Zagólski Olaf, Gajda Mariusz, Czajecki Krzysztof
Oddział Otolaryngologiczny, Specjalistyczne Centrum Diagnostyczno-Zabiegowe-Medicina, Kraków.
Przegl Lek. 2007;64(9):598-600.
Granular cell tumor (Abrikosov's tumor) of the larynx is a very uncommon lesion. Up to date, only about 200 cases have been reported. The exact origin of granular cell tumor is still unclear, however most authors believe it to be a neoplastic process derived from neuroectoderm. Immunohistochemical positive staining for S-100 protein is found in all cases. Complete resection of the lesion with an attempt to leave remaining laryngeal structures intact, generally results in total recovery. The majority of reported tumors were removed by microlaryngoscopy.
63-year-old female presented 2-month-long history of increasing dysphonia. She had smoked 20 cigarettes a day for over 30 years. Indirect laryngoscopy disclosed oedematous mucosa in both vocal folds. No tumor was observed. Applying Kleinsasser procedure, a tumor 3 mm in diameter covered with normal mucosa was found growing in the posterior wall of the bottom of the right ventricle. The tumor as well as hypertrophic mucosa of the vocal folds were removed. Histopathological examination of the operative specimen revealed a granular cell tumor and chronic laryngitis. Immunohistochemically tumor cells were positive for S-100. The patient has been asymptomatic for 6 months.
Surgical removal of the laryngeal granular cell tumor with indications and extent of the resection like in benign tumors, was therapeutically efficient in the presented case.
喉颗粒细胞瘤（阿布里科索夫瘤）是一种非常罕见的病变。截至目前，仅报道了约200例病例。颗粒细胞瘤的确切起源仍不清楚，然而大多数作者认为它是一种源自神经外胚层的肿瘤性过程。所有病例均发现S-100蛋白免疫组化阳性染色。完整切除病变并尽量保留剩余喉结构完整，通常可完全康复。大多数报道的肿瘤通过显微喉镜切除术切除。
一名63岁女性有2个月渐进性声音嘶哑病史。她每天吸烟20支，超过30年。间接喉镜检查发现双侧声带黏膜水肿。未观察到肿瘤。采用克莱因萨瑟手术，发现右心室底部后壁有一个直径3毫米、被正常黏膜覆盖的肿瘤。切除肿瘤及声带肥厚的黏膜。手术标本的组织病理学检查显示为颗粒细胞瘤和慢性喉炎。免疫组化显示肿瘤细胞S-100阳性。患者6个月来无症状。
在本病例中，按照良性肿瘤的适应证和切除范围手术切除喉颗粒细胞瘤，治疗效果良好。
