Department of Gastroenterology Pathology, Kitasato University East Hospital, Kanagawa, Japan.
Dig Endosc. 2010 Oct;22(4):325-8. doi: 10.1111/j.1443-1661.2010.01022.x.
A 60-year-old man had a positive fecal occult-blood test on a medical check-up. Colonoscopy revealed a yellowish-white submucosal tumor 8 mm in diameter in the rectum. Endoscopic ultrasonography showed a well-demarcated mass with a homogeneous, low-level, internal echo in the second to third layers of the rectal wall. A carcinoid tumor was suspected, and the mass was resected endoscopically. Histopathological examination revealed a granular-cell tumor. Gastrointestinal granular-cell tumors rarely arise in the rectum, and the preoperative diagnosis of small lesions is often difficult. In our patient, granular-cell tumor was difficult to differentially diagnose because the endoscopic and endoscopic ultrasonographic findings closely resembled those of carcinoid tumor. Interestingly, the endoscopic characteristics of the rectal granular-cell tumor in our patient resembled those of a carcinoid tumor.
一位 60 岁男性在体检时粪便潜血检测呈阳性。结肠镜检查发现直肠处有一个直径 8mm 的黄白色黏膜下肿瘤。内镜超声检查显示直肠壁第二至三层有界限清楚的肿块，内部回声均匀、低水平。怀疑为类癌肿瘤，行内镜下肿块切除术。组织病理学检查显示为颗粒细胞瘤。胃肠道颗粒细胞瘤很少发生在直肠，小病变的术前诊断通常较为困难。在我们的患者中，颗粒细胞瘤由于内镜和内镜超声检查结果与类癌肿瘤非常相似，难以鉴别诊断。有趣的是，我们患者的直肠颗粒细胞瘤的内镜特征与类癌肿瘤相似。
