alexa Morphologic spectrum, immunohistochemical analysis, and clinical features of a series of granular cell tumors of soft tissues: a study from a tertiary referral cancer center.


Journal of Cancer Science & Therapy

Author(s): Rekhi B, Jambhekar NA

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Abstract A granular cell tumor (GCT) is relatively uncommon and objectively diagnosed with neural markers on immunohistochemistry (IHC). Recent studies have described additional markers for a GCT. Herein, we present morphologic spectrum of 12 GCTs of soft tissues and skin, including 10 benign and 2 malignant subtypes with an optimal diagnostic IHC panel. Eleven cases occurred in women and 1 in a man, with a mean age of 45.5 years. Six cases occurred in soft tissues and skin of extremities, 4 in the breast soft tissues, and 1 case each in the back and preauricular region, respectively. Cytologic smears in 2 cases displayed polygonal cells with abundant, eosinophilic, granular cytoplasm. On histopathology, all cases invariably revealed a nonencapsulated infiltrating tumor comprising groups and nests of granular cells with vesicular nuclei. In 5 cases, granular cells were noted in close proximity to the nerves. Two malignant GCTs revealed necrosis, mitoses, and nuclear atypia. Immunohistochemistry in 10 cases (83.3\%) showed diffuse S-100 positivity in all 7 benign and 2 malignant cases: cytoplasmic CD68 positivity (all 10 cases) and membranous vimentin staining (all 4 cases). Inhibin showed cytoplasmic positivity in 3 of 6 cases. A single malignant GCT showed focal desmin reactivity. All were surgically managed. A GCT is a discrete tumor entity and can be identified from other granular lesions by its proximity to nerves and objective identification with diffuse S-100 positivity, CD68 positivity, and membranous vimentin positivity that form an optimal IHC panel in limited resource settings, irrespective of benign or malignant types. This article was published in Ann Diagn Pathol and referenced in Journal of Cancer Science & Therapy

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