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1.
BMJ Case Rep ; 17(8)2024 Aug 16.
Article in English | MEDLINE | ID: mdl-39153762

ABSTRACT

Granular cell tumours (GCT) of the breast have similar clinical and radiological features to breast carcinomas. We present a case of a female patient with a tender, palpable lump, and associated skin changes. Imaging of the lesion was suspicious of malignancy. Initial histological examination showed uniform sheets of polygonal cells with abundant granular cytoplasm, and follow-up immunohistochemistry showed strongly positive staining of tumour cells with S100 and CD68, confirming the diagnosis of GCT. Wide local excision with complete resection margins was performed as a curative treatment for this lesion. This case report highlights the importance of considering GCTs in the differential diagnoses of breast lesions suspicious of malignancy and emphasises the necessity of accurate diagnosis of GCT for proper treatment.


Subject(s)
Breast Neoplasms , Granular Cell Tumor , Humans , Female , Granular Cell Tumor/pathology , Granular Cell Tumor/surgery , Granular Cell Tumor/diagnostic imaging , Granular Cell Tumor/diagnosis , Breast Neoplasms/pathology , Breast Neoplasms/diagnosis , Breast Neoplasms/surgery , Diagnosis, Differential , Immunohistochemistry , Adult , Mammography , S100 Proteins/analysis , S100 Proteins/metabolism , Breast/pathology , Breast/diagnostic imaging , Middle Aged
2.
J Cancer Res Ther ; 20(3): 1042-1044, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-39023615

ABSTRACT

ABSTRACT: Granular cell tumors (GCTs) are uncommon soft tissue tumors, which are difficult to diagnose merely by clinical examination. Fine-needle aspiration cytology (FNAC), being an effective first-line investigation, plays a significant role in the preoperative diagnosis of GCT. However, the tumor can mimic certain other lesions; hence, a cytopathologist needs to be aware of its characteristic morphology. We report here a case of GCT, presented as a subcutaneous nodule in the first finger web. A differential diagnosis of lipoma/neurofibroma was made clinically. FNAC was done and showed characteristic features of granular cell tumor along with intranuclear inclusions and subsequently, it was confirmed on histopathology.


Subject(s)
Granular Cell Tumor , Skin Neoplasms , Humans , Granular Cell Tumor/pathology , Granular Cell Tumor/diagnosis , Granular Cell Tumor/surgery , Skin Neoplasms/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/surgery , Biopsy, Fine-Needle , Diagnosis, Differential , Cytodiagnosis/methods , Male , Adult , Female
3.
Pathol Oncol Res ; 30: 1611834, 2024.
Article in English | MEDLINE | ID: mdl-39049934

ABSTRACT

Herein, we detail a multidisciplinary approach and sequential treatment for two infants with congenital granular cell epulis (CGCE). Ultrasonic examinations at 34 weeks of gestation revealed prominent oral masses in both fetuses. To devise a carefully considered treatment strategy, a comprehensive multidisciplinary consultation including oral and maxillofacial surgeons, pediatricians, obstetricians, and anesthesiologists was convened. Following cesarean sections, the lesions were successfully removed, measuring approximately 30 × 15 mm and 30 × 20 mm in size, respectively. Immunohistochemical analysis showed that vimentin was positive, S-100 protein was negative, and NSE protein and CD68 protein were negative. These findings underscore the importance of prenatal diagnosis of congenital granular cell epulis for the effective management of these rare benign conditions.


Subject(s)
Granular Cell Tumor , Prenatal Diagnosis , Humans , Female , Pregnancy , Granular Cell Tumor/surgery , Granular Cell Tumor/pathology , Granular Cell Tumor/congenital , Prenatal Diagnosis/methods , Infant, Newborn , Gingival Neoplasms/surgery , Gingival Neoplasms/pathology , Gingival Neoplasms/congenital , Adult , Male , Ultrasonography, Prenatal
4.
Can Vet J ; 65(7): 703-706, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38952757

ABSTRACT

Testicular tumors are rarely reported in rabbits. In this case study, a 4-year-old Holland lop rabbit, previously diagnosed with unilateral cryptorchidism, was presented because of enlargement of the descended testis. The rabbit was clinically normal. Following unilateral orchiectomy and scrotal ablation, histopathological analysis revealed 2 distinct types of testicular tumor in the descended testis: a granular cell tumor and a seminoma. To the best of the author's knowledge, this is the first documented report of simultaneous testicular tumors in the testis of a rabbit with unilateral cryptorchidism.


Tumeur à cellules granulaires et séminome simultanés dans le testicule descendu d'un lapin cryptorchideLes tumeurs testiculaires sont rarement rapportées chez le lapin. Dans cette étude de cas, un lapin Holland Lop de 4 ans, précédemment diagnostiqué avec une cryptorchidie unilatérale, a été présenté en raison d'une hypertrophie du testicule descendu. Le lapin était cliniquement normal. Après orchidectomie unilatérale et ablation scrotale, l'analyse histopathologique a révélé 2 types distincts de tumeur testiculaire dans le testicule descendu : une tumeur à cellules granuleuses et un séminome. À la connaissance de l'auteur, il s'agit du premier rapport documenté de tumeurs testiculaires simultanées dans le testicule d'un lapin atteint de cryptorchidie unilatérale.(Traduit par Dr Serge Messier).


Subject(s)
Cryptorchidism , Granular Cell Tumor , Orchiectomy , Seminoma , Testicular Neoplasms , Animals , Male , Rabbits , Testicular Neoplasms/veterinary , Testicular Neoplasms/pathology , Testicular Neoplasms/surgery , Cryptorchidism/veterinary , Cryptorchidism/surgery , Cryptorchidism/pathology , Seminoma/veterinary , Seminoma/pathology , Seminoma/surgery , Granular Cell Tumor/veterinary , Granular Cell Tumor/pathology , Granular Cell Tumor/surgery , Orchiectomy/veterinary
5.
Arkh Patol ; 86(4): 48-50, 2024.
Article in Russian | MEDLINE | ID: mdl-39073542

ABSTRACT

The report of the biopsy diagnosis of the granular cell tumor with rare localization in the breast is given. Currently, the tumor is considered a neoplasm of neuroectodermal origin. Differential diagnostic criteria for the tumor are positive expression in cytoplasm of protein S-100, absence of expression of epithelial antigens, histiocytic antigens, oncoproteins, estrogens and progesterone receptors, PAS-positive reaction of intracellular granules. With ultrasound examination and mammography, a tumor always initially assessed as cancer or calcification.


Subject(s)
Breast Neoplasms , Granular Cell Tumor , Humans , Granular Cell Tumor/pathology , Granular Cell Tumor/metabolism , Granular Cell Tumor/diagnosis , Granular Cell Tumor/diagnostic imaging , Female , Breast Neoplasms/pathology , Breast Neoplasms/diagnosis , Breast Neoplasms/metabolism , Diagnosis, Differential , Adult , Middle Aged , Mammography
7.
Oral Maxillofac Surg ; 28(3): 1383-1397, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38904898

ABSTRACT

BACKGROUND: Granular Cell Tumor (GCT) is an uncommon benign lesion in the oral cavity whose pathogenesis remains poorly understood. Due to their infrequent occurrence and similarity to other oral lesions, they are often forgotten during the initial clinical diagnosis. Therefore, understanding its prevalence, clinical and pathological characteristics is crucial for an accurate diagnosis and adequate management. METHODS: All cases diagnosed as GCTs in six Brazilian and Argentinian oral diagnostic centers were re-evaluated by HE staining, and clinical, demographic, and histopathological data were collected and evaluated. RESULTS: The series comprised 45 female (73.8%) and 16 male (26.2%), with a 2.8:1 female-to-male ratio and a mean age of 35.3 ± 16.9 years (range: 7-77 years). Most cases occurred on the tongue (n = 49; 81.6%) and presented clinically as asymptomatic papules or nodules (n = 50; 89.3%) with a normochromic (n = 25; 45.5%) or yellowish (n = 11; 20.0%) coloration and sizes ranging from 0.2 to 3.0 cm (mean ± SD: 1.40 ± 0.75 cm). Morphologically, most tumors were characterized by a poorly delimited proliferation (n = 52; 88.1%) of cells typically rounded to polygonal containing abundant, eosinophilic, finely granular cytoplasm. Pustulo-ovoid bodies of Milian were identified in all lesions (n = 61; 100%). Entrapment of skeletal striated muscle (n = 44; 72.1%) and nerve fibers (n = 42; 68.9%) were common findings. Pseudoepitheliomatous hyperplasia (PEH) was observed in 23 cases (39.0%). In only 27.7% of cases (n = 13) there was agreement between the clinical and histopathological diagnosis. Outcome information was available from 16 patients (26.2%), with clinical follow-up ranging from 4 to 36 months (mean 13.3 months), and none developed local recurrence. CONCLUSIONS: The clinical and histopathological features of GCTs were consistent with those described in previous studies. In general, these lesions have a predilection for the lateral region of the tongue in adult women. It is essential to consider GCTs in the differential diagnosis of yellow or normochromic papules and nodules in the oral cavity. Histopathological evaluation is essential for the definitive diagnosis and the prognosis is excellent.


Subject(s)
Granular Cell Tumor , Mouth Neoplasms , Humans , Granular Cell Tumor/pathology , Male , Female , Adult , Middle Aged , Adolescent , Child , Mouth Neoplasms/pathology , Aged , Young Adult , Brazil
8.
Medicina (Kaunas) ; 60(4)2024 Mar 31.
Article in English | MEDLINE | ID: mdl-38674222

ABSTRACT

Background and Objectives: Our report contributes a unique case of a non-neural GCT occurring in an unusual location, with its development during pregnancy adding to its rarity. Materials and Methods: Granular cell tumors (GCTs), also known as Abrikossoff's tumors, are rare neoplasms of Schwann cell origin with predominantly benign behavior. We present a case of a 29-year-old female with a non-neural variant of a GCT discovered incidentally during a cesarean section, situated on the posterior surface of the rectus abdominis muscle. Results: Histologically, the tumor exhibited features consistent with a benign non-neural GCT, confirmed through an immunohistochemical analysis. Despite the atypical presentation and challenging surgical removal due to prior scarring, the patient experienced no postoperative complications and showed no signs of recurrence during follow-up. Conclusions: This case highlights the importance of considering GCTs in differential diagnoses, particularly in unusual anatomical locations, and underscores the favorable prognosis associated with timely surgical intervention.


Subject(s)
Granular Cell Tumor , Granulosa Cell Tumor , Rectus Abdominis , Humans , Female , Rectus Abdominis/pathology , Rectus Abdominis/surgery , Adult , Granular Cell Tumor/surgery , Granular Cell Tumor/diagnosis , Granular Cell Tumor/pathology , Pregnancy , Muscle Neoplasms/surgery , Muscle Neoplasms/diagnosis , Muscle Neoplasms/pathology , Cesarean Section
9.
J Cutan Pathol ; 51(6): 434-438, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38527927

ABSTRACT

Granular cell tumors (GCTs) are rare, indolent neoplasms classically characterized by eosinophilic granular cytoplasm, infiltrations of polygonal cells in the collagenous stroma, and pustulo-ovoid bodies of Milian. We describe a case of a 10-year-old female presenting with a GCT of the upper arm, remarkable for positive Melan-A expression without additional melanocytic features. The differentiation between granular cells versus melanocytic neoplasms carries significant implications for clinical management, and such diagnoses should be considered carefully in the setting of unusual immunophenotypes.


Subject(s)
Granular Cell Tumor , MART-1 Antigen , Skin Neoplasms , Humans , Female , Skin Neoplasms/pathology , Skin Neoplasms/metabolism , Child , Granular Cell Tumor/pathology , Granular Cell Tumor/metabolism , Granular Cell Tumor/diagnosis , MART-1 Antigen/metabolism , Biomarkers, Tumor/metabolism
10.
Fetal Pediatr Pathol ; 43(3): 251-256, 2024.
Article in English | MEDLINE | ID: mdl-38345043

ABSTRACT

BACKGROUND: Granular cell tumors occur in all ages and many anatomic sites. In the craniofacial region, they typically arise in soft tissue, not bone. We present a primary intra-osseous granular cell tumor of the sphenoid and central skull base arising in a 12- year- old girl. CASE REPORT: A 12-year-old female with sickle cell disease and Jeavons syndrome presented with seizures. Imaging and partial resection revealed an expansile benign granular cell tumor (GCT) involving the sphenoid body, pterygoid process, and central skull base. The disease has remained stable after 36-month follow up. DISCUSSION: GCT primarily involving the osseous sphenoid/skull base has not been previously reported in a child. Although mostly benign, some are aggressive, with malignant transformation in 1-2%. Surgery is the mainstay of treatment, but in the skull base this may be limited by adjacent critical structures. Decision-making is guided by anatomic extent, histology, and clinical behavior.


Subject(s)
Granular Cell Tumor , Skull Base Neoplasms , Sphenoid Bone , Humans , Female , Child , Granular Cell Tumor/pathology , Granular Cell Tumor/diagnosis , Granular Cell Tumor/surgery , Sphenoid Bone/pathology , Skull Base Neoplasms/pathology , Skull Base Neoplasms/diagnosis , Skull Base Neoplasms/surgery , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/pathology , Skull Base/pathology , Skull Base/diagnostic imaging
11.
Pediatr Dev Pathol ; 27(3): 211-217, 2024.
Article in English | MEDLINE | ID: mdl-38179814

ABSTRACT

BACKGROUND: Pediatric granular cell tumors (GCT) involving the gastrointestinal tract (GIT) are rare with limited case report/series reported to date. METHODS: Multicenter retrospective study of pediatric GIT GCT. RESULTS: A total of 10 cases were included in the study with a median age of 13.5 years (range: 7-18 years) and were predominantly female patients (60%). In half of the patients no significant medical history was present with the remaining 5 having Crohn disease (10%), eosinophilic esophagitis (EoE) (10%), Crohn disease and EoE (10%), growth hormone deficiency (10%), and aplasia cutis congenita (10%). The GCT median size was 1.3 cm (range: 1-1.6 cm) and were more commonly located in the esophagus (70%) followed by the stomach (20%) and rectum (10%). Most of the cases showed round/polygonal tumor cells with abundant granular cytoplasm, and none of the cases had nuclear atypia, increased mitotic activity, or tumor cell necrosis. None of our cases received specific therapy for GCT other than clinical follow-up, and none of the patients had evidence of local recurrence or metastatic disease. CONCLUSION: We present our multicenter experience with GIT GCT, all cases had a benign course. Interestingly, 4 of the esophageal GCT cases (including 2 patients with EoE) showed an eosinophil-rich esophagitis in the underlying mucosa.


Subject(s)
Gastrointestinal Neoplasms , Granular Cell Tumor , Humans , Granular Cell Tumor/pathology , Granular Cell Tumor/diagnosis , Adolescent , Female , Child , Male , Retrospective Studies , Gastrointestinal Neoplasms/pathology , Gastrointestinal Neoplasms/diagnosis
12.
Laryngoscope ; 134(4): 1523-1530, 2024 Apr.
Article in English | MEDLINE | ID: mdl-37782552

ABSTRACT

OBJECTIVE: Granular cell tumor of the larynx is an uncommon, typically benign lesion that may be confused for a malignant neoplasm based on histopathology. This review examines cases of granular cell tumor of the larynx in adults to highlight key distinctions in diagnosis/management and demonstrate how misclassification may lead to unnecessary escalations in therapy. DATA SOURCES AND METHODS: A systematic search of PubMed, Ovid, and EBSCO Search Hosts was completed in December 2021. The search yielded 501 articles with 87 full-text articles included in the review. Primary search terms included granular cell, tumor, larynx, and adult. Primary endpoints were patient presentation, primary management, pathological features, and disease course. RESULTS: A systematic review of 87 articles identified 200 patients with granular cell tumors (GCTs) of the larynx. Of the 200 patients, 50.3% were males and 49.7% were females. Of these, 54.0% were reported as white patients, and 46.0% were reported as black patients. The most common presenting symptoms were dysphonia (85.9%) and stridor/dyspnea (14.1%). On examination, the lesions were most commonly polypoid/nodular and firm. Pseudoepitheliomatous hyperplasia (PEH) was identified in 33.5% of cases, and 2% of cases were malignant. GCTs were misdiagnosed as other malignant lesions in 11% of cases. In benign cases, 13.5% of patients underwent additional surgeries beyond simple excision/laryngofissure, including laryngectomy and neck dissection. Less than 2% of lesions reoccurred. CONCLUSION: Granular cell tumors of the larynx are typically benign lesions that may be misdiagnosed with unnecessary escalation of treatment. However, most lesions resolve via primary surgical excision. Laryngoscope, 134:1523-1530, 2024.


Subject(s)
Granular Cell Tumor , Laryngeal Diseases , Larynx , Male , Adult , Female , Humans , Granular Cell Tumor/diagnosis , Granular Cell Tumor/surgery , Granular Cell Tumor/pathology , Larynx/pathology , Laryngeal Diseases/surgery , Laryngectomy , Hyperplasia/pathology
13.
Zhonghua Jie He He Hu Xi Za Zhi ; 46(11): 1121-1123, 2023 Nov 12.
Article in Chinese | MEDLINE | ID: mdl-37914424

ABSTRACT

Granular cell tumor (GCT) is a relatively rare tumor that develops in soft tissues at various sites in the body, and GCT originating in the bronchus is rather rare. Here, we reported a case of primary GCT of the bronchial to improve the understanding of this disease.


Subject(s)
Granular Cell Tumor , Humans , Granular Cell Tumor/pathology , Bronchi/pathology
15.
Radiologia (Engl Ed) ; 65 Suppl 2: S83-S87, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37858358

ABSTRACT

Granular cell tumors (GrCT) are histologically unique neoplasms that often manifest as painless solitary nodules located in the dermis or submucosal tissue. In this article we analyze the radiologic features of this type of tumor in five patients by magnetic resonance imaging (MRI), analyzing morphologic and signal characteristics. MR imaging findings were similar to other publications and we demonstrate low ADC values in our series.


Subject(s)
Granular Cell Tumor , Humans , Granular Cell Tumor/diagnostic imaging , Granular Cell Tumor/pathology , Magnetic Resonance Imaging/methods
16.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 41(4): 414-420, 2023 Aug 01.
Article in English, Chinese | MEDLINE | ID: mdl-37474473

ABSTRACT

OBJECTIVES: To analyze the clinicopathological features of maxillofacial granular cell tumors (GCT) with the aid of immunohistochemical staining. METHODS: Seven cases of maxillofacial GCT were retrospectively collated, and the microscopic morphology of maxillofacial GCT was analyzed. The expression of S-100, neuron-specific enolase (NSE), SOX-10, CD68, actin, desmin, and Ki-67 in GCT was detected by immunohistochemical staining. The cases were observed in the follow-ups after clinical treatment. RESULTS: All seven GCT tumors lacked envelopes and were poorly defined. Microscopically, the sizes of the tumor cells were large and appeared with inconspicuous cell membranes, forming a syncytium-like appearance. The cytoplasm was filled with characteristic eosinophilic granules. The immunohistochemical results showed that six cases were NSE-positive, five cases were S-100-positive, seven cases were CD68-positive, five cases were SOX-10-positive, one case was actin-positive, and seven cases were desmin-negative. The Ki-67 index did not exceed 5% in all cases. In the follow-up sessions, none of the six cases presented a recurrence. CONCLUSIONS: Maxillofacial GCT has a characteristic histological structure. Immunohistochemical S-100, CD68, and other indicators can assist in diagnosis, and the prognosis is good after clinical resection.


Subject(s)
Granular Cell Tumor , Humans , Ki-67 Antigen/metabolism , Granular Cell Tumor/diagnosis , Granular Cell Tumor/pathology , Granular Cell Tumor/surgery , Retrospective Studies , Actins/metabolism , Desmin/metabolism , S100 Proteins/metabolism
18.
Neuropathology ; 43(6): 472-478, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37147874

ABSTRACT

Granular cell tumors of the neurohypophysis (GCT) are rare benign neoplasms belonging, along with pituicytoma and spindle cell oncocytoma, to the family of TTF1-positive low-grade neoplasms of the posterior pituitary gland. GCT usually present as a solid sellar mass, slowly growing and causing compressive symptoms over time, occasionally with suprasellar extension. They comprise polygonal monomorphous cells with abundant granular cytoplasm, which is ultrastructurally filled with lysosomes. Here we report the case of a GCT presenting as a third ventricle mass, radiologically mimicking chordoid glioma, with aberrant expression of GFAP and Annexin-A, which lends itself as an example of an integrated diagnostic approach to sellar/suprasellar and third ventricle masses.


Subject(s)
Cerebral Ventricle Neoplasms , Craniopharyngioma , Glioma , Granular Cell Tumor , Pituitary Gland, Posterior , Pituitary Neoplasms , Third Ventricle , Humans , Pituitary Gland, Posterior/metabolism , Pituitary Gland, Posterior/pathology , Third Ventricle/diagnostic imaging , Third Ventricle/pathology , Granular Cell Tumor/diagnostic imaging , Granular Cell Tumor/pathology , Cerebral Ventricle Neoplasms/diagnostic imaging , Cerebral Ventricle Neoplasms/pathology , Pituitary Neoplasms/diagnostic imaging , Glioma/pathology
19.
Cytopathology ; 34(4): 388-394, 2023 07.
Article in English | MEDLINE | ID: mdl-37009646

ABSTRACT

The cytomorphological features of benign mesenchymal tumours of the tongue have rarely been reported. Herein, we present the cytomorphological features of adult-type rhabdomyoma, which occurred in the tongue of a female patient, and granular cell tumour (GCT), which occurred in the tongue of a male patient; both patients were in their mid-50s. The cytological features of the adult-type rhabdomyoma case included large polygonal to ovoid cells with abundant and granular cytoplasm with predominantly peripherally located, uniform, round to oval nuclei and small nucleoli. Cross-striation and crystalline intracytoplasmic structures were not seen. The cytological features of the GCT case included large cells with abundant granular pale cytoplasm, small round nuclei and small distinct nucleoli. The cytological differential diagnoses of these tumours overlap; thus, the cytological findings of the different entities included in their differential diagnoses are discussed.


Subject(s)
Granular Cell Tumor , Rhabdomyoma , Tongue Neoplasms , Humans , Male , Adult , Female , Tongue Neoplasms/diagnosis , Tongue Neoplasms/pathology , Rhabdomyoma/diagnosis , Rhabdomyoma/pathology , Granular Cell Tumor/diagnosis , Granular Cell Tumor/pathology , Cell Nucleus/pathology , Tongue/pathology
20.
Am J Clin Pathol ; 160(1): 106-112, 2023 07 05.
Article in English | MEDLINE | ID: mdl-37026754

ABSTRACT

OBJECTIVES: Granular cell tumor (GCT) commonly presents in the subcutaneous tissue and head and neck region, and it is uncommon in the gastrointestinal tract. Experience with esophageal GCTs in the pediatric population is limited, with only 7 cases reported in the literature, 3 with eosinophilic esophagitis (EoE). METHODS: Case information from 11 pediatric patients with GCTs of the esophagus was retrieved. H&E and immunohistochemical slides were reviewed with clinical, endoscopic, and follow-up data from all patients. RESULTS: In total, 7 male and 4 female patients were included, with ages ranging from 3 to 14 years. Indications for esophagogastroduodenoscopy (EGD) included EoE (n = 3), follow-up for Crohn disease, and other nonspecific complaints. Endoscopically, all patients had a single submucosal, firm mass protruding into the lumen, with normal overlying mucosa. The nodules were removed endoscopically in multiple fragments in all cases. Histologically, the tumors showed sheets and trabeculae of cells containing bland nuclei, inconspicuous nucleoli, and abundant pink granular cytoplasm without atypical features. All tumors were immunoreactive for S100, CD68, and SOX10. Follow-up showed that all patients were disease-free (median, 2 years). CONCLUSIONS: We report the largest series of pediatric esophageal GCTs with coincidental association with EoE. These EGD findings are characteristic, and removal by biopsy is both diagnostic and therapeutic.


Subject(s)
Esophageal Neoplasms , Granular Cell Tumor , Humans , Male , Child , Female , Immunohistochemistry , Granular Cell Tumor/complications , Granular Cell Tumor/pathology , Esophageal Neoplasms/complications , Esophageal Neoplasms/pathology , Biopsy
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