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颗粒细胞瘤:110例患者的临床病理研究

Granular cell tumor: a clinicopathologic study of 110 patients.

作者信息

Lack E E, Worsham G F, Callihan M D, Crawford B E, Klappenbach S, Rowden G, Chun B

出版信息

J Surg Oncol. 1980;13(4):301-16. doi: 10.1002/jso.2930130405.

Abstract

The clinicopathologic features of 118 granular cell tumors (GCT) encountered at two affiliated hospitals were reviewed. A total of 110 patients were affected over this 32-year period of study (71 men, 39 women), and in 5% GCT were multiple. Patients ranged in age from 16 to 58 years (average 32 years) and were symptomatic for an average duration of 11 months prior to diagnosis. There was a greater than expected frequency of GCT among black patients (29%). Although tongue was the single most common anatomic site involved, relatively more GCT (44%) occurred in skin or subcutaneous tissue. Less common locations were breast parenchyma (10 cases), rectal mucosa and anus (6), vulva (4), esophagus and larynx (2 cases each). The correct preoperative diagnosis of this protean tumor was made in only three patients. GCT were surgically treated with the average diameter of resected tumor being 1.2 cm (range 0.2--3.5 cm). Pseudoepitheliomatous hyperplasia was noted in 11 tumors and in one vulvar GCT there was overlying in situ squamous cell carcinoma. Tumors were incompletely excised in 24 of 56 patients having adequate followup; only five of these 24 patients experienced a local recurrence of tumor. Malignant behavior was not observed. Results of histochemical and ultrastructural study are briefly discussed. The precise histogenesis of GCT is uncertain but Schwann cell origin is favored in most cases.

摘要

回顾了两家附属医院收治的118例颗粒细胞瘤(GCT)的临床病理特征。在这32年的研究期间,共有110例患者患病(男性71例,女性39例),5%的GCT为多发。患者年龄在16至58岁之间(平均32岁),诊断前症状出现的平均持续时间为11个月。黑人患者中GCT的发生率高于预期(29%)。虽然舌头是最常受累的单一解剖部位,但相对更多的GCT(44%)发生在皮肤或皮下组织。较少见的部位有乳腺实质(10例)、直肠黏膜和肛门(6例)、外阴(4例)、食管和喉(各2例)。只有3例患者术前正确诊断了这种多变的肿瘤。GCT均接受了手术治疗,切除肿瘤的平均直径为1.2 cm(范围0.2 - 3.5 cm)。11例肿瘤中发现有假上皮瘤样增生,1例外阴GCT伴有原位鳞状细胞癌。在56例有充分随访的患者中,24例肿瘤切除不完全;这24例患者中只有5例出现肿瘤局部复发。未观察到恶性行为。简要讨论了组织化学和超微结构研究结果。GCT的确切组织发生尚不确定,但大多数情况下倾向于施万细胞起源。

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