, and final histopathology showed GCT. Both patients were well 1 1/2 and 6 years after presentation.
GCT of the bile duct can be diagnosed on endoscopic brushing and should be considered in the cytologic differential diagnosis in the appropriate clinical settings.
胆道颗粒细胞瘤（GCTs）较为罕见。GCTs在年轻黑人女性中显著多发，这些患者通常表现为梗阻性黄疸。据我们所知，这是内镜刷检细胞学诊断出的首例2例胆道GCT报告。
病例1，一名24岁黑人女性，有5个月瘙痒病史。影像学检查显示胆总管远端有肿块。内镜活检及胆管刷检诊断为GCT。惠普尔手术证实为GCT。病例2，一名38岁黑人女性，有7个月瘙痒和黄疸病史。影像学检查显示肝门部肝总管狭窄。狭窄部位的内镜刷检细胞学检查仅发现几张颗粒细胞片，最初筛查时被漏诊。因怀疑胆管癌而行手术，最终组织病理学检查显示为GCT。两名患者在就诊后1.5年和6年时情况良好。
胆管GCT可通过内镜刷检诊断，在适当的临床情况下应考虑将其纳入细胞学鉴别诊断。
