Pancreatic granular cell tumor diagnosed by endoscopic ultrasound-guided fine needle aspiration biopsy

  • Chonlada Krutsri
  • Tomohisa IwaiEmail author
  • Mitsuhiro Kida
  • Hiroshi Imaizumi
  • Toshihiro Kawano
  • Masayoshi Tadehara
  • Masafumi Watanabe
  • Kosuke Okuwaki
  • Hiroshi Yamauchi
  • Koizumi Wasaburo
Case Report


Pancreatic granular cell tumors (GCTs) are rare and making an imaging diagnosis of pancreatic GCT is difficult because it has no definite characteristics on contrast-enhanced computed tomography (CE-CT) or magnetic resonance imaging (MRI) owing to varying findings. We report about a 32-year-old woman who presented with an incidental finding of a pancreatic tumor with a past history of excision of a right forearm GCT nodule 12 years ago. CE-CT revealed a 23-mm-sized homogeneous low enhancement tumor in the arterial phase in the pancreatic body. Abdominal MRI revealed a lobulated hypointense mass in T1WI and high signal in DWI. Endoscopic ultrasonography (EUS) revealed that the tumor was oval, hypoechoic with posterior echo enhancement, and had a well-defined border. Although EUS-guided fine needle aspiration revealed benign granular cells of the pancreas, she underwent laparoscopic surgery because the metastatic tumor from the past lesion was not excluded. The pathological finding was benign GCT of the pancreas and it was considered as an original lesion. In the previous reports, most of the resected cases were considered to be pancreatic cancer or neuroendocrine tumor preoperatively. Compared to CE-CT and MRI, EUS imaging and EUS-FNA are more reliable diagnosis tools for pancreatic GCT. Although malignant GCT accounts for approximately 1–2% of all cases, surgical resection or strict follow-up should be considered because it is difficult to predict its biological behavior.


Granular cell tumors (GCT) Pancreatic GCT Endoscopic ultrasound-guided fine needle aspiration biopsy 


Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Human and animal rights

This study does not include any data about human specimen. All procedures followed have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

This is a case report and does not involve human subjects and does not apply to giving informed consent.


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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  • Chonlada Krutsri
    • 1
  • Tomohisa Iwai
    • 2
    Email author
  • Mitsuhiro Kida
    • 2
  • Hiroshi Imaizumi
    • 2
  • Toshihiro Kawano
    • 2
  • Masayoshi Tadehara
    • 2
  • Masafumi Watanabe
    • 2
  • Kosuke Okuwaki
    • 2
  • Hiroshi Yamauchi
    • 2
  • Koizumi Wasaburo
    • 2
  1. 1.Department of Surgery, Faculty of Medicine Ramathibodi HospitalMahidol UniversityBangkokThailand
  2. 2.Department of Gastroenterology, Kitasato University School of MedicineKitasato University HospitalSagamiharaJapan

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