Granular Cell Tumors of the Gastrointestinal Tract: Clinicopathologic Associations in a Large Series
Baishali Bhattacharya, Sahar Samaha. Miraca Life Sciences Research Institute, Phoenix, AZ
Background: We designed this study to use a large national pathology database to better characterize the demographic and clinicopathologic features of granular cell tumors (GCT) of the gastrointestinal tract. Because these tumors are relatively uncommon, their characteristics remain poorly defined.
Design: From the Miraca Life Sciences database we extracted demographic data, location, presentation, endoscopic features, method of removal, and follow up data from all patients who had a diagnosis of GCT between 1.2008 and 12.2010. All pertinent slides, including special and immunostains, were retrieved and re-examined.
Results: There were 63 GCT from 62 patients (median age 50 years, range 22-75; 60% female). There were 30 GCTs in the esophagus (15 in the lower third; 8 in the mid-esophagus; 2 in the upper esophagus; 5 unspecified); 2 in the stomach; and 31 in the colon (25 in the ascending colon; 2 in the transverse; 3 in the descending; and 1 in the rectum). Patients with esophageal GCTs presented with epigastric pain (13 patients) and gastroesophageal reflux disease (GERD) (11 patients); in contrast, 71% of colonic GCTs were discovered incidentally during screening colonoscopy. The endoscopic appearance was non-specific, variously described as polyps, nodules, and submucosal lesions. Most tumors were biopsied, particularly in the esophagus, while approximately 25% (mostly in the colon) were snared. All tumors were smaller than 1 cm (range 2 to 9 mm). The pattern of growth differed slightly in the esophagus and colon: esophageal tumors tended to exhibit a sub-epithelial nodular expansive proliferation. Colonic GCTs showed submucosal and mucosal proliferation, with nested or infiltrative pattern and some hyalized stroma. None of the tumors showed mitotic activity, necrosis or pleomorphism. Metastases were not reported in any of the patients.
Conclusions: In our series, GCTs of the gastrointestinal tract were predominantly found in the esophagus (mostly in the lower third) and the right colon. Essentially all cases were detected incidentally, either during screening colonoscopy or during esophagogastroduodenoscopy performed for unrelated indications (GERD and abdominal pain). None of the tumors had either histopathological or clinical features of malignancy.
Monday, March 4, 2013 1:00 PM
Poster Session II # 120, Monday Afternoon