Clinical and pathological features of atypical granular cell tumor of the jejunum

ZHANG Qi; SUN Defeng; YU Miao; XU Rongrong; ZHANG Rongrong

doi:10.3969/j.issn.1007-8096.2025.08.011

Abstract：Objective To explore the clinical and pathological characteristics,diagnosis,differential diagnosis,treatment and prognosis of the atypical granular cell tumor originating from the jejunum.Methods A retrospective analysis of primary atypical granular cell tumor of the jejunum was cenducted.The pathological morphological characteristics,immunohistochemical expressions and clinical features were analyzed by HE staining and immunohistochemistry.Results The patient was a 57-year-old female,and the initial clinical diagnosis was a jejunal tumor accompanied by intussusception.Grossly,it was a submucosal tumor measuring 3×3×2 cm.The cut surface was grayish-yellow,solid,and of firm texture.Microscopically,the tumor was located in the submucosa,and a superficial ulcer could be seen on the surface.The tumor cells were arranged in nests,which were surrounded by fibrous connective tissue.Some of the tumor cells were round or oval in shape,with eosinophilic and granular cytoplasm,and eosinophilic globules were observable.The nuclei of some tumor cells were vacuolated,and the nucleoli were large and prominent.Some of the tumor cells were spindle-shaped,and there was 1 mitotic figure per 10 HPF.Immunohistochemical results showed that the tumor expressed S-100,NSE,CD56,SOX-10,and CD68,but did not express CD 117,inhibin-α,vimentin,desmin,DOG-1,CD34,SMA,CKpan,TFE-3.The proliferation index of ki-67 was 10％.Special staining showed positive results for AB-PAS.Conclusion To our knowledge,this is the first reported case of an atypical GCT originating from the jejunum.According to the six classification criteria proposed by Fanburg-Smith in 1998,this case meets one of the criteria.Meanwhile,through pathological histology and immunohistochemistry,it is finally confirmed as an atypical granular cell tumor.