下咽颗粒细胞瘤2例及临床特征分析

doi:10.6040/j.issn.1673-3770.0.2024.267

摘要/Abstract

摘要： 目的探讨下咽颗粒细胞瘤(granular cell tumor, GCT)的临床特征,提高耳鼻喉科医生对此肿瘤的敏感性认识减少误诊及漏诊发生。方法完善相关检查并在支撑喉镜下行下咽肿物切除术。结果 2例术后病理提示为下咽颗粒细胞瘤。1例随访至今3年无复发,1例随访1年无复发。结论下咽GCT女性较男性多发,良性多见,临床症状不典型,病理学为诊断金标准,需与下咽其他肿物相鉴别。手术切除为主要根治方式,术后复发少见,术后应密切随访。

关键词: 颗粒细胞瘤, 下咽, 梨状窝, 环后

Abstract: Objective Discuss the clinical features of granular cell tumor(GCT)of the hypopharynx, aiming to raise awareness among otolaryngologists to enhance sensitivity towards this tumor and reduce the occurrence of misdiagnosis and missed diagnoses. Methods Improve relevant examinations and perform hypopharyngeal mass excision under support laryngoscopy. Results Two postoperative pathological cases were diagnosed as hypopharyngeal granular cell tumors. One case has been followed up for 3 years with no recurrence, and the other has been followed up for 1 year with no recurrence. Conclusion Hypopharyngeal GCT is more common in women than in men, with benign cases being more frequent. The clinical symptoms are non-specific, and pathology is the gold standard for diagnosis, requiring differentiation from other hypopharyngeal masses. Surgical resection is the primary curative method, with recurrence being rare post-surgery. Close follow-up is essential after surgery.

Key words: Granular cell tumor, Hypopharyngeal, Posterior fossa, Posterior cricoid

中图分类号:

R766.5

李德民,董念,马旭,张瑾,丁德涛,吴允刚. 下咽颗粒细胞瘤2例及临床特征分析[J]. 山东大学耳鼻喉眼学报, 2025, 39(6): 126-132.

LI Demin, DONG Nian, MA Xu, ZHANG Jin, DING Detao, WU Yungang. Granular cell tumor of the hypopharynx:two cases report and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2025, 39(6): 126-132.

