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Intussusception of the Small Intestine Due to Granular Cell Tumor, Report of a Case Noriyuki Hagino 1 , Yasuhiro Kawauchi 1 , Ryoichi Tomita 1 , Fumio Umakoshi 2 1The First Department of Surgery, Nihon University, School of Medicine 2Department of Surgery, Social Medical Insurance Yokohama Chuo Hospital pp.181-186
Published Date 1986/2/25
DOI https://doi.org/10.11477/mf.1403110102
  • Abstract
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 Granular cell tumor occurs especially in the soft tissue and the tongue. And the gastrointestinal tract is one of the extremely uncommon locatlons for it We experienced one case of granular cell tumor of the jejunum which intussuscepted. To our knowledge, this is the first reported case in our country.

 The patient was 58-year-old woman who was admitted to our hospital complaining of intermittent upper abdominal pain with vomiting. The flat plate of the abdomen revealed coils of small intestine disiended by gas and niveau. Upper gastrointestinal series showed complete obstruction of the small intestine. At operation the jejunum intussuscepted. This was reheved and on exploring, a tumor about the size of a walnut was found one hundred and fifty centimeters below the ligament of Treitz. The segment of the small intestine with the tumor was resected. The excised tumor was polypoid, measuring 3×3×2.8cm. The mucosal surface showed erosions with hemorrhage. The cut surface was yellowtsh-white.

 On histologic examination the tumor was seen to consist of granular cells. The nests of granular cells were situated between the mucosa and the submucosal collagenous tissue. In the deeper part of the tumor, the granular cell seemed to infiltrate into the muscle layer. The tumor was without capsule. The tumor cells were large and polyhedral, oval or slender spindle-shaped with finely eosinophilic granular cytoplasm. The fine granules of the tumor cells strongly stained by Sudan black B, Oil red O and were faintly colored with PAS and S-100 protein stains. They reacted negatively with Alcian blue. By electron microscopic examination the granules were considered to be autophagosome or secondary lysosome. The tumor had cellular atypism with several mitosis.

 We concluded this tumor was granular cell neoplasm with malignant potential.


Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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