Table
of Contents | List of Diagnoses |
Case 1 | Case 2
61 year old female with abdominal wall mass
Discussion
Granular cell tumor (GCT) is a benign
neural tumor characterized by large granular-appearing eosinophilic cells.1
Granular cell tumors are tumors that may arise from various soft tissue,
including extremity and visceral sites.2 These lesions often
are multifocal (10-15% of cases), but usually benign.1,2
GCT can occur at any age, but commonly in the adults. It is very
rare in children.1 It appears to be more common in women.
GCT tends to be poorly circumscribed.
The cells are rounded, polygonal or slightly spindled. The nuclei may be
small and dark, or large with vesicular chromatin.1 The
cytoplasm is eosinophilic with fine to coarse granules which represent
phagolysosomes, strongly PAS-positive, diastatse resistance.1
There may be nuclear atypia occasionally, but this does not necessarily
indicate malignancy.1
Granular cells do not contain glycogen.
Immunohistochemically GCT is positive for S100, NSE, CD68.
Rarely, there may be malignant granular
cell tumor. Features such as necrosis, spindling, vesicular nuclei with
prominent nucleoli, greater than 2 mitoses/10 HP, high N/C ratio and
pleomorphism are suggestive of malignancy. Tumors with 3 or more of these
features are considered malignant and have, approximately, a 40% risk of
causing death.1
References:
1Weiss SW, Goldblum JR.
Enzinger and Weiss’s soft tissue tumor. 4th Eds. Mosby.
2Elkousy H, Harrelson J,
Dodd L, et al. Granular cell tumors of the extremities. Clin Orthop. 2000
Nov;(380):191-8.