参考文献

[1] Neelon D, Lannan F, Childs J. Granular cell tumor[M]. Treasure Island(FL): StatPearls Publishing, 2025
[2] Rekhi B, Jambhekar NA. Morphologic spectrum, immunohistochemical analysis, and clinical features of a series of ranular cell tumors of soft tissues: a study from a tertiary referral cancer center[J]. Ann Diagn Pathol. 2010, 14(3):162-167. doi::10.1016/j.anndiagpath.2010.01.005
[3] Tamborini F, Cherubino M, Scamoni S, et al. Granular cell tumor of the toe: a case report[J]. Dermatol Res Pract, 2010, 2010: 184125. doi:10.1155/2010/184125
[4] Barakat M, Kar AA, Pourshahid S, et al. Gastrointestinal and biliary granular cell tumor: diagnosis and management[J]. Ann Gastroenterol, 2018, 31(4): 439-447. doi:10.20524/aog.2018.0275
[5] Porta N, Mazzitelli R, Cacciotti J, et al. A case report of a rare intramuscular granular cell tumor[J]. Diagn Pathol, 2015, 10: 162. doi:10.1186/s13000-015-0390-1
[6] Honda K, Tanaka S, Kishimoto M, et al. Granular cell tumor of hypopharynx: report of a rare case[J]. Acta Otolaryngol Suppl, 2007(557): 73-76. doi:10.1080/00016480601068055
[7] Koltsidopoulos P, Chaidas K, Chlopsidis P, et al. Granular cell(Abrikossoff)tumor in the head and neck: a series of 5 cases[J]. Ear Nose Throat J, 2016, 95(1): 36-39.
[8] Piazza C, Casirati C, Peretti G, et al. Granular cell tumor of the hypopharynx treated by endoscopic CO2 laser excision: report of two cases[J]. Head Neck, 2000, 22(5): 524-529. doi:10.1002/1097-0347(200008)22:5524::aid-hed14>3.0.co;2-d
[9] Hung KC, Chu YH, Lin YS. Granular cell tumor of the hypopharynx[J]. Otolaryngol Head Neck Surg, 2008, 138(4): 533-534. doi:10.1016/j.otohns.2007.11.030
[10] Bradford Bell EJ, Thomas GR, Leibowitz J, et al. Benign and malignant granular cell tumor of the hypopharynx: two faces of a rare entity[J]. Head Neck Pathol, 2021, 15(1): 281-287. doi:10.1007/s12105-020-01157-9
[11] 陈学军, 封丽菲, 尹高菲, 等. 头颈部颗粒细胞瘤12例临床特点分析及文献回顾[J]. 临床耳鼻咽喉头颈外科杂志, 2022, 36(8): 625-629. doi:10.13201/j.issn.2096-7993.2022.08.012 CHEN Xuejun, FENG Lifei, YIN Gaofei, et al. Clinical characteristics and literature review of 12 cases of granulosa cell tumor of head and neck[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2022, 36(8): 625-629. doi:10.13201/j.issn.2096-7993.2022.08.012
[12] 李笑颖, 吴允刚, 王彩华, 等. 下咽环后颗粒细胞瘤1例[J]. 中国耳鼻咽喉头颈外科, 2021, 28(1): 62-63. doi:10.16066/j.1672-7002.2021.01.017 LI Xiaoying, WU Yungang, WANG Caihua, et al. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2021, 28(1): 62-63. doi:10.16066/j.1672-7002.2021.01.017
[13] 李颖, 马林, 金花兰. 下咽颗粒细胞瘤1例[J]. 军医进修学院学报, 2012, 33(4): 3.
[14] Mobarki M, Dumollard JM, Dal Col P, et al. Granular cell tumor a study of 42 cases and systemic review of the literature[J]. Pathol Res Pract, 2020, 216(4): 152865. doi:10.1016/j.prp.2020.152865
[15] Eguia A, Uribarri A, Gay Escoda C, et al. Granular cell tumor: report of 8 intraoral cases[J]. Med Oral Patol Oral Cir Bucal, 2006, 11(5): 425-428.
[16] 范学亮, 郑鹤, 王春锋. 颗粒细胞瘤10例临床病理特征分析[J]. 肿瘤基础与临床, 2023, 36(3): 223-226. doi:10.3969/j.issn.1673-5412.2023.03.008 FAN Xueliang, ZHENG He, WANG Chunfeng. Clinicopathological analysis of 10 patients with granulosa cell tumor[J]. Journal of Basic and Clinical Oncology, 2023, 36(3): 223-226. doi:10.3969/j.issn.1673-5412.2023.03.008
[17] Fanburg-Smith JC, Meis-Kindblom JM, Fante R, et al. Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation[J]. Am J Surg Pathol, 1998, 22(7): 779-794. doi:10.1097/00000478-199807000-00001
