Duodenal gangliocytic paraganglioma with lymph node metastases: A case report and comparative review of 31 cases

Table 2 Pathologic features of gangliocytic paragangliomas found to have metastases

General	Rare tumor of uncertain origin and low malignant potential, composed of epithelioid cells, spindle cells, and ganglion-like cells
Clinical features	Most often 5th-7th decade of life
	Most often abdominal pain or gastrointestinal bleeding
Gross findings	90% occurring in second portion of duodenum
	10-90 cm in greatest dimension (average 30 cm)
Cytologic findings	Typically cellular specimen
	Epithelioid cells predominate
	All three components may be present
Histologic findings	Epithelioid cells, spindle-like/sustentactular cells, and ganglion-like cells
	Submucosal
	Unencapsulated
	Necrosis absent
	No to rare mitoses
	Frequent extension beyond submucosa and/or lymphovascular invasion
	Metastases: 75% of those reported demonstrated all three cellular components; 25% predominantly epithelioid