The purpose of this series was to review the spectrum of sonographic and mammographic features of granular cell tumors (GCTs) of the breast and to compare their frequency relative to breast carcinoma.
Ten cases of a breast GCT diagnosed during the last 13 years were analyzed for the imaging characteristics and clinical features. Sonographic images were reviewed for location, size, echogenicity, margins, height-width ratio, and sound transmission. Mammograms were reviewed for tumor size, location, margin characteristics, spiculations, and calcifications. The frequency of GCTs was compared with that of breast carcinoma during the same study period.
Of 10 GCT cases, 9 tumors occurred in female patients, and 1 occurred in a male patient. The mean patient age was 51.8 years, and the mean lesion size was 1.57 cm. All 7 tumors visualized on sonography were hypoechoic masses. Posterior enhancement was noted in 3 of 7 cases, and posterior shadowing was noted in 2 of 7 cases. Two of 7 did not show any posterior enhancement or shadowing. Two of 7 masses were taller than wide. Of 8 tumors visualized on mammography, 5 were spiculated, and 3 were well circumscribed. Calcifications were not visualized in any tumor. During the same period, 1482 cases of breast carcinoma were diagnosed, making the frequency of GCTs of the breast about 6.7 per thousand breast carcinomas.
Granular cell tumors of the breast are rare neoplasms with a relative frequency of 6.7 per thousand breast carcinomas in our series, which was higher than reported in literature. Spiculations are a common imaging feature and mimic carcinoma when present.
"The shape of the " taller than wider " nodule, although not extensively described, has been previously mentioned in the literature where, in agreement with our work, it was found to be specific but with reduced sensitivity . In breast cancer, this concept of AP growth is widely accepted  but is less so for the thyroid. US reports of thyroid nodules often describe only one diameter, in particular, the longitudinal diameter and lack information regarding the AP or axial diameters. "
[Show abstract][Hide abstract] ABSTRACT: Objective. Ultrasonographic characteristics are associated with thyroid malignancy. Our aim was to compare the diagnostic value of ultrasound features in the detection of thyroid malignancy in both solid and mixed nodules. Methods. We prospectively studied female patients (≥50 years) referred to ultrasound-guided fine needle aspiration biopsy. Ultrasound features considered suspicious were hypoechogenicity, microcalcifications, irregular margins, high anteroposterior (AP)/axial-ratio, and absent halo. Associations were separately assessed in mixed and solid nodules. Results. In a group of 504 elderly female patients (age = 69 ± 8 years), the frequency of malignant cytology was 6%. Thirty-one percent of nodules were mixed and 60% were solid. The rate of malignant cytology was similar for mixed and solid nodules (7.4 versus 5.8%, P: 0.56). While in mixed nodules none of the ultrasound characteristics were associated with malignant cytology, in solid nodules irregular margins and microcalcifications were significant (all P < 0.05). The combination of irregular margins and/or microcalcifications significantly increased the association with malignant cytology only in solid nodules (OR: 2.76 (95% CI: 1.25-6.10), P: 0.012). Conclusions. Ultrasound features were of poor diagnostic value in mixed nodules, which harbored malignant lesions as often as solid nodules. Our findings challenge the recommended minimal size for ultrasound-guided fine needle aspiration biopsy in mixed nodules.
Journal of Thyroid Research 06/2014; 2014:761653. DOI:10.1155/2014/761653
[Show abstract][Hide abstract] ABSTRACT: A 54-year-old male presented with a painless, hard, irregular lump in his right breast, with fixation to the pectoralis muscle. Mammography and ultrasound showed a 2.5-cm mass suspicious of malignancy. The patient underwent a wide local excision. A 2.5-cm hard, stellate lump was found and sent to the pathologist, which revealed this to be a benign granular cell tumor. Granular cell tumor of the breast is a rare neoplasm, of unknown etiology, which is benign in 98% of cases, but mimics breast cancer, causing challenging diagnostic and therapeutic dilemmas. Traditional imaging techniques do not recognize any feature specific for this tumor. Only excisional biopsy allows the detection of the distinct histological and immunohistochemical profile of the lesion (granular cytoplasm and staining for the S-100 protein). Only local surgical excision is indicated. General and senologist surgeons must be aware of this entity to avoid unnecessary mastectomy or lymphadenectomy.
[Show abstract][Hide abstract] ABSTRACT: Granular cell tumour of the breast (GCTB) is a rare tumour which arises from Schwann cells. It is a largely benign tumour but in extremely rare cases can exhibit malignant characteristics. It poses a particular problem as it's characteristics can mimic breast carcinoma clinically, radiologically and macroscopically. This results in the potential misdiagnosis of breast carcinoma and over treatment of patients. Typically GCTBs are benign, solitary lesions but variations include malignant GCTBs, colocalisation with breast malignancies and multicentricity. These tumours can be investigated using mammography, ultrasound and magnetic resonance imaging. However none of these modalities have yet identified any GCTB specific characteristics. On pathological examination they can be identified using both microscopic and immunohistochemical features. The cells have a distinctive granular eosinophilic cytoplasm associated with typical nuclei and abundant lysosomes. Immunohistochemically they are positive for S100 protein, CD68 and neuron specific endolase (NSE). They are treated with wide local excision and while they may reoccur, are associated with a good prognosis.
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