[18] Nasser H, Ahmed Y, Szpunar SM, et al. Malignant granular cell tumor: a look into the diagnostic criteria[J]. Pathol Res Pract, 2011, 207(3): 164-168. doi:10.1016/j.prp.2010.12.007
[19] Battistella M, Cribier B, Feugeas JP, et al. Vascular invasion and other invasive features in granular cell tumours of the skin: a multicentre study of 119 cases[J]. J Clin Pathol, 2014, 67(1): 19-25. doi:10.1136/jclinpath-2013-201642
[20] Kapur P, Rakheja D, Balani JP, et al. Phosphorylated histone H3, Ki-67, p21, fatty acid synthase, and cleaved caspase-3 expression in benign and atypical granular cell tumors[J]. Arch Pathol Lab Med, 2007, 131(1): 57-64. doi:10.5858/2007-131-57-PHHKPF
[21] 申泽良, 姚莉洪, 蒋鸿杰, 等. 颌面部颗粒细胞瘤临床病理及免疫组织化学分析[J]. 华西口腔医学杂志, 2023, 41(4): 414-420. doi:10.7518/hxkq.2023.2023035 SHEN Zeliang, YAO Lihong, JIANG Hongjie, et al. Clinicopathological and immunohistochemical analysis of maxillofacial granular cell tumor[J]. West China Journal of Stomatology, 2023, 41(4): 414-420. doi:10.7518/hxkq.2023.2023035
[22] 薛潋滟, 芮晓清, 何巧, 等. 小儿会厌谷囊肿的MRI表现及相关病理学基础与临床[J]. 医学影像学杂志, 2021, 31(6): 917-921. XUE Lianyan, RUI Xiaoqing, HE Qiao, et al. MRI manifestations of vallecular cyst in children and its related pathological basis and clinical manifestations[J]. Journal of Medical Imaging, 2021, 31(6): 917-921.
[23] 邢淑英, 常志红. 鼻内窥镜下咽囊囊肿切除一例报告[J]. 北京医学, 1996,(1): 42.
[24] 王翰菁, 倪鑫, 王军, 等. 下咽食管纤维血管性息肉[J]. 临床耳鼻咽喉头颈外科杂志, 2013, 27(6): 305-306. WANG Hanjing, NI Xin, WANG Jun, et al. Hypopharyngeal and esophageal fibrovascular polyp[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2013, 27(6): 305-306.
[25] 黄鲲, 陶绮蕾, 纪振华, 等. 原发于下咽的巨大神经鞘瘤1例[J]. 中国耳鼻咽喉头颈外科, 2021, 28(11): 724-725. doi:10.16066/j.1672-7002.2021.11.016 HUANG Kun, TAO Qilei, JI Zhenhua, et al. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2021, 28(11): 724-725. doi:10.16066/j.1672-7002.2021.11.016
[26] 韩飞燕, 王英. 鼻腔鼻窦神经鞘瘤13例临床分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 21-25, 32. doi:10.6040/j.issn.1673-3770.0.2022.229 HAN Feiyan, WANG Ying. Clinical analysis of 13 cases of neurilemmomas in the nasal cavity and paranasal sinuses[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(2): 21-25, 32. doi:10.6040/j.issn.1673-3770.0.2022.229
[27] Moon HH, Jin K, Choi YJ, et al. Imaging findings of granular cell tumours of the head and neck[J]. Clin Radiol, 2023, 78(12): e1075-e1080. doi:10.1016/j.crad.2023.09.003
[28] Chen YH, Chen YY, Chen XQ, et al. Colonic granular cell tumor: Report of 11 cases and management with review of the literature[J]. Oncol Lett, 2018, 16(2): 1419-1424. doi:10.3892/ol.2018.8811
[29] Mirambeaux M, Paulino H, Acra-Tolari R, et al. Rare case of pediatric upper airway obstruction: laryngeal granular cell tumor[J]. Cureus, 2022, 14(3): 22829. doi:10.7759/cureus.22829
[30] Srivastava P, Da Cruz Paula A, Weigelt B, et al. Granular cell tumor of thyroid: a case series with molecular characterization highlighting unique pitfalls[J]. Endocrine, 2022, 76(2): 395-406. doi:10.1007/s12020-022-03006-x
[31] 石祥呈, 屈重霄, 林瀛, 等. 10例乳腺颗粒细胞瘤临床病理分析[J]. 中国实用医刊, 2019, 46(11): 8-10. doi:10.3760/cma.j.issn.1674-4756.2019.11.003 SHI Xiangcheng, QU Zhongxiao, LIN Ying, et al. Clinicopathological analysis on 10 cases of breast granular cell tumor[J]. Chinese Journal of Practical Medicine, 2019, 46(11): 8-10. doi:10.3760/cma.j.issn.1674-4756.2019.11.003
[32] Hogan C, Acharya V, Tsitsiou Y, et al. Laryngeal granular cell tumour: a very rare diagnosis for a child presenting with hoarse voice in the UK[J]. BMJ Case Rep, 2020, 13(7): e232851. doi:10.1136/bcr-2019-232851

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