Granular cell tumor of the biliary system: a report of 2 cases with cytologic diagnosis on endoscopic brushing.
BACKGROUND
Granular cell tumors (GCTs) of biliary system are rare. GCTs show a striking preponderance for young, black females, who generally present with obstructive jaundice. To our knowledge, these are the first 2 reports of GCT of biliary system identifed on endoscopic brushing cytology.


METHODS
In case 1, a 24-year-old, black woman presented with a 5-month history of pruritus. Radiographic studies demonstrated a mass in the distal common bile duct. Endoscopic biopsy and bile duct brushing were diagnosed as GCT. A Whipple procedure was confirmatory of GCT. In case 2, a 38-year-old, black female presented with a 7-month history of pruritus and jaundice. Radiographic studies showed a stricture of the common hepatic duct at the hilum. Endoscopic brushing cytology of the stricture yielded only a few sheets of granular cells that were missed on initial screening. Suspicion of cholangiocarcinoma prompted surgery, and final histopathology showed GCT. Both patients were well 1 1/2 and 6 years after presentation.


CONCLUSIONS
GCT of the bile duct can be diagnosed on endoscopic brushing and should be considered in the cytologic differential diagnosis in the appropriate clinical settings.
Hoda
Rana S
RS
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. hodars@musc.edu
Minamiguchi
Sachiko
S
Lewin
David N
DN
Foody
William
W
Weselow
Grace
G
Wildi
Stephan M
SM
D000230:Adenocarcinoma / Q000208:ethnology / Q000473:pathology* / Q000503:physiopathology; D000328:Adult; D000367:Age Factors; D001650:Bile Duct Neoplasms / Q000208:ethnology / Q000473:pathology* / Q000503:physiopathology; D044383:Black People; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D003135:Common Bile Duct / Q000000981:diagnostic imaging / Q000473:pathology*; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System / Q000592:standards*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006500:Hepatic Duct, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D011537:Pruritus / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography