臨床整形外科47巻3号

2012年03月発行

症例報告

腹壁原発悪性顆粒細胞腫の1例

著者： 湯田淳一朗¹ 石川朗² 田村元¹

所属機関： ¹山形県立中央病院中央検査部病理 ²山形県立中央病院整形外科

ページ範囲：P.283 - P.286

　症例は61歳の女性で，数年前から左側腹部腫瘤を自覚していた．初診時のCT(computed tomography)で左腹壁腫瘤に加え，肝，肺，右殿部脂肪層内に腫瘤を認めた．腹壁およびその後，殿部の生検で好酸性顆粒状胞体を有する大型の腫瘍細胞が増生していた．核異型は軽度であった．腫瘍細胞はS-100蛋白とCD68が陽性で，MIB-1(mindbomb homolog 1)陽性率が高く，腹壁原発悪性顆粒細胞腫であり，右殿部への転移と診断した．顆粒細胞腫は本例のように異型が軽度でも悪性の転帰をとることがある．顆粒細胞腫においてもMIB-1陽性率が高い場合は，良悪性の判断に有用であった．

参考文献

1) Al-Sarraf M, Loud AV, Vaitkevicius VK:Malignant granular cell tumor:Histochemical and electron microscopic study. Arch Pathol 91:550-558, 1971

2) Chelly I, Bellil K, Mekni A, et al:Malignant granular cell tumor of the abdomen wall:Pathologica 97:130-132, 2005

3) Fauburg-Smith JC, Meis-kindbloom JM, Fante R, et al:Malignant granular cell tumor of soft tissue:diagnostic criteria and clinicopathologic correlation. Am J Surg Pathol 22:779-794, 1998

4) Jardines L, Cheung L, LiVolsi V, et al:Malignant granular cell tumor:Report of a case and review of the literature. Surgery 116:49-54, 1994

5) Kurtin PJ, Bonin DM:Immunoihistochemical demonstration of the lysosome-associated glycoprotein CD68 (KP-1) in granular cell tumors and Schwannomas. Hum Pathol 25:1172-1178, 1994

6) Lack EE, Worsham GF, Callihan MD, et al:Granular cell tumor. A clinicopathologic study of 110 patients. J Surg Oncol 13:301-316, 1980

7) Le BH, Boyer PJ, Lewis JE, et al:Granular cell tumor. Immunohistochemical assessment of inhibin-α, protein gene product 9.5, S100 Protein, CD68, and Ki-67 proliferative index with clinical correlation. Arch Pathol Lab Med 128:771-775, 2004

8) Mukai M:Immunohistochemical localization of S-100 protein and peripheral nerve myelin proteins (P2 protein, PO protein) in granular cell tumors. Am J Pathol 112:139-146, 1983

9) Qureshi NA, Tahir M, Carmichael AR:Granular cell tumor of soft tissues:a case report and literature review. Int Semin Surg Oncol 3:21, 2006

10) Simsir A, Osborne BM, Greenebaum E, et al:Malignant granular cell tumor;a case report and review of the recent literature. Hum Pathol 27:853-858, 1996

11) Tawfiq K, Lodovico B, Mehdi T:Granular cell tumor clinical spectrum of the benign and malignant entity. Cancer 60:220-227, 1987

12) Tsuchida T, Okada K, Itoi E, et al:Intramuscular malignant granular cell tumor. Skeltal Radiol 26:116-121, 1997

13) Tsuneyoshi M, Enjoji M:Granular cell tumor;a clinicopathologic study of 48 cases. 福岡医誌69:495-505, 1978