title: Granular cell tumor of the biliary system: a report of 2 cases with cytologic diagnosis on endoscopic brushing.
abstract: 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.
authors.affiliation: Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina 29425, USA. hodars@musc.edu
authors.forename: Rana S
authors.initials: RS
authors.lastname: Hoda
authors.forename: Sachiko
authors.initials: S
authors.lastname: Minamiguchi
authors.forename: David N
authors.initials: DN
authors.lastname: Lewin
authors.forename: William
authors.initials: W
authors.lastname: Foody
authors.forename: Grace
authors.initials: G
authors.lastname: Weselow
authors.forename: Stephan M
authors.initials: SM
authors.lastname: Wildi
mesh_terms: 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