Granular cell tumor of the esophagus: a clinicopathological study of 31 cases

Granular cell tumors (GCTs) in esophagus are rare tumors lacking of systemic large group reports. In this study, we summarized the clinical characteristics, histological features and therapeutic approaches of 31 cases. GCTs generally located at middle and distal of the esophagus in middle aged and elderly patients with no incidence of gender differences. Histologically, tumor cells were mainly plump and polygonal with abundant, granular, amphophilic or eosinophilic cytoplasm. The growth pattern was solid or nested, usually with minimal infiltration and inflammatory infiltrates and lymphoid aggregation. All GCTs in the present study were benign according to Nasser criteria. Nestin, NSE, CD68 and S100 protein were moderate to strong positive. Moreover, a developmental morphology of a GCT was found, which included areas of relatively normal Schwann cells, transitional cells and typical cells of GCTs. All patients received endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Twenty-six patients were followed up and remained clinically well. In conclusion, GCTs of esophagus are neurogenic origin tumors with favourable prognosis. Definite diagnosis of GCTs relies upon pathological examination. The Nasser criteria for stratification are practical in guiding treatment strategy. ESD is a recommended therapeutic strategy, and the range of application is expanding.