Gu Hui, Yu Lan, Wu Yu
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Diagnostics (Basel). 2025 May 26;15(11):1336. doi: 10.3390/diagnostics15111336.
Granular cell tumors (GCTs) are rare neurogenic tumors with Schwann cell differentiation. Although most are benign, 1-2% exhibit malignant behavior. The imaging features of GCTs remain poorly characterized due to their rarity and anatomic variability. This study aims to elucidate the manifestations of GCTs in multimodal imaging across different anatomic locations. We retrospectively analyzed 66 histopathologically confirmed GCT cases (2011-2024), assessing their clinical presentations, pathological characteristics, and imaging findings from ultrasound ( = 31), CT ( = 14), MRI ( = 8), and endoscopy ( = 15). Two radiologists independently reviewed the imaging features (location, size, morphology, signal/density, and enhancement). The cohort (mean age: 42 ± 12 years; 72.7% female) showed tendency in location towards soft tissue (48.4%), the digestive tract (30.3%), the respiratory system (7.6%), the breasts (7.6%), and the sellar region (6.1%). Six cases (9.1%) were malignant. The key imaging findings by modality were as follows: Ultrasound: Well-circumscribed hypoechoic masses in soft tissue (96.1%) and irregular margins in the breasts (80%, BI-RADS 4B) were found. MRI: The sellar GCTs exhibited T1-isointensity, variable T2-signals (with 50% showing "star-like crack signs"), and heterogeneous enhancements. The soft tissue GCTs were T1-hypointense (75%) with variable T2-signals. CT: Pulmonary/laryngeal GCTs appeared as well-defined hypodense masses with mild/moderate enhancements. Endoscopy: Submucosal/muscularis hypoechoic nodules with smooth surfaces were found. Malignant GCTs were larger (mean: 93 mm vs. 30 mm) but lacked pathognomonic imaging features. Three malignant cases demonstrated metastases. GCTs exhibit distinct imaging patterns based on their anatomical location. While certain features (e.g., star-like crack signs) are suggestive, imaging cannot reliably differentiate benign from malignant variants. Histopathological confirmation remains essential to diagnosis, particularly given the potential for malignant transformations (at 9.1% in our series). Multimodal imaging guides the localization and biopsy planning, but clinical-radiological-pathological correlation is crucial for the optimal management.
颗粒细胞瘤（GCTs）是一种罕见的具有施万细胞分化的神经源性肿瘤。虽然大多数为良性，但1%-2%会表现出恶性行为。由于其罕见性和解剖学变异性，GCTs的影像学特征仍未得到充分描述。本研究旨在阐明不同解剖部位的GCTs在多模态成像中的表现。我们回顾性分析了66例经组织病理学证实的GCT病例（2011年至2024年），评估了它们的临床表现、病理特征以及超声（n = 31）、CT（n = 14）、MRI（n = 8）和内镜检查（n = 15）的影像学表现。两名放射科医生独立审查了影像学特征（位置、大小、形态、信号/密度和强化情况）。该队列（平均年龄：42±12岁；72.7%为女性）在位置上倾向于软组织（48.4%）、消化道（30.3%）、呼吸系统（7.6%）、乳房（7.6%）和鞍区（6.1%）。6例（9.1%）为恶性。各模态的关键影像学表现如下：超声：软组织中边界清晰的低回声肿块（96.1%），乳房中边缘不规则（80%，BI-RADS 4B）。MRI：鞍区GCTs表现为T1等信号、T2信号多变（50%表现为“星状裂纹征”）以及不均匀强化。软组织GCTs为T1低信号（75%），T2信号多变。CT：肺/喉GCTs表现为边界清晰的低密度肿块，有轻度/中度强化。内镜检查：发现表面光滑的黏膜下/肌层低回声结节。恶性GCTs更大（平均：93 mm对30 mm），但缺乏特征性影像学表现。3例恶性病例出现转移。GCTs根据其解剖位置表现出不同的影像学模式。虽然某些特征（如星状裂纹征）具有提示性，但影像学不能可靠地区分良性和恶性变体。组织病理学确诊对诊断仍然至关重要，特别是考虑到恶性转化的可能性（在我们的系列中为9.1%）。多模态成像指导定位和活检计划，但临床-放射-病理相关性对于最佳管理至关重要。
