A 67-year-old man with a positive fecal occult blood test underwent colonoscopy, which revealed an 8-mm diameter elevated lesion in the rectum. The surface was smooth and not eroded (A). It was removed by electrosurgical snare polypectomy. Histopathologic evaluation of the resected specimen disclosed a well-demarcated lesion in the submucosa covered by normal mucosa. The tumor contained plump spindle cells with small nuclei (B, H&E, orig. mag. ×15). The abundant cytoplasm of these cells was filled with coarse red granules, presumably irregular lysosomes, that stained intensely with periodic acid-Schiff stain. The nuclei and cytoplasm stained with antibodies to S-100 protein. A histopathologic diagnosis of granular cell tumor was made. Granular cell tumor is found in the rectum only rarely.
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