Case Number : CT0066 Adam_Bates

Granular cell tumor
 

Wounderful picture of Granular Cell tumor with the large polyhhedral cells containing abundant fine to coarsly granular esinophilic cytoplasm. Also demonstrating the pustulo-ovoid bodies of Milian, large cytoplasmic granules surrounded by a clear halo. Can not be more beautiful than this picture!!!!
 

Dear All. Interesting you have all gone for a granular cell tumour. I thought this represented accumulation of lysosomes seen in a number of conditions including granular cell change in a dermatofibroma, granular cell change in smooth mucles tumours and polypoid non neural granular cell tumour described by Le Boit. So surely the differential is broader - or am I missing something?
 

The comment of Dr Jonathan is interesting however, I believe this is Granular cell tumor due to the characteristic cells, Large polyhydral with the characteristic granules and pustulo-ovoid bodies. The cells in the polypoid granular cell tumor (primitive non neural granular cell tumor) are different, being spindled to ovoid. They show also some cytological atypia and scattered mitoses. However, they also have esinophilic granular cytoplasm. I think if granular cell changes happened in dermatofibroma or smooth muscles tumor the whole context will be different.
 

Looks like granular cell tumour but at this field I agree with Jonathan you can not rule out other differentials including Congenital epulis or congenital granular cell tumor, which is S100 negative
 

Thank you for your contributions. Sorry for the late reply. I agree with all the comments. This is a Granular cell tumor, and focal granular cell change can be seen in a wide range of conditions, however, one usually finds areas in the lesion showing classical features of the condition. Great discussion and see you all tomorrow.