[Abrikosov's tumor with local destructive growth in the wall of the urinary bladder].
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A case of granular cell myoblastoma of the gallbladder in a 39-year old Japanese female is presented. Granular cell myoblastomas arising in the biliary tract are a rare occurrence. This tumor has not yet been reported in the gallbladder.
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Granular cell tumour is a rare neoplasm consisting of nests or ribbons of polyhedral cells with granular eosinophilic cytoplasm and small, dense nuclei. It may occur at various sites throughout the body. Two cases, one of the tongue and one of the rectum, are reported and the pathology and management of this uncommon neoplasm are discussed.
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Granular cell tumor (GCT), although nearly ubiquitous, is seen infrequently in the vulva. A review of the surgical pathology files from Grady Memorial Hospital, Atlanta, Georgia, from 1983 through 1987 identified eight cases of vulvar GCT. Five of the eight patients had more than one skin and soft tissue lesion. Two of the five had biopsy-proven multicentric GCT with a unique clinical course. One of the patients was a 32-year-old woman with multiple vulvar, lingual, laryngeal, bronchial and pulmonary GCT, necessitating multiple excisions and ultimately pneumonectomy. The second patient had multiple GCTs in the vulva and inguinal area and finally in both lungs, resulting in her death at age 39. No dependable microscopic features could be identified to distinguish benign GCT from its more aggressive variant. However, Feulgen DNA histomorphometry demonstrated aneuploidy in the patient with apparent lung metastases, whereas the tumors from patients with a benign course as well as from the patient with multiorgan involvement were diploid. In three of five patients who could be interviewed there was a history of soft tissue tumors in members of the family. The multifocal nature and possible familial component of GCT need to be explored further.
Endobronchial localizations of the granular cell tumours or Abrikossoff's tumour are very rare (6%) but their association with malignant tumours is exceptional and perhaps fortuitous. The clinical manifestations are generally the consequence of bronchial erosion and blocking. Bronchial endoscopy is the essential examination which allows the tumour to be seen and a biopsy to be made. Pathological examination confirms the diagnosis. The typicall cell of granular cell tumour is a large, polygonal one with finely granular eosinophilic cytoplasm and a small dark vesicular nucleus. Such cells are arranged in syncytial masses containing long, spindleshape cells with elongated nuclei. If the optical and elctron microscope description is well known, the histogenesis of the disease is still in dispute; the neurogenic origin seems to be the best one, but at present there is not enough evidence to make this assumption a certainty. Surgical exeresis is the only therapy to bring about a cure, but clinical supervision is necessary because of a possible relapse.
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Three cases of multiple granular cell myoblastoma are reported. In the discussion the authors emphasize the frequency, pathogeny, evolution and new classification of this type of proliferative disorders.
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Histology and ultrastructure of human granular cell tumors (GCT) are studied. Apart from "granular" cells which are the main component of the tumor, GCT contain the cells of ordinary structure with signs of neurogenic differentiation, cell processus typical for the nervous tissue and peripheral nervous tissue tumors (these processus are in a close space connection with "granular" cells) as well as structurally transitional cells. This implies that "granular" cells are likely to originate from the ordinary lemmocytes as a result of disturbance and hypertrophy of intracellular processus. Preoperative diagnosis of this rare peculiar neurogenic tumor is difficult and the diagnosis is possible only after the operative material examination. If other signs of malignancy are lacking, infiltrative growth typical for these tumors allows one to consider them locally-destructive neoplasms.
Usually the myeloblastoma of the tongue (Abrikossoff's tumour) is a benign tumour. Two cases are reported that differ from those described in the literature in respect of findings, course and histology. Particular reference is made to the malignant nature of this tumour.
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Pseudoneoplastic tumors are considered as a clinicoanatomic entity with a characteristic macro- and microscopic pattern, obscure etiology and genesis. The dissection data have demonstrated the forms of pseudoneoplastic processes. Observations of the most rare pseudotumors, such as "inflammatory" pseudotumor and tumor-like myositis ossificans are presented. "Inflammatory" pseudotumors are characterized by the involvement of the immune system cells, increased fibrillogenesis, and intensive osteogenesis in the lungs and the stomach. Cases of pseudoneoplastic myositis ossificans combined with tissue malformation are given particular attention.
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