F de 35 ans, se plaignant d'une tumfaction
ferme de la parotide droite, augmentant de volume progressivement
depuis 3 ans, sans douleur ou déficit facial.
La parotide mesurant 4,5 x 2,7 x 1,3 cm comporte
une zone tumorale mal délimite de 1,5cm de consistance ferme, blanchtre,
Les prélévements réalisés présentent des remaniements
inflammatoires chroniques au niveau du tissu glandulaire, avec métaplasie
canalaire. Dans la zone tumorale,
des lobules et les canaux sont entourés voire engainés par des nappes cellulaires avec un stroma
La prolifération infiltrant le tissu péri-capsulaire,
s'étend dans les septa inter-lobulaires. Elle est formée de nappes
de cellules de grande taille à cytoplasme
abondant, granulaire, noyaux ovoïdes ou arrondis avec légère
anisonuclose. Des globules ou vésicules éosinophiles intracytoplasmiques, PAS positives sont perçues. Elles
montrent une richesse cytoplasmique en enzymes hydrolytiques (Luxol).
L'immunohistochimie montre une positivitéà la proteine S100, et la Vimentine
dans ces cellules, objectivant leur extension
peri-canalaire dans certains foyers.
Tumeur à cellules granuleuses
Abstracts et Réferences
Ann Diagn Pathol 1999 Feb;3(1):35-8
Nose Throat J 2001 Jul;80(7):454-7
Granular cell tumor of the parotid:
a case report and literature review.
Smith JL 2nd, Feehery JM, O'Hara BJ, Rao VM, Vernose
Jefferson Medical College, Philadelphia, USA.
Granular cell tumors are relatively uncommon soft tissue
lesions that originate in Schwann's cells. Although these
tumors can occur at any site, their presence in the parotid
gland is very unusual. This article describes one such
case in a 48-year-old woman, followed by a brief review
of the literature on this subject.
Granular cell tumor of the parotid.
Said-Al-Naief N, Ivanov K, Jones M, Som P, Urken M, Brandwein
Departments of Otolaryngology and Pathology, Mount Sinai School
of Medicine, New York, NY, 10021, USA.
A case of granular cell tumor of the major salivary glands is
presented. This tumor appeared as an expansive multinodular mass
that arose from facial nerve trunks. The presenting symptoms of
facial pain and paresis and the intraoperative findings of tumor
adhesion to nerves led to the clinical impression of malignancy.
At intraoperative consultation, the tumor resembled an acinic
cell carcinoma. Pathologists should be aware that granular cell
tumors may involve the major salivary glands and that it should
be considered in the diagnostic differential diagnosis
| Int J Oral Maxillofac Surg
Granular cell tumor of the parotid gland. A
Carinci F, Marzola A, Hassanipour A.
Department of Maxillofacial Surgery, University of Ferrara, Italy.
Granular cell tumor (GCT), or granular cell myoblastoma, is a
relatively uncommon lesion of the soft tissues. The tumor is thought
to derive from a Schwann cell or from a perineural undifferentiated
mesenchymal cell. GCT can occur in any organ, but the parotid
gland is very unusual. A case of GCT of the parotid gland in a
30-year-old woman is described.
|J Am Acad Dermatol 1981 Aug;5(2):171-82
Granular cell tumor. An analysis of 16 cases
and review of the literature.
Sixteen patients with granular cell tumors were seen between 1964
and 1979. The medical data of these patients showed an average
age incidence of 39 years and a greater frequency among Negroes
(69%) and in female patients (62.5%). The most common sign (in
12 of 16 patients) was the presence of an asymptomatic mass. There
was a total of 88 tumors in 16 patients; 74 arose in the skin,
6 in the oral cavity, 2 each in the breast and perineum, and 1
each in the larynx, parotid gland, eyelid, and appendix. Multiple
tumors were noted in 4 patients (25%), all of whom were Negroes.
The histogenesis of this tumor is still controversial but appears
to favor the theory of multipotential undifferentiated mesenchymal
|Laryngoscope 1980 Oct;90(10 Pt 1):1646-51
Multiple granular cell tumor.
Jones JK, Kuo TT, Griffiths CM, Itharat S.
Eleven cases of granular cell tumor were reviewed. In two of the
cases multiple sites of involvement were seen. The tumor occurred
in the oral cavity in both of these cases and each was initially
wrongly diagnosed as squamous cell carcinoma. The most common
site was the subcutaneous tissue (nine patients) and the tongue
was involved in three cases. In one patient the parotid gland
was involved. Eight of the patients were females and three were
males; seven were black and four were white. The importance of
differentiating between squamous cell carcinoma and granular cell
tumor is stressed, as is the need for a simple wide surgical excision.
Granular cell tumor
(Ackerman's Surgical Pathology, 8th Ed.)
The classic location of granular cell tumor, also known as granular
cell myoblastoma, is the tongue. It has been seen, however, in many
other locations such as the skin, vulva, breast, larynx, bronchus,
esophagus, stomach, appendix, rectum, anus, bile ducts, pancreas,
urinary bladder, uterus, brain, pituitary gland, and soft tissue.
Multiplicity of lesions can be observed, particularly in black patients.
A few congenital examples have been reported, most of them located
in the gingiva, but some exhibiting systemic involvement.
These tumors are usually small, although we have seen cases measuring
up to 5 cm in diameter. They have a hard consistency and ill-defined
margins. This, plus the ulceration sometimes complicating the larger
cutaneous tumors, explains why they are sometimes confused clinically
and on gross inspection with a malignant neoplasm. Rarely, they
have a polypoid shape. The individual cells are large and their
cytoplasm highly granular . Most granules are small and regular.
They alternate with larger round droplets having a homogeneous eosinophilic
appearance and a stronger PAS positivity. If the tumor grows near
an epithelial surface, such as the skin, vulva, or larynx, secondary
epithelial hyperplasia occurs that may be incorrectly diagnosed
as carcinoma. Elastosis is often present in the stroma.
Histochemically, the cytoplasmic granules contain large amounts
of hydrolytic enzymes (such as acid
phosphatase), and they are consistently positive for Luxol fast
blue. Ultrastructurally, they have the
appearance of lysosomes. Other interesting electron microscopic
findings are the presence of a second cell population with "angulated
bodies" resulting in a Gaucher celllike appearance and of replicated
basal lamina material around the granular cells, the latter suggesting
repeated cycles of cellular injury and repair.
Immunohistochemically, positivity has been described (in at least
some of the lesions) for S-100 protein, laminin, HLADR, myelin basic
protein, and CEA. The presence of the latter two markers remains
controversial; the apparent CEA reactivity may be caused by the
presence of a cross-reacting antigen. The expression of HLADR is
thought to be related not to the cell of origin but
rather to some common immunologic pathogenesis.
The large majority of the granular cell tumors pursue a benign clinical
course. Most cases reported in the old literature as malignant granular
cell myoblastomas are in reality examples of alveolar soft part
sarcoma. However, there have been several well-documented cases
of tumors with a light and electron microscopic appearance comparable
with that of granular cell tumor that have resulted in distant metastases.
The histogenesis of this lesion is still discussed. Most writers
on the subject favor a Schwann's cell origin, based on histochemical,
immunohistochemical, and ultrastructural findings and on the occurrence
of typical lesions, within nerves. However, in some lesions, there
is no evidence of Schwann's cell participation. Furthermore, changes
histochemically and ultrastructurally indistinguishable from those
previously discussed have been documented in neoplastic and non-neoplastic
smooth muscle cells and in tumoral ameloblasts. We therefore favor
the view that granular cell tumor is not a specific entity but rather
the expression of a degenerative change that can occur not only
in Schwann's cells but also in a variety of other cell types, whether
previously normal or forming part of a benign or a malignant neoplasm,
such as MPNST, leiomyosarcoma, or angiosarcoma. We favor making
the diagnosis of granular cell tumor only when the entire lesion
is granular and to designate the other cases according to their
basic component, noting that focal granular changes are present.