Concurrence of granular cell tumor and Mycobacterium tuberculosis

Granular cell tumors (GCT) are rare, usually benign neoplasms of Schwann cell origin. Since discovery in 1926, fewer than 80 cases of GCT involving the lung have been reported. This report presents a 45-year-old male who presented with symptoms consistent with chronic pancreatitis associated with night sweats, weight loss, and a chronic productive cough. Chest radiography revealed a 3 x 4 cm left upper lobe lung mass with an unremarkable right lung field. Bronchoscopy revealed mixed mucosal abnormalities in the left upper lobe and a 4-mm polypoidal lesion in the right lower lobe. Bronchial washings stained positive for acid-fast bacilli. The left upper lobe lesion biopsy showed granulomatous inflammation with caseous necrosis consistent with tuberculosis. The right lower lobe lesion was a GCT without evidence of tuberculosis. This report reviews the literature regarding GCT and presents this unusual case of granular cell tumor co-occurring with active tuberculosis.