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Difference between revisions of "Granular cell tumour"
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| Caption = Granular cell tumour. [[H&E stain]]. | | Caption = Granular cell tumour. [[H&E stain]]. | ||
| Micro = cells with abundant eosinophilic granular cytoplasm (granules ~ 1-3 micrometers, poorly demarcated on LM), +/-[[pseudoepitheliomatous hyperplasia]] | | Micro = cells with abundant eosinophilic granular cytoplasm (granules ~ 1-3 micrometers, poorly demarcated on LM), +/-[[pseudoepitheliomatous hyperplasia]] | ||
| Subtypes = | | Subtypes = benign (common), malignant (uncommon) | ||
| LMDDx = [[squamous cell carcinoma]], [[oncocytoma]], adjacent ulcer, [[xanthoma]], [[melanocytic nevus]] with neurotization | | LMDDx = [[squamous cell carcinoma]], [[oncocytoma]], adjacent ulcer, [[xanthoma]], [[melanocytic nevus]] with neurotization | ||
| Stains = PAS +ve | | Stains = PAS +ve | ||
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| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = usually good (benign) | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = xanthoma, other [[skin]] lesions | ||
}} | }} | ||
The '''granular cell tumour''' is a rare histomorphologically distinctive neoplasm found at many sites. The classic location is the head and neck. | The '''granular cell tumour''' is a rare histomorphologically distinctive neoplasm found at many sites. The classic location is the [[head and neck pathology|head and neck]]. | ||
==General== | ==General== | ||
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***Gene implicated in ''[[Noonan syndrome]] 1''. | ***Gene implicated in ''[[Noonan syndrome]] 1''. | ||
*May mimic (well-differentiated) [[squamous cell carcinoma]] - histopathologically. | *May mimic (well-differentiated) [[squamous cell carcinoma]] - histopathologically. | ||
**There is a well-described phenomenon called ''pseudoepitheliomatous hyperplasia''.<ref name=pmid16487362>{{cite journal |author=Abu-Eid R, Landini G |title=Morphometrical differences between pseudoepitheliomatous hyperplasia in granular cell tumours and squamous cell carcinomas |journal=Histopathology |volume=48 |issue=4 |pages=407–16 |year=2006 |month=March |pmid=16487362 |doi=10.1111/j.1365-2559.2006.02350.x |url=}}</ref> | **There is a well-described phenomenon called ''[[pseudoepitheliomatous hyperplasia]]''.<ref name=pmid16487362>{{cite journal |author=Abu-Eid R, Landini G |title=Morphometrical differences between pseudoepitheliomatous hyperplasia in granular cell tumours and squamous cell carcinomas |journal=Histopathology |volume=48 |issue=4 |pages=407–16 |year=2006 |month=March |pmid=16487362 |doi=10.1111/j.1365-2559.2006.02350.x |url=}}</ref> | ||
Aside: | Aside: | ||
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*[[Melanocytic nevus]] with neurotization. | *[[Melanocytic nevus]] with neurotization. | ||
*[[Xanthoma]]. | *[[Xanthoma]]. | ||
===Malignant features=== | |||
Features of malignancy (3 of 6 required):<ref name=pmid9669341>{{cite journal |author=Fanburg-Smith JC, Meis-Kindblom JM, Fante R, Kindblom LG |title=Malignant granular cell tumor of soft tissue: diagnostic criteria and clinicopathologic correlation |journal=Am. J. Surg. Pathol. |volume=22 |issue=7 |pages=779–94 |year=1998 |month=July |pmid=9669341 |doi= |url=}}</ref> | |||
*[[Necrosis]]. | |||
*Spindled tumour cells. | |||
*Vