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Bubola J, Magalhaes M, Leong I, Chugh D, Bradley G. Oral granular cell tumors: an analysis of the clinical and histopathologic features of 126 tumors. Oral Surg Oral Med Oral Pathol Oral Radiol 2025:S2212-4403(25)00776-X. [PMID: 40254476 DOI: 10.1016/j.oooo.2025.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2024] [Revised: 02/06/2025] [Accepted: 02/09/2025] [Indexed: 04/22/2025]
Abstract
OBJECTIVE To characterize the clinical and histologic features of oral granular cell tumors (GCTs). STUDY DESIGN A retrospective search of the archives of our diagnostic oral pathology service was performed for GCTs diagnosed between 1989 and 2023. A total of 126 tumors in 122 patients were retrieved. RESULTS There was a female predilection with a female-to-male ratio of 2.3:1. The age range was 5-73 years (mean = 33.3). The most commonly involved site was the tongue (81.0%), followed by the lips (7.9%). Most GCTs were pink, but many lesions appeared yellow or white. Histologically, most GCTs were sessile masses comprised of sheets or nodules of tumor cells. Uncommonly, GCTs were pedunculated (3.2%), papillary (2.4%), ulcerated (3.2%), or desmoplastic (11.1%). Pseudoepitheliomatous hyperplasia, histologically mimicking squamous cell carcinoma, was present in 25.4% of tumors. While 65.9% of GCTs demonstrated positive surgical margins, only 3 tumors recurred. CONCLUSIONS To the best of our knowledge, this is the largest series of oral GCTs with a comprehensive analysis of the clinical and histologic features. It is important for clinicians and pathologists to be aware of the spectrum of features observed in GCTs in order to avoid erroneous classification as malignancy.
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Affiliation(s)
- Justin Bubola
- Oral Pathology & Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
| | - Marco Magalhaes
- Oral Pathology & Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dental and Maxillofacial Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Iona Leong
- Oral Pathology & Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada; Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Deepika Chugh
- Oral Pathology & Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Department of Dentistry, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Grace Bradley
- Oral Pathology & Oral Medicine, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
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Agaimy A, Stoehr R, Fisher C, Chrisinger JSA, Demicco EG, Tögel L, Michal M, Michal M. ALK -rearranged Mesenchymal Neoplasms With Prominent Foamy/Pseudolipogenic Cell Morphology : Expanding the Phenotypic Spectrum of ALK Fusion Neoplasms and Report of Novel Fusion Partners. Am J Surg Pathol 2024; 48:1455-1463. [PMID: 38979776 DOI: 10.1097/pas.0000000000002283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
The category of ALK -rearranged mesenchymal neoplasms has been evolving rapidly, with reports of morphologically diverse lesions of cutaneous, soft tissue, and visceral origin. While some of these represent morphologically defined entities harboring recurrent ALK fusions (inflammatory myofibroblastic tumor and epithelioid fibrous histiocytoma), others are unclassified by morphology with variable overlap with the tyrosine kinase family of neoplasia and their underlying ALK fusions cannot be suspected based on morphology. We herein report 3 cases that expand the anatomic, morphologic, and genotypic spectrum of ALK -rearranged unclassified neoplasms. Patients were all adults aged 46 to 69 (median: 63) who presented with a mass located in the gingiva, subcutis of the back, and submucosal posterior pharyngeal wall. The tumor size ranged from 1 to 2.7 cm (median: 1.6). Conservative surgery was the treatment in all patients. Follow-up was available for one patient who remained disease-free at 14 months. Histologically, all tumors displayed large polygonal cells with foamy to granular and lipogenic-like microvacuolated copious cytoplasm and medium-sized round nuclei with 1 or 2 prominent nucleoli. Mitoses and necrosis were not seen. The initial diagnostic impression was PEComa, inflammatory rhabdomyoblastic tumor and unclassified pseudolipogenic neoplasm. Strong cytoplasmic ALK was detected by immunohistochemistry in all cases. Other positive markers include Cathepsin K (2/2), desmin (1/3), focal MyoD1 (1/1), focal SMA (1/3), and focal EMA (1/2). Targeted RNA sequencing revealed ALK fusions with exon 20 (2 cases) and exon 19 (one case) of ALK fused to RND3 (exon 3), SQSTM1 (exon 6), and desmin (intron 6). Methylation profiling in the desmin-fused case (initially diagnosed as inflammatory rhabdomyoblastic tumor) revealed an inflammatory myofibroblastic tumor match with a low confidence score of 0.5 and a flat copy number variation (CNV) profile. No NF1 mutation was detected in this case, altogether excluding an inflammatory rhabdomyoblastic tumor. Our study highlights and expands the morphologic and anatomic diversity of ALK- fused neoplasms and documents novel fusion partners ( RND3 and desmin).
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Affiliation(s)
- Abbas Agaimy
- Institute of Pathology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg
- Comprehensive Cancer Center, European Metropolitan Area Erlangen-Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - Robert Stoehr
- Institute of Pathology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg
- Comprehensive Cancer Center, European Metropolitan Area Erlangen-Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - Cyril Fisher
- Department of Cellular Pathology, University Hospitals Birmingham, Birmingham, UK
| | - John S A Chrisinger
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO
| | - Elizabeth G Demicco
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital and Laboratory Medicine and Pathobiology, University of Toronto, Canada
| | - Lars Tögel
- Institute of Pathology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg
- Comprehensive Cancer Center, European Metropolitan Area Erlangen-Nuremberg (CCC ER-EMN), Erlangen, Germany
| | - Michal Michal
- Department of Pathology, Faculty of Medicine, Charles University, Plzen, Czech Republic
- Bioptical Laboratory, Ltd., Plzen, Czech Republic
| | - Michael Michal
- Department of Pathology, Faculty of Medicine, Charles University, Plzen, Czech Republic
- Bioptical Laboratory, Ltd., Plzen, Czech Republic
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Jing FZ, Campbell EH, Otley CC, Wieland CN, Vidal NY. Nonneural granular cell tumor treated with Mohs micrographic surgery. JAAD Case Rep 2024; 52:103-106. [PMID: 39385804 PMCID: PMC11462175 DOI: 10.1016/j.jdcr.2024.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2024] Open
Affiliation(s)
- Frank Z. Jing
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Elliott H. Campbell
- Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Clark C. Otley
- Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Carilyn N. Wieland
- Division of Dermatopathology, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Nahid Y. Vidal
- Division of Dermatologic Surgery, Department of Dermatology, Mayo Clinic, Rochester, Minnesota
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Cheng NH, Smith D, Errickson C, Ashi S. A rare case of cutaneous granular cell tumor with unusual Melan-A expression in a child. J Cutan Pathol 2024; 51:434-438. [PMID: 38527927 DOI: 10.1111/cup.14619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
Granular cell tumors (GCTs) are rare, indolent neoplasms classically characterized by eosinophilic granular cytoplasm, infiltrations of polygonal cells in the collagenous stroma, and pustulo-ovoid bodies of Milian. We describe a case of a 10-year-old female presenting with a GCT of the upper arm, remarkable for positive Melan-A expression without additional melanocytic features. The differentiation between granular cells versus melanocytic neoplasms carries significant implications for clinical management, and such diagnoses should be considered carefully in the setting of unusual immunophenotypes.
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Affiliation(s)
- Nina H Cheng
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - David Smith
- Department of Dermatology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | - Carla Errickson
- Department of Dermatology, St. Luke's University Health Network, Bethlehem, Pennsylvania, USA
| | - Shaymaa Ashi
- Schweiger Dermatology Group, Philadelphia, Pennsylvania, USA
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Kiskinov PI, Palavurov AM, Mollova-Kyosebekirova AY, Atliev KT, Zanzov EI, Anastasova VN. Unique Case of Rare Non-Neural Granular Cell Tumor of the Rectus Abdominis Muscle. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:576. [PMID: 38674222 PMCID: PMC11051885 DOI: 10.3390/medicina60040576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Our report contributes a unique case of a non-neural GCT occurring in an unusual location, with its development during pregnancy adding to its rarity. Materials and Methods: Granular cell tumors (GCTs), also known as Abrikossoff's tumors, are rare neoplasms of Schwann cell origin with predominantly benign behavior. We present a case of a 29-year-old female with a non-neural variant of a GCT discovered incidentally during a cesarean section, situated on the posterior surface of the rectus abdominis muscle. Results: Histologically, the tumor exhibited features consistent with a benign non-neural GCT, confirmed through an immunohistochemical analysis. Despite the atypical presentation and challenging surgical removal due to prior scarring, the patient experienced no postoperative complications and showed no signs of recurrence during follow-up. Conclusions: This case highlights the importance of considering GCTs in differential diagnoses, particularly in unusual anatomical locations, and underscores the favorable prognosis associated with timely surgical intervention.
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Affiliation(s)
- Petar Ivanov Kiskinov
- Department of Propaedeutics of Surgical Diseases, Section of Plastic, Reconstructive and Aesthetic Surgery and Thermal Trauma, Medical University Plovdiv, “Saint George” University Hospital, 4002 Plovdiv, Bulgaria; (E.I.Z.); (V.N.A.)
| | - Anastas Metaxov Palavurov
- Department of Urology and General Medicine, Medical University Plovdiv, “Saint George” University Hospital, 4002 Plovdiv, Bulgaria; (A.M.P.); (K.T.A.)
| | | | - Kiril Todorov Atliev
- Department of Urology and General Medicine, Medical University Plovdiv, “Saint George” University Hospital, 4002 Plovdiv, Bulgaria; (A.M.P.); (K.T.A.)
| | - Elean Ivanov Zanzov
- Department of Propaedeutics of Surgical Diseases, Section of Plastic, Reconstructive and Aesthetic Surgery and Thermal Trauma, Medical University Plovdiv, “Saint George” University Hospital, 4002 Plovdiv, Bulgaria; (E.I.Z.); (V.N.A.)
| | - Vania Nikolaeva Anastasova
- Department of Propaedeutics of Surgical Diseases, Section of Plastic, Reconstructive and Aesthetic Surgery and Thermal Trauma, Medical University Plovdiv, “Saint George” University Hospital, 4002 Plovdiv, Bulgaria; (E.I.Z.); (V.N.A.)
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6
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Yan J. Granular cell tumor of the breast: A case report and review of literature. World J Clin Cases 2023; 11:8044-8049. [DOI: 10.12998/wjcc.v11.i33.8044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/26/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Granular cell tumor (GCT) of the breast (GCTB) is a rare neoplasm that can exhibit malignant characteristics both clinically and radiologically. This tumor can also coexist and colocalize with breast carcinoma.
CASE SUMMARY We present a patient with this uncommon tumor and discuss the diagnostic and therapeutic approaches in order to further the knowledge of GCTB and prevent misdiagnosis and overtreatment. The characteristics of the tumor, methods of diagnosis, therapy and postoperative pathological outcomes were analyzed, and relevant literatures of GCTs were reviewed. The patient underwent surgery after core needle biopsy, and the excised neoplasm was sent for pathological examination. Histological analysis revealed nests of cells with abundant pink granular cytoplasm, confirming the diagnosis of GCTB.
CONCLUSION As manifestations of GCT and malignancy can mimic each other, a careful histological examination is essential before major surgery. Treatment consisting of complete excision with close clinical follow-up is recommended.
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Affiliation(s)
- Jun Yan
- Department of Breast Surgery, The University of Hong Kong - Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
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Kneitz H, Frings V, Kircher S, Goebeler M. Expression of Connexin 43 in Granular Cell Tumors of the Skin, Tongue and Esophagus. Dermatopathology (Basel) 2023; 10:184-192. [PMID: 37366801 DOI: 10.3390/dermatopathology10020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Granular cell tumors (GCT) are rare neoplasms of Schwann cell origin occurring in the skin and in other organs. The etiopathogenesis of GCT is yet poorly understood. Connexin 43 (Cx43) is the most broadly expressed gap junction protein in humans, the tumoral role of which has been investigated in several types of tumors. Its role in GCT of the skin, oral cavity and gastrointestinal tract is as yet unknown. METHODS Herein, we present a study on the immunohistochemical expression of Cx43 in GCT of the skin (n = 15), tongue (n = 4) and esophagus (n = 3). Immunolabeling was scored positive (weak (+), moderate (++) or strong (+++)). RESULTS Cx43 was expressed by all cases of GCT of the skin, tongue and esophagus (22/22), showing moderate to strong staining. All tissue sections of GCT were characterized by a diffuse, cytoplasmic staining pattern of the tumor cells. None of those showed membranous or nuclear staining. CONCLUSION Our results suggest that Cx43 probably plays an important role in the development of this rare tumor entity.
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Affiliation(s)
- Hermann Kneitz
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Verena Frings
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Stefan Kircher
- Department of Pathology, University Hospital Würzburg, 97080 Würzburg, Germany
| | - Matthias Goebeler
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, 97080 Würzburg, Germany
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8
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Fischer GM, Papke DJ. Gene fusions in superficial mesenchymal neoplasms: Emerging entities and useful diagnostic adjuncts. Semin Diagn Pathol 2023:S0740-2570(23)00046-1. [PMID: 37156707 DOI: 10.1053/j.semdp.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
Cutaneous mesenchymal neoplasms are diagnostically challenging because of their overlapping morphology, and, often, the limited tissue in skin biopsy specimens. Molecular and cytogenetic techniques have identified characteristic gene fusions in many of these tumor types, findings that have expanded our understanding of disease pathogenesis and motivated development of useful ancillary diagnostic tools. Here, we provide an update of new findings in tumor types that can occur in the skin and superficial subcutis, including dermatofibrosarcoma protuberans, benign fibrous histiocytoma, epithelioid fibrous histiocytoma, angiomatoid fibrous histiocytoma, glomus tumor, myopericytoma/myofibroma, non-neural granular cell tumor, CIC-rearranged sarcoma, hybrid schwannoma/perineurioma, and clear cell sarcoma. We also discuss recently described and emerging tumor types that can occur in superficial locations and that harbor gene fusions, including nested glomoid neoplasm with GLI1 alterations, clear cell tumor with melanocytic differentiation and ACTIN::MITF translocation, melanocytic tumor with CRTC1::TRIM11 fusion, EWSR1::SMAD3-rearranged fibroblastic tumor, PLAG1-rearranged fibroblastic tumor, and superficial ALK-rearranged myxoid spindle cell neoplasm. When possible, we discuss how fusion events mediate the pathogenesis of these tumor types, and we also discuss the related diagnostic and therapeutic implications of these events.
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Affiliation(s)
- Grant M Fischer
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America
| | - David J Papke
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States of America.
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9
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Kim NY, Jang JW, Huh YJ, Ro YS, Paik SS, Ko JY. Dermatofibroma-like dermal non-neural granular cell tumor. J Cutan Pathol 2023; 50:316-320. [PMID: 36178226 DOI: 10.1111/cup.14336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/30/2022] [Accepted: 09/25/2022] [Indexed: 11/26/2022]
Abstract
Non-neural granular cell tumor (NNGCT) is a rare tumor with uncertain lineage. It presents as an asymptomatic polypoid or plaque-like lesion, especially on trunk. Because the granular cells are usually strongly reactive with S-100 stain, conventional granular cell tumors (GCTs) are regarded as those of neural or Schwann cell origin. Unlike GCTs, NNGCT is not reactive for S-100 protein and is thought to derive elsewhere, presumably from mesenchymal stem cells. A 20-year-old woman presented with a solitary, dermatofibroma-like, brownish nodule on her right arm. The lesion developed 3 months before presentation without subjective symptoms. Histopathologic examination revealed a grenz zone overlying a poorly circumscribed tumor extending through the reticular dermis. The tumor cells were large and polygonal, and they had numerous eosinophilic small granules in the cytoplasm. Immunohistochemical stains were positive for CD68, vimentin, factor XIIIa, CD10, and cyclin D1. Stains for S-100 protein, neuron-specific enolase, and CD34 were negative. Based on these findings, the lesion was diagnosed as dermal NNGCT.
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Affiliation(s)
- Na Young Kim
- Department of Dermatology, Hanyang University College of Medicine, Seoul, South Korea
| | - Ju Wang Jang
- Department of Dermatology, Hanyang University Guri Hospital, Gyeonggi-do, South Korea
| | - Yun Jung Huh
- Department of Dermatology, Hanyang University College of Medicine, Seoul, South Korea
| | - Young Suck Ro
- Department of Dermatology, Hanyang University College of Medicine, Seoul, South Korea
| | - Seung Sam Paik
- Department of Patholoy, Hanyang University College of Medicine, Seoul, South Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University College of Medicine, Seoul, South Korea
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Hobbs LK, Kozak MD, Gradecki SE, McGahren ED, Raghavan SS. A rapidly growing nodule on the leg of an adolescent: A unique presentation of a non-neural granular cell tumor. J Cutan Pathol 2022; 49:1040-1043. [PMID: 34981846 DOI: 10.1111/cup.14197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/29/2021] [Accepted: 01/02/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Landon K Hobbs
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Merrick D Kozak
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Sarah E Gradecki
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Eugene D McGahren
- Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Shyam S Raghavan
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
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11
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El Ochi MR, Essaoudi A, Allaoui M, Abrid JE, Touri S, Moussaoui N, El Ktaibi A, Damiri A, Chahdi H, Oukabli M. Dermal nonneural granular cell tumor: a case report. J Surg Case Rep 2022; 2022:rjac317. [PMID: 35794991 PMCID: PMC9252479 DOI: 10.1093/jscr/rjac317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Dermal nonneural granular cell tumor is a rare neoplasm of uncertain histogenesis that Le Boit and colleagues originally described in 1991. It arises commonly from the back, extremities and head and neck. To the best of our knowledge, only 50 cases have been reported in adults in the English literature. A 42-year-old man presented with a polypoid skin nodule of the front side of the chest wall, measuring 1,8 × 1,5 cm. The lesion was removed completely with tumor-free margins. Microscopically, the tumor was composed of a diffuse infiltrate of polygonal cells, S 100 negatives, with abundant granular cytoplasm and vesicular nuclei. The diagnosis of dermal nonneural granular cell tumor was retained. No recurrence was noted during follow up of 6 months. The prognosis is good.
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Affiliation(s)
- Mohamed Reda El Ochi
- Department of Pathology, Mohammed V Military Hospital , Rabat, Morocco
- Faculty of Medicine and Pharmacy of Rabat, Mohammed V University , Rabat, Morocco
| | - Amine Essaoudi
- Department of Pathology, Mohammed V Military Hospital , Rabat, Morocco
- Faculty of Medicine and Pharmacy of Rabat, Mohammed V University , Rabat, Morocco
| | - Mohamed Allaoui
- Department of Pathology, Mohammed V Military Hospital , Rabat, Morocco
- Faculty of Medicine and Pharmacy of Rabat, Mohammed V University , Rabat, Morocco
| | | | | | | | - Abderrahim El Ktaibi
- Department of Pathology, Mohammed V Military Hospital , Rabat, Morocco
- Faculty of Medicine and Pharmacy of Rabat, Mohammed V University , Rabat, Morocco
| | - Amal Damiri
- Department of Pathology, Mohammed V Military Hospital , Rabat, Morocco
- Faculty of Medicine and Pharmacy of Rabat, Mohammed V University , Rabat, Morocco
| | - Hafsa Chahdi
- Department of Pathology, Mohammed V Military Hospital , Rabat, Morocco
- Faculty of Medicine and Pharmacy of Rabat, Mohammed V University , Rabat, Morocco
| | - Mohamed Oukabli
- Department of Pathology, Mohammed V Military Hospital , Rabat, Morocco
- Faculty of Medicine and Pharmacy of Rabat, Mohammed V University , Rabat, Morocco
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12
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Amphlett A. An Update on Cutaneous Granular Cell tumours for Dermatologists and Dermatopathologists. Clin Exp Dermatol 2022; 47:1916-1922. [PMID: 35727729 DOI: 10.1111/ced.15309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
Granular cell tumours are rare soft tissue neoplasms which occur at a wide variety of sites and commonly involve the skin. Distinction between benign and malignant granular cell tumours is important because benign tumours are commonly cured by complete excision and malignant tumours commonly recur and cause fatal metastatic disease. Communication between the dermatologist and pathologist is also important, as the pathologist may provide false reassurance by evaluating a benign appearing part of a clinically malignant tumour. The following review summarises the current literature on the epidemiology, clinical presentation, pathology, radiology, treatment and prognosis of cutaneous granular cell tumours, with a focus on improving diagnosis and management for dermatologists and dermatopathologists.
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13
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Chukwudebe O, Brown RA. IMMUNOHISTOCHEMICAL AND MOLECULAR UPDATES IN CUTANEOUS SOFT TISSUE NEOPLASMS. Semin Diagn Pathol 2022; 39:257-264. [DOI: 10.1053/j.semdp.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/04/2022] [Accepted: 02/18/2022] [Indexed: 11/11/2022]
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14
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Triantafyllou A, Ruggles N. Lysosomal and cytoskeletal events in epithelial salivary tumours as assessed by imunohistochemistry for CD63 and HSP27. Pathol Res Pract 2022; 229:153691. [DOI: 10.1016/j.prp.2021.153691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
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15
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Papke DJ, Hornick JL. Recent advances in the diagnosis, classification and molecular pathogenesis of cutaneous mesenchymal neoplasms. Histopathology 2021; 80:216-232. [DOI: 10.1111/his.14450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 12/01/2022]
Affiliation(s)
- D J Papke
- Department of Pathology Brigham and Women’s Hospital and Harvard Medical School Boston MA USA
| | - J L Hornick
- Department of Pathology Brigham and Women’s Hospital and Harvard Medical School Boston MA USA
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16
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Brown RA, Cloutier JM, Bahrani E, Liman A, Tasso D, Palmer A, Manning MA, Galperin I, Rieger KE, Novoa RA, Lau H, Louie CY. Immunohistochemical ALK Expression in Granular Cell Atypical Fibroxanthoma: A Diagnostic Pitfall for ALK-Rearranged Non-neural Granular Cell Tumor. Am J Dermatopathol 2021; 43:831-834. [PMID: 33767072 DOI: 10.1097/dad.0000000000001931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Atypical fibroxanthoma (AFX) is a neoplasm that most commonly occurs on sun-damaged skin of the head and neck in elderly patients and that usually exhibits indolent clinical behavior with complete excision. The granular cell variant of AFX demonstrates overlapping histopathologic features with dermal non-neural granular cell tumor (NNGCT), which typically arises on the extremities of young to middle aged adults with rare reports of regional metastasis. A subset of NNGCT harbors ALK rearrangements and expresses ALK by immunohistochemistry. Here, we present 2 cases of granular cell AFX occurring on the scalp of males aged 73 and 87 with ALK expression by immunohistochemistry and no evidence of an ALK rearrangement on fluorescence in situ hybridization, representing a diagnostic pitfall for NNGCT.
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Affiliation(s)
- Ryanne A Brown
- Department of Pathology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
- Department of Pathology, Stanford University School of Medicine, Stanford, CA
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA
| | - Jeffrey M Cloutier
- Department of Pathology, Stanford University School of Medicine, Stanford, CA
| | - Eman Bahrani
- Department of Pathology, Stanford University School of Medicine, Stanford, CA
| | - Agnes Liman
- Department of Pathology, Veterans Affairs Central California Health Care System, Fresno, CA; and
| | - David Tasso
- Department of Pathology, Veterans Affairs Central California Health Care System, Fresno, CA; and
| | - Adrian Palmer
- Department of Pathology, Veterans Affairs Central California Health Care System, Fresno, CA; and
| | - Melanie A Manning
- Department of Pathology, Stanford University School of Medicine, Stanford, CA
| | - Ilana Galperin
- Cytogenetics Laboratory, Department of Pathology, Stanford Health Care, Palo Alto, CA
| | - Kerri E Rieger
- Department of Pathology, Stanford University School of Medicine, Stanford, CA
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA
| | - Roberto A Novoa
- Department of Pathology, Stanford University School of Medicine, Stanford, CA
- Department of Dermatology, Stanford University School of Medicine, Stanford, CA
| | - Hubert Lau
- Department of Pathology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Christine Y Louie
- Department of Pathology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
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17
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Takeda M, Sano Y, Shigekawa S, Kitazawa R, Sugimoto R, Izutani H. Use of uniportal video-assisted thoracic surgery combined with a posterior approach to resect a dumbbell-shaped mediastinal granular cell tumor: A case report. Int J Surg Case Rep 2021; 88:106460. [PMID: 34649074 PMCID: PMC8517829 DOI: 10.1016/j.ijscr.2021.106460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction A dumbbell-shaped mediastinal granular cell tumor has never been reported, and there have been no reports of dumbbell-shaped tumors resected with a combination of uniportal video-assisted thoracic surgery and the posterior approach. Presentation of case An 18-year-old woman was diagnosed with a mediastinal dumbbell-shaped granular cell tumor by computed tomography. Complete resection was achieved via a posterior approach combined with the uniportal video-assisted thoracic surgery. First, a T3 left hemilaminectomy was performed in the prone position and the tumor located inside the intervertebral foramen was removed as far as possible. Next, the patient was repositioned to the right lateral decubitus position, a 2.5-cm skin incision was made on the 4th intercostal posterior axillary line, and resection of the residual tumor was performed. Pathological diagnosis of the resected tumor revealed a benign granular cell tumor. The patient recovered post-surgery and no tumor was reported in the 4-month follow-up magnetic resonance imaging. Discussion This is the first reported case of a mediastinal dumbbell-shaped granular cell tumor and its successful resection using a combined posterior and uniportal video-assisted thoracic surgery approach. Conclusion This is a potentially safe and effective procedure for mediastinal granular cell tumors, with outstanding cosmetic advantages.
Our case presented with a rare mediastinal dumbbell-shaped granular cell tumor. The tumor was resected using a combined posterior and uniportal VATS approach. This is a safe and effective procedure for mediastinal dumbbell-shaped tumors.
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Affiliation(s)
- Masashi Takeda
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan
| | - Yoshifumi Sano
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan.
| | - Seiji Shigekawa
- Department of Neurosurgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan
| | - Riko Kitazawa
- Department of Molecular Pathology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan
| | - Ryujiro Sugimoto
- Department of Thoracic Surgery, Kure Kyosai Hospital, 2-3-28 Nishi-chuou, Kure City 737-8505, Japan
| | - Hironori Izutani
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan
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18
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Sagrera A, Montenegro T, Luján D. Primitive Polypoid Granular Cell Tumor. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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19
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Mancuso JB, Haddock ES, Tucker S, Newbury R, Hinds B, Tom WL. Congenital cutaneous non-neural granular cell tumor mimicking herpetic infection: Case report and review of the literature. Pediatr Dermatol 2021; 38:647-651. [PMID: 33738854 DOI: 10.1111/pde.14569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We present a case of a female neonate with a cluster of six skin colored to yellowish pseudovesicular papules on her right forearm present since birth, initially thought to be a herpes simplex virus infection. Punch biopsy with immunostaining revealed a diagnosis of S100-negative, CD163-positive congenital cutaneous non-neural granular cell tumor. Only four other reports are presented in the literature of this entity, three of which also presented on the arm with somewhat similar clinical findings. We briefly reviewed the subtypes of classic and S100-negative non-neural granular cell tumors.
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Affiliation(s)
| | - Ellen S Haddock
- Department of Dermatology, University of California San Diego, San Diego, CA, USA
| | - Suzanne Tucker
- Department of Pathology, Rady Children's Hospital, San Diego, CA, USA
| | - Robert Newbury
- Department of Pathology, Rady Children's Hospital, San Diego, CA, USA
| | - Brian Hinds
- Department of Dermatology, University of California San Diego, San Diego, CA, USA
| | - Wynnis L Tom
- Department of Dermatology, University of California San Diego, San Diego, CA, USA
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20
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Taban SM, Barna RA, Dema ALC, Ratiu IM, Popa O, Plopeanu AD. Unexpected diagnosis for a gastric polyp: Granular cell tumor: Case report and review of the literature. Exp Ther Med 2021; 21:536. [PMID: 33815609 PMCID: PMC8014985 DOI: 10.3892/etm.2021.9968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/03/2021] [Indexed: 11/30/2022] Open
Abstract
A granular cell tumor (GCT) is a rare neoplasia that originates from Schwann cells. It usually appears in the skin or soft tissues, but it may occur anywhere in the body. The gastrointestinal tract is an unusual developmental site for a GCT, the esophagus being the most common site of origin for this tumor. The stomach is one of the most unique sites of origin for GCT, with less than 80 cases being mentioned in the literature. Histologically, GCTs consist of fusiform and polygonal cells, with granular cytoplasm, arranged in compact ‘nests’. Immunohistochemically, these tumors show positivity for S100 protein, CD68, CD56 and, in a smaller percentage, they are positive for other antibodies, most notably inhibin alpha. We report the case of a 52-year-old woman with a solitary GCT that had developed in the gastric cardia, discovered on a routine gastroscopy and successfully treated by endoscopic submucosal dissection.
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Affiliation(s)
- Sorina Maria Taban
- Department of Microscopic Morphology-Morphopathology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Robert Alexandru Barna
- Department of Internal Medicine II, Discipline of Gastroenterology and Hepatology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania.,Anatomic Pathology Service, 'Pius Brînzeu' County Emergency Clinical Hospital, 300723 Timisoara, Romania
| | - Alis Liliana Carmen Dema
- Department of Microscopic Morphology-Morphopathology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Iulia Maria Ratiu
- Department of Internal Medicine II, Discipline of Gastroenterology and Hepatology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania
| | - Oana Popa
- Department of Microscopic Morphology-Morphopathology, 'Victor Babeș' University of Medicine and Pharmacy, Timisoara, 300041 Timisoara, Romania.,Endocrinology Clinic, 'Pius Brînzeu' County Emergency Clinical Hospital, 300723 Timisoara, Romania
| | - Andrei Dorel Plopeanu
- Anatomic Pathology Service, 'Pius Brînzeu' County Emergency Clinical Hospital, 300723 Timisoara, Romania
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21
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Sagrera A, Montenegro T, Luján D. Primitive Polypoid Granular Cell Tumor. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:S0001-7310(20)30511-1. [PMID: 33253654 DOI: 10.1016/j.ad.2019.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/07/2019] [Accepted: 05/13/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- A Sagrera
- Servicio de Dermatología, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Las Palmas, España.
| | - T Montenegro
- Servicio de Anatomía Patológica, Complejo Hospitalario Universitario Insular - Materno Infantil, Las Palmas de Gran Canaria, Las Palmas, España
| | - D Luján
- Servicio de Dermatología, Complejo Hospitalario Universitario Insular-Materno Infantil, Las Palmas de Gran Canaria, Las Palmas, España
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22
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Torre-Castro J, Moya-Martínez C, Núñez-Hipólito L, Mendoza-Cembranos MD, Eraña-Tomás I, Jo-Velasco M, Saus C, Solares J, Requena L, Santonja C. Three additional cases of non-neural granular cell tumor with novel immunohistochemical findings. J Cutan Pathol 2020; 47:1026-1032. [PMID: 32643817 DOI: 10.1111/cup.13801] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/18/2020] [Accepted: 07/01/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Non-neural granular cell tumor (NNGCT) is an uncommon neoplasm of controversial histogenesis and its histopathologic differential diagnosis includes, in addition to conventional GCT, other dermal tumors that may exhibit granular cell change. METHODS Three patients with a diagnosis of NNGCT were identified in the authors' files. Hematoxylin and eosin-stained sections and immunohistochemical studies were performed. RESULTS Histopathological study of the three lesions showed dermal proliferation of granular cells arranged in thick fascicles between collagen bundles. The lesions showed positivity for Factor XIIIa, CD163, CD68, NKIC3, vimentin, ALK, fascin, and cyclin D1. CONCLUSION To our knowledge, positivity for cyclin D1 has not been reported to date in NNGCT. In borderline cases, where the diagnosis is unclear despite histopathologic and immunohistochemical findings, positivity for cyclin D1 may favor the diagnosis of NNGCT. Further investigations to assess the differentiation of this rare neoplasm are needed.
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Affiliation(s)
- Juan Torre-Castro
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Cristina Moya-Martínez
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Lucía Núñez-Hipólito
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | | | - Itziar Eraña-Tomás
- Department of Pathology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Margarita Jo-Velasco
- Department of Pathology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Carles Saus
- Department of Pathology, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Julia Solares
- Department of Pathology, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - Luis Requena
- Department of Dermatology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Carlos Santonja
- Department of Pathology, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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23
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Shahabi A, Hastings H, Winfield H, Khiyami A. A rare case of a non-neural granular cell tumor presenting as an enlarging right chest wall nodule in a 4-year-old male and review of the literature. SAGE Open Med Case Rep 2020; 8:2050313X20938246. [PMID: 32754335 PMCID: PMC7378716 DOI: 10.1177/2050313x20938246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 06/03/2020] [Indexed: 11/15/2022] Open
Abstract
Non-neural granular cell tumor was first described in 1991 as an unusual primitive, polypoid variant of the conventional granular cell tumor. To date, this neoplasm remains a rare entity and the cell of origin is uncertain. While the histological features are similar to the conventional granular cell tumor, it represents a distinct entity that is negative for S100 and lacks true nerve sheath differentiation. Here, we describe a case of a 4-year-old male who presented with a painless, soft nodule on his right chest wall that was slowly increasing in size. The mass was excised and sent for pathologic analysis. Microscopic examination reveals spindle and epithelioid cells with vesicular nuclei and prominent granular eosinophilic cytoplasm. Immunohistochemical analysis shows negative staining for S100 and AE1/AE3/PCK26 but is positive for CD68. A diagnosis of a non-neural granular cell tumor was made. We report a rare and diagnostically challenging case in a pediatric patient.
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Affiliation(s)
- Ali Shahabi
- Department of Pathology, MetroHealth
Medical Center, Case Western Reserve University, Cleveland, OH, USA
- Ali Shahabi, Department of Pathology,
MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth
Drive, Cleveland, OH 44109, USA. Emails:
;
| | - Hope Hastings
- Department of Pathology, MetroHealth
Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Harry Winfield
- Department of Dermatology, MetroHealth
Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Amer Khiyami
- Department of Pathology, MetroHealth
Medical Center, Case Western Reserve University, Cleveland, OH, USA
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24
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Meyer A, Billings SD. What's new in nerve sheath tumors. Virchows Arch 2019; 476:65-80. [PMID: 31707590 DOI: 10.1007/s00428-019-02671-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/22/2019] [Accepted: 09/22/2019] [Indexed: 12/16/2022]
Abstract
Peripheral nerve sheath tumors are commonly encountered and frequently pose challenges to the pathologist and the clinician. This review discusses the wide range of entities with an emphasis on new discoveries in the past decade. Clinical, histologic, immunohistochemical, and pathogenetic findings are discussed with an emphasis on clinical implications and differential diagnosis.
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25
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Cohen JN, Yeh I, Jordan RC, Wolsky RJ, Horvai AE, McCalmont TH, LeBoit PE. Cutaneous Non-Neural Granular Cell Tumors Harbor Recurrent ALK Gene Fusions. Am J Surg Pathol 2019; 42:1133-1142. [PMID: 30001233 DOI: 10.1097/pas.0000000000001122] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Non-neural granular cell tumor (NNGCT; also known as primitive polypoid granular cell tumor) is a rare neoplasm composed of large ovoid cells with abundant granular cytoplasm, variable nuclear pleomorphism, and the potential for regional lymph node spread. In contrast to conventional granular cell tumor (GCT), NNGCT lacks S100 expression and can exhibit greater nuclear atypia and mitotic activity. Therefore, we investigated clinicopathologic features of 12 NNGCT, and also used next-generation sequencing to identify potential driver events in a subset of NNGCT and 6 GCT. NNGCT demonstrated mild-to-moderate nuclear pleomorphism, variable mitotic activity (0 to 10/10 high-power fields), and were S100. Genetic analysis of 5 cutaneous NNGCT revealed gene fusions involving the anaplastic lymphoma kinase gene (ALK) in 3 cases (60%). Specifically, an interstitial deletion of chromosome 2 resulting in an in-frame fusion of dyanactin 1 (DCTN1) to ALK was identified in 2 cases, and a translocation resulting in a fusion between sequestosome 1 (SQSTM1) on chromosome 5 and ALK was identified in one case. Two of 6 GCT (33%) showed gains of chromosome 7. No other molecular or chromosomal alterations were detected in NNGCT and GCT. ALK immunohistochemistry revealed weak-to-moderate positivity in 4/9 cutaneous NNCGT (44%) including all 3 tumors with ALK fusions. Three oral NNGCT lacked ALK expression. NNGCT with ALK immunostaining did not have morphologic features distinguishing them from those without ALK staining. Our results demonstrate that a subset of NNGCT harbor ALK fusions, suggest that NNGCT are molecularly diverse, and further substantiate NNGCT as distinct from GCT.
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Affiliation(s)
| | - Iwei Yeh
- Dermatopathology.,Clinical Cancer Genomics Laboratory.,Helen Diller Cancer Center, University of California, San Francisco
| | - Richard C Jordan
- Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco.,Orofacial Sciences, Pathology & Radiation Oncology
| | - Rebecca J Wolsky
- Departments of Pathology.,Department of Pathology, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | | | - Timothy H McCalmont
- Departments of Pathology.,Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco
| | - Philip E LeBoit
- Departments of Pathology.,Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco
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26
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Sorrells TC, Winn A, Sulit DJ. Granular cell cutaneous epithelioid angiomatous nodule. J Cutan Pathol 2019; 46:864-866. [PMID: 31209887 DOI: 10.1111/cup.13527] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 05/28/2019] [Accepted: 06/11/2019] [Indexed: 11/29/2022]
Abstract
Cutaneous epithelioid angiomatous nodule is an uncommon vascular lesion usually described as composed of epithelioid endothelial cells with vesicular nuclei and eosinophilic cytoplasm. A granular cell variant has not been previously described. Endothelial cells can present with granular cytoplasm as documented with reports of granular cell angiosarcoma. The granularity is thought to be due to increased intracytoplasmic lysosomes. We present a case of a benign superficial vascular lesion composed of a sheet-like proliferation of epithelioid endothelial cells with distinctly granular cytoplasm confirmed as of endothelial origin with positive staining for CD31 and ERG.
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Affiliation(s)
| | - Aubrey Winn
- Department of Dermatology, Naval Medical Center, San Diego, California
| | - Daryl J Sulit
- Department of Dermatology, Naval Medical Center, San Diego, California
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27
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[The histopathology and immunohistochemistry of granular cell tumour. A study of 12 cases with a brief historical note]. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2018; 52:11-19. [PMID: 30583826 DOI: 10.1016/j.patol.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/23/2018] [Accepted: 05/25/2018] [Indexed: 11/21/2022]
Abstract
INTRODUCTION AND OBJECTIVE Granular cell tumour (GCT) is a benign neoplasm of neural/schwannian origin, usually presenting as a single asymptomatic lesion, mainly located in the dermis and subcutaneous tissue or submucosa, although multiple tumours may occur. Microscopically, GCTs are composed of large cells with abundant eosinophilic, granular cytoplasm arranged in sheets, nests, cords or trabeculae. Based on the cytological characteristics and the presence of necrosis, three types are recognized: benign, atypical and malignant. We aim to present the cytological and immunohistochemical characteristics of 12 granular cell tumours. MATERIALS AND METHODS 12 cases of GCT were selected from the consultation files of one of the authors (COH) The paraffin embedded tissue was processed for immunostaining with S-100 protein, calretinin, CD68, α-inhibin, PGP9.5, CD57 (Leu7), CD63 (NKI / C3), Gap43 (growth-associated protein-43), SOX10, TFE-3 and Ki-67. RESULTS AND CONCLUSIONS 6 male and 6 female patients, with an average age of 40, made up the study group. The most frequent location for the tumours was in the subcutaneous soft tissues of the arms. There were no malignant cases. All tumours were positive for S-100, CD57, SOX10, calretinin, CD68, PGP9.5, α-inhibin and TFE-3, with a low Ki-67 (1-5%). Additionally, we reported, for the first time, the positive immunoreaction to Gap43 (growth-associated protein-43) in GCT.
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28
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Gallo G, Kutzner H, Mentzel T, Cesinaro AM. Cellular neurothekeoma: Report of two cases with unusual immunohistochemical features. J Cutan Pathol 2018; 46:80-83. [PMID: 30311258 DOI: 10.1111/cup.13370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/25/2018] [Accepted: 09/30/2018] [Indexed: 11/29/2022]
Abstract
Cellular neurothekeoma (CNT) is a dermal lesion with still unknown histogenesis, characterized by immunohistochemical staining for NKI/C3, NSE, MiTF, CD10 and CD68, whereas S100 protein, desmin and cytokeratins are negative. Particularly, in several studies NKI/C3 has been reported as a strong marker of CNT. We describe herein the clinical, histopathological and immunohistochemical features of two cases morphologically consistent with myxoid CNT, one of which showing some atypical features, both characterized by negative immunohistochemical staining for NKI/C3. Our findings stress the importance of morphology in diagnosing CNT and underline the fact that NKI/C3 can fail to stain cases belonging to the "neurothekeoma family." In selected cases of CNT, an expanded immunohistochemical panel is mandatory to differentiate this tumor from other dermal lesions.
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Affiliation(s)
- Graziana Gallo
- Department of Pathology, Azienda Ospedaliero-Universitaria di Modena, Italy
| | | | | | - Anna M Cesinaro
- Department of Pathology, Azienda Ospedaliero-Universitaria di Modena, Italy
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29
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Kabir B, Ramien M, Al Shammary M, de Nanassy J, El Demellawy D. Dermal non-neural granular cell tumor in a 3-year-old child. Pediatr Dermatol 2018; 35:e241-e242. [PMID: 29766548 DOI: 10.1111/pde.13520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Dermal non-neural granular cell tumors, also known as primitive polypoid granular cell tumors, are a rare group of distinct cutaneous non-neural granular cell tumors. Pediatric cases are rare, and to the best of our knowledge, we report the youngest patient with dermal non-neural granular cell tumors.
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Affiliation(s)
- Bilaal Kabir
- Faculty of Health Sciences at the University of Ottawa, Ottawa, ON, Canada
| | - Michele Ramien
- Faculty of Health Sciences at the University of Ottawa, Ottawa, ON, Canada.,Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | | | - Joseph de Nanassy
- Faculty of Health Sciences at the University of Ottawa, Ottawa, ON, Canada.,Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Dina El Demellawy
- Faculty of Health Sciences at the University of Ottawa, Ottawa, ON, Canada.,Department of Pediatric Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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30
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Perret RE, Jullie ML, Vergier B, Coindre JM, Le Loarer F. A subset of so-called dermal non-neural granular cell tumours are underlined by ALK
fusions, further supporting the idea that they represent a variant of epithelioid fibrous histiocytoma. Histopathology 2018; 73:532-534. [DOI: 10.1111/his.13645] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Raul E Perret
- Department of Biopathology; Bergonié Institut; Bordeaux France
| | - Marie-Laure Jullie
- Department of Pathology; CHU Bordeaux; Hôpital Haut Lévêque; Pessac France
| | - Beatrice Vergier
- Department of Pathology; CHU Bordeaux; Hôpital Haut Lévêque; Pessac France
- University of Bordeaux; Talence France
| | - Jean-Michel Coindre
- Department of Biopathology; Bergonié Institut; Bordeaux France
- University of Bordeaux; Talence France
| | - François Le Loarer
- Department of Biopathology; Bergonié Institut; Bordeaux France
- University of Bordeaux; Talence France
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31
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Marchand Crety C, Garbar C, Madelis G, Guillemin F, Soibinet Oudot P, Eymard JC, Servagi Vernat S. Adjuvant radiation therapy for malignant Abrikossoff's tumor: a case report about a femoral triangle localisation. Radiat Oncol 2018; 13:115. [PMID: 29925410 PMCID: PMC6011335 DOI: 10.1186/s13014-018-1064-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 06/14/2018] [Indexed: 12/28/2022] Open
Abstract
Background Granular cell or Abrikossoff’s tumors are usually benign however rare malignant forms concern 1 to 3% of cases reported. Pelvic locations are exceptional. Case presentation We report a case of a 43-years-old patient who had a benign Abrikossoff’s tumor localized in the right femoral triangle diagnosed at the biopsy. The patient underwent a surgical tumorectomy and inguinal lymph nodes resection. Histologically, the tumor showed enough criteria to give diagnosis of malignancy: nuclear pleomorphism, tumor cell spindling, vesicular nuclei with large nucleoli. Moreover, five lymph nodes were metastatic. Immunohistochemistry findings confirmed the diagnosis of granular cell tumor which is positive for S100 protein and CD68 antibodies. The mitotic index was nevertheless low with a Ki67 labeling index of 1–2%. A large surgical revision with an inguinal curage following radiotherapy were decided on oncology committee. Adjuvant radiotherapy on the tumor bed and right inguinal area of 50 Gy in conventional fractionation was delivered with the aim of reducing local recurrence risk. There was no recurrence on longer follow-up (10 months post radiotherapy). Conclusions Adjuvant radiotherapy seems an appropriate therapeutic approach, even if controversial, given that some authors report effectiveness on local disease progression.
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Affiliation(s)
- C Marchand Crety
- Department of Radiation Therapy, Institut de Cancérologie Jean Godinot, Reims, France
| | - C Garbar
- Department of Pathology, Institut de Cancérologie Jean Godinot, Reims, France
| | - G Madelis
- Department of Medical Physic, Institut de Cancérologie Jean Godinot, Reims, France
| | - F Guillemin
- Department of Surgery, Institut de Cancérologie Jean Godinot, Reims, France
| | - P Soibinet Oudot
- Department of Medical Oncology, Institut de Cancérologie Jean Godinot, Reims, France
| | - J C Eymard
- Department of Medical Oncology, Institut de Cancérologie Jean Godinot, Reims, France
| | - S Servagi Vernat
- Department of Radiation Therapy, Institut de Cancérologie Jean Godinot, Reims, France.
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Park JY, Kwon WJ, Park BW, Cho EB, Park EJ, Kim KH, Kim KJ. Congenital Non-Neural Granular Cell Tumor Mimicking Nevus Lipomatosus Superficialis. Ann Dermatol 2017; 29:776-778. [PMID: 29200768 PMCID: PMC5705361 DOI: 10.5021/ad.2017.29.6.776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 11/23/2016] [Accepted: 12/16/2016] [Indexed: 11/23/2022] Open
Abstract
A 4-month-old infant presented with asymptomatic soft nodules on his right forearm, which had developed since birth. On the suspicion of nevus lipomatosus superficialis (NLS), biopsy was performed. Histopathologic findings showed monomorphic polygonal cells with abundant granular cytoplasm. Immunohistochemical stains for CD68 and vimentin were strongly positive, but were negative for S-100 protein. Based on the pathologic findings, the patient was diagnosed as non-neural granular cell tumor (NN-GCT). GCT can be divided into conventional and non-neural GCT by immunoreactivity for S-100 protein. NN-GCT is typically manifested as a well-circumscribed, papulo-nodular dermal mass, and is known to occur in a younger group than does in conventional GCT, but is rare among children. To our knowledge, there have been no case reports of NN-GCT which appeared at birth and presented as grouped nodules. Therefore, we report this interesting case of congenital NN-GCT clinically mimicking NLS.
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Affiliation(s)
- Jun Yeong Park
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Won Joo Kwon
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Bok Won Park
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun Byul Cho
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eun Joo Park
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kwang Ho Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kwang Joong Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
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Deguchi Y, Iwahashi N, Horiuchi Y, Ikejima M, Tanaka T, Ino K, Furukawa K. Non-neural granular cell tumor of the uterine corpus mimicking uterine leiomyoma: A case report. Mol Clin Oncol 2017; 7:351-354. [PMID: 28781812 PMCID: PMC5530305 DOI: 10.3892/mco.2017.1324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 06/02/2017] [Indexed: 12/12/2022] Open
Abstract
Non-neural granular cell tumors (GCTs) are clinically rare, whereas cases arising in the uterine corpus are exceedingly rare. Only three uterine cervical cases of GCTs have been reported to date and, to the best of our knowledge, there are no reports of GCT of the uterine corpus in the literature. We herein describe the first case of non-neural GCT arising from the uterine corpus reported to date. A 55-year-old premenopausal woman was referred to the Department of Obstetrics and Gynecology of Hashimoto Municipal Hospital (Wakayama, Japan) with a suspected uterine tumor. The tumor presented as a uterine leiomyoma-like mass on radiological examinations, but the diagnosis of non-neural GCT was established based on pathological and immunohistochemical examinations. Microscopically, histological examination of the entire surgical specimen revealed large polygonal cells with abundant eosinophilic granular cytoplasm and round to oval nuclei. Immunohistochemistry revealed positive periodic acid-Schiff staining of the cytoplasmic granules, which was resistant to diastase. In addition, the tumor cells stained positive for CD68, but negative for S-100, neuron-specific enolase, cytokeratin, CD34, α-smooth muscle actin, desmin, estrogen receptor and progesterone receptor. It is important for gynecologists to be aware of the possibility of non-neural GCT of the uterine corpus, for which accurate diagnosis, complete resection and long-term follow-up are crucial, as it may be easily misdiagnosed as uterine leiomyoma.
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Affiliation(s)
- Yoko Deguchi
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan.,Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Naoyuki Iwahashi
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan.,Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Yuko Horiuchi
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan.,Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Miwa Ikejima
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan.,Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Tomoyuki Tanaka
- Department of Clinical Pathology, Hidaka General Hospital, Gobo, Wakayama 644-0002, Japan
| | - Kazuhiko Ino
- Department of Obstetrics and Gynecology, Wakayama Medical University, Wakayama 641-0012, Japan
| | - Kenichi Furukawa
- Department of Obstetrics and Gynecology, Hashimoto Municipal Hospital, Hashimoto, Wakayama 648-0005, Japan
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Goto K. Similarity between non-neural granular cell tumors and granular cell fibrous papules. J Cutan Pathol 2017; 44:726. [DOI: 10.1111/cup.12974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 05/24/2017] [Accepted: 05/26/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Keisuke Goto
- Department of Pathology and Cytology; Karolinska University Hospital; Huddinge Sweden
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Fernandez-Flores A, Cassarino DS, Riveiro-Falkenbach E, Rodriguez-Peralto JL, Fernandez-Figueras MT, Monteagudo C. Cutaneous dermal non-neural granular cell tumor is a granular cell dermal root sheath fibroma. J Cutan Pathol 2017; 44:582-587. [DOI: 10.1111/cup.12926] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 02/20/2017] [Accepted: 02/27/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Angel Fernandez-Flores
- Department of Cellular Pathology; Hospital El Bierzo; Ponferrada Spain
- Biomedical Investigation Institute of A Coruña, CellCOM-ST Group; A Coruña Spain
- Department of Cellular Pathology; Hospital de la Reina; Ponferrada Spain
| | - David S. Cassarino
- Department of Dermatology; Los Angeles Medical Center (LAMC), Southern California Kaiser Permanente; Los Angeles California
| | - Erica Riveiro-Falkenbach
- Department of Pathology; Hospital Universitario 12 de Octubre; Madrid Spain
- Universidad Complutense, Medical School (UCM), Instituto i + 12; Madrid Spain
| | - José Luis Rodriguez-Peralto
- Department of Pathology; Hospital Universitario 12 de Octubre; Madrid Spain
- Universidad Complutense, Medical School (UCM), Instituto i + 12; Madrid Spain
- Department of Histopathology; Hospital Universitario 12 de Octubre; Madrid Spain
| | | | - Carlos Monteagudo
- Biomedical Research Institute INCLIVA; Valencia Spain
- University of Valencia, Medical School; Valencia Spain
- Hospital Clinico Universitario de Valencia; Valencia Spain
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Cardis MA, Ni J, Bhawan J. Granular cell differentiation: A review of the published work. J Dermatol 2017; 44:251-258. [PMID: 28256763 DOI: 10.1111/1346-8138.13758] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 12/25/2022]
Abstract
Since the initial description of the granular cell tumor in 1926, numerous other neoplasms, both benign and malignant, have been described to exhibit granular cell change. In most cases, diagnosis remains straightforward via recognition of retained histopathological morphology of the archetypal tumor, despite the presence of focal granular appearance. However, tumors with granular cell differentiation can present a diagnostic challenge either by mimicking alternative diagnoses, or by failing to exhibit architectural clues of the primary entity, thus requiring an immunohistochemical work-up. In light of this, it is important to be aware of the various entities that have been reported to exhibit granular cell morphology. In this review such tumors are discussed along with pertinent clinical and histopathological features.
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Affiliation(s)
- Michael A Cardis
- MedStar Washington Hospital Center/MedStar Georgetown University Hospital, Washington, District of Columbia, USA
| | - Jonathan Ni
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jag Bhawan
- Boston University School of Medicine, Boston, Massachusetts, USA
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Rawal YB, Dodson TB. S-100 Negative Granular Cell Tumor (So-called Primitive Polypoid Non-neural Granular Cell Tumor) of the Oral Cavity. Head Neck Pathol 2016; 11:404-412. [PMID: 27709427 PMCID: PMC5550384 DOI: 10.1007/s12105-016-0760-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022]
Abstract
Four cases of cutaneous S-100 negative granular cell tumor were described in 1991. Until now, only 3 cases of oral involvement have been documented in English literature. Two additional cases of oral S-100 negative granular cell tumor are described. Immunohistochemical markers were applied to exclude other lesions that may show the presence of granular cells. The clinical findings were correlated with the histopathological and immunohistochemical features to arrive at the appropriate diagnosis. S-100 negative granular cell tumors are erythematous polypoid masses commonly mistaken for granulation tissue or a pyogenic granuloma. Any part of the oral cavity may be affected. Histopathologically, the lesions consist of sheets, nests, and fascicles of granular cells that are S-100 negative. The granular cells are non-reactive to SMA, HMB45, Melan A, and CD163. The intracytoplasmic granules are diffusely and strongly positive to NKI/C3. The cell lineage of the S-100 negative granular cell tumor is obscure. Absence of staining with CD163 excludes a histiocytic lineage. Absence of staining with S-100 excludes a neural origin. Absence of staining with S-100 and key melanoma markers HMB45 and Melan A also excludes a melanocytic origin. In this context, positive reactivity with NKI/C3 is indicative of presence of intracytoplasmic lysosomal granules only. Greater awareness of this lesion in the oral cavity will result in better characterization of its biologic potential.
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Affiliation(s)
- Yeshwant B. Rawal
- 0000000122986657grid.34477.33Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, B-204 Magnuson Health Sciences Center, 1959 NE Pacific Street, Box 357133, Seattle, WA 98195 USA
| | - Thomas B. Dodson
- 0000000122986657grid.34477.33Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, B-204 Magnuson Health Sciences Center, 1959 NE Pacific Street, Box 357133, Seattle, WA 98195 USA
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Abstract
Congenital granular cell tumors are uncommon benign tumors of newborns that mainly affect oral mucosa, especially the maxillary alveolar ridge. They are predominantly seen in female newborns, and cutaneous involvement is extremely rare. In this report, we present a case of congenital granular cell tumor on the arm of one of the male monozygotic twins and discuss the differential diagnosis of granular cell phenotype.
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Machado I, Cruz J, Lavernia J, Llombart-Bosch A. Solitary, multiple, benign, atypical, or malignant: the “Granular Cell Tumor” puzzle. Virchows Arch 2016; 468:527-538. [DOI: 10.1007/s00428-015-1877-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 10/13/2015] [Accepted: 10/22/2015] [Indexed: 12/23/2022]
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40
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Orbital granular cell tumours: clinical and pathologic characteristics of six cases and literature review. Eye (Lond) 2016; 30:529-37. [PMID: 26742863 DOI: 10.1038/eye.2015.268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 11/04/2015] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE To retrospectively assess the clinicopathological characteristics of orbital granular cell tumours (GCTs). METHODS A non-comparative review of the clinical characteristics, imaging, histopathological features, management, and prognosis of five cases of benign GCT and one case of malignant GCT (MGCT) was conducted, along with a review of the English language literature. RESULTS Among the six cases, four tumours were adherent to the extraocular muscle (EOM), and three tumours to the optic nerve (ON). Morphologic examinations revealed polygonal cells containing periodic-acid-Schiff-positive eosinophilic granules. All tumours (100%) were positive for VIM and NSE, five (83.3%) tumours were positive for S-100, and three (50%) tumours were positive for CD68. The follow-up examination of the MGCT witnessed recurrence and brain metastasis despite several thorough resections, but the patient remained alive; the follow-up examination of the four benign GCTs that had received incomplete excision revealed recurrence in one patient and dramatic shrinkage of the residual tumour in another; there was no recurrence in the other two patients. CONCLUSIONS GCT should be considered in the differential diagnosis of orbital tumours, which may affect EOMs and ON. The natural course of GCT can include tumour progression, stability, or spontaneous regression. To avoid recurrence, complete resection is recommended for orbital GCT. To the best of our knowledge, primary orbital MGCT is reported for the first time.
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Abstract
Classic granular cell tumor is a mesenchymal neoplasm that commonly occurs on the skin, but is not infrequently found in the oral cavity, primarily on the dorsal tongue. Diagnosis is usually straightforward with hematoxylin and eosin stained slides. Immunohistochemical studies on classic granular cell tumor shows positive immunostaining for S-100 and vimentin, while CD68 is variably positive. We report a case of otherwise unremarkable oral granular cell tumor that was immunohistochemically negative for S-100, and positive for vimentin and CD68, and discuss the differential diagnosis. The results of the immunohistochemical studies in our case are compared with those of classic S-100 positive oral granular cell tumors, as well as cutaneous and oral S-100 negative granular cell tumors. Classic S-100 positive granular cell tumors and S-100 negative granular cell tumors of the oral cavity can only be distinguished by immunohistochemical studies; however, the necessity of this distinction is unclear, as both are benign lesions in which recurrence is unlikely.
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42
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Abstract
Microphthalmia transcription factor (MITF) is an established melanocytic marker originally credited with a high degree of specificity. We report a series of 11 atypical fibroxanthoma (AFX) from 2 laboratories showing positive MITF staining. Although there are multiple case reports illustrating MITF staining in a range of tumors, aberrant staining in AFX has not been previously reported. Awareness of the possibility of MITF positivity in AFX is important to avoid a misdiagnosis of melanoma. We also report positive MITF staining in 2 nonneural granular cell tumors and discuss the overlap with the granular subtype of AFX.
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43
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López-Villaescusa M, Rodríguez-Vázquez M, García-Arpa M, García-Angel R. Primitive Polypoid Granular-Cell Tumor. ACTAS DERMO-SIFILIOGRAFICAS 2014. [DOI: 10.1016/j.adengl.2014.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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44
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López-Villaescusa MT, Rodríguez-Vázquez M, García-Arpa M, García-Angel R. Primitive polypoid granular-cell tumor. ACTAS DERMO-SIFILIOGRAFICAS 2014; 105:878-9. [PMID: 24721004 DOI: 10.1016/j.ad.2014.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 02/18/2014] [Accepted: 03/03/2014] [Indexed: 11/25/2022] Open
Affiliation(s)
- M T López-Villaescusa
- Servicio de Dermatología, Complejo Hospitalario Universitario de Albacete, Albacete, España.
| | - M Rodríguez-Vázquez
- Servicio de Dermatología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - M García-Arpa
- Servicio de Dermatología, Hospital de Ciudad Real, Ciudad Real, España
| | - R García-Angel
- Servicio de Anatomía Patológica, Complejo Hospitalario Universitario de Albacete, Albacete, España
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Newton P, Schenker M, Wadehra V, Husain A. A case of metastatic non-neural granular cell tumor in a 13-year-old girl. J Cutan Pathol 2014; 41:536-8. [DOI: 10.1111/cup.12336] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 03/03/2013] [Accepted: 07/07/2013] [Indexed: 12/01/2022]
Affiliation(s)
- Peter Newton
- Department of Cellular Pathology; The Royal Victoria Infirmary; Newcastle upon Tyne NE1 4LP UK,
| | - Michael Schenker
- Department of Plastic Surgery; The Royal Victoria Infirmary; Newcastle upon Tyne NE1 4LP UK
| | - Viney Wadehra
- Department of Cellular Pathology; The Royal Victoria Infirmary; Newcastle upon Tyne NE1 4LP UK,
| | - Akhtar Husain
- Department of Cellular Pathology; The Royal Victoria Infirmary; Newcastle upon Tyne NE1 4LP UK,
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47
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Feci L, Miracco C, Fimiani M, Rubegni P. A case of primitive non-neural granular cell tumor presenting as a single painless bleeding nodule. Dermatol Pract Concept 2014; 4:59-61. [PMID: 24855577 PMCID: PMC4029257 DOI: 10.5826/dpc.0402a12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Accepted: 12/28/2013] [Indexed: 10/31/2022] Open
Abstract
Primitive non-neural granular cell tumor is a rare tumor of uncertain lineage that clinically presents as a solitary painless nodule most typically on the extremity or trunk of an adult. We report the case of a 20-year-old man with a small reddish papule on the abdomen, measuring about 2 x 3 mm, surrounded by a faint erythematous halo. Dermoscopy examination shows diffuse red color and weak whitish striae. However, only histological and immunohistochemical evaluation allowed us to perform the correct diagnosis.
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Affiliation(s)
- Luca Feci
- Dept. Clinical Medicine and Immunological Sciences, Dermatology Section, University of Siena, Siena, Italy
| | - Clelia Miracco
- Dept. of Oncology, Pathology Section, University of Siena, Siena, Italy
| | - Michele Fimiani
- Dept. Clinical Medicine and Immunological Sciences, Dermatology Section, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dept. Clinical Medicine and Immunological Sciences, Dermatology Section, University of Siena, Siena, Italy
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Abstract
Pleomorphic neoplasms are typically associated with high-grade malignant behavior, but this does not readily apply to primary cutaneous tumors. Despite morphologic features suggestive of malignancy, atypical fibroxanthoma, the classic example of a pleomorphic dermal neoplasm, is characterized by indolent clinical behavior. Atypical fibroxanthoma is a distinctive clinicopathologic disease affecting sun-damaged skin of elderly males. Histologically, it is often ulcerated and dermal based with pushing growth, characterized by a sheet-like and fascicular growth of pleomorphic epithelioid, spindled, and multinucleated tumor cells with brisk and atypical mitotic activity. However, no positive discriminatory histologic or immunohistochemical features exist. Its diagnosis is one exclusion with a wide differential diagnosis, mainly including other mesenchymal, melanocytic, and epithelial neoplasms. Particular considerations are pleomorphic dermal sarcoma, invasive melanoma, squamous cell carcinoma, metaplastic carcinoma, poorly differentiated cutaneous angiosarcoma, cutaneous leiomyosarcoma, myxofibrosarcoma, variants of fibrous histiocytoma (FH), pleomorphic fibroma, and non-neural granular cell tumor. The behavior of these tumors is varied and ranges from outright malignant to entirely benign, requiring confident diagnosis to reliably predict behavior and guide treatment. Although challenging, because of significant clinical and pathologic overlap, it is usually possible to establish a definitive diagnosis when attention is paid to the often subtle differentiating features. This requires careful tumor sampling, recognition of the subtle distinguishing morphologic features, judicious use and analysis of immunohistochemistry, and interpretation of the findings in the appropriate clinical setting.
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Ordóñez NG. Value of melanocytic-associated immunohistochemical markers in the diagnosis of malignant melanoma: a review and update. Hum Pathol 2014; 45:191-205. [PMID: 23648379 DOI: 10.1016/j.humpath.2013.02.007] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 02/12/2013] [Accepted: 02/15/2013] [Indexed: 11/21/2022]
Abstract
Since the identification of S100 protein as an immunohistochemical marker that could be useful in the diagnosis of melanoma in the early 1980s, a large number of other melanocytic-associated markers that could potentially be used to assist in the differential diagnosis of these tumors have also been investigated. A great variation exists, however, among these markers, not only in their expression in some subtypes of melanoma, particularly desmoplastic melanoma, but also in their specificity because some of them can also be expressed in nonmelanocytic neoplasms, including various types of soft tissue tumors and carcinomas. This article reviews the information that is currently available on the practical value of some of the markers that have more often been recommended for assisting in the diagnosis of melanomas, including those that have only recently become available.
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Affiliation(s)
- Nelson G Ordóñez
- Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.
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50
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Chan JKC. The wonderful colors of the hematoxylin-eosin stain in diagnostic surgical pathology. Int J Surg Pathol 2014; 22:12-32. [PMID: 24406626 DOI: 10.1177/1066896913517939] [Citation(s) in RCA: 221] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The hematoxylin-eosin (H&E) stain has stood the test of time as the standard stain for histologic examination of human tissues. This simple dye combination is capable of highlighting the fine structures of cells and tissues. Most cellular organelles and extracellular matrix are eosinophilic, while the nucleus, rough endoplasmic reticulum, and ribosomes are basophilic. This review discusses the spectrum, intensity, and texture of colors observed in H&E-stained slides to illustrate their value in surgical pathology diagnosis. Changes in color of the nuclei occur in the presence of nuclear pseudoinclusions (such as papillary thyroid carcinoma) or inclusions (such as viral infection, surfactant, immunoglobulin, and biotin). The color of the cytoplasm of spindly cells can provide clues to their nature, such as basophilic (fibroblast), eosinophilic (smooth muscle and others), and amphophilic (myofibroblast). Eosinophilic globules have diagnostic value for sclerosing polycystic adenosis of salivary gland, low-grade B-cell lymphoma, solid pseudopapillary tumor of pancreas, and inclusion body fibromatosis. Eosinophilic granules are characteristic of granular cells (lysosome-rich), oncocytic cells (mitochondria-rich), and cells with secretory products (including neuroendocrine cells). Eosinophilic crystals can be diagnostic of lymphoma/plasmacytoma and crystal-storing histiocytosis. Basophilic granules or inclusions are diagnostic of acinic cell carcinoma and malakoplakia (Michaelis-Gutmann bodies). Yellow or brown inclusions are characteristic of hyalinizing trabecular adenoma of thyroid (yellow bodies), brown bowel syndrome, and malignant melanoma. Extracellular eosinophilic deposits can be produced by many conditions, but amyloid and monoclonal immunoglobulin deposition disease are important considerations. Extracellular basophilic deposits may be seen in small cell carcinoma and systemic lupus erythematosus, but they differ in that the former is blue (nuclear material) while the latter is purple (nuclear material plus immunoglobulin).
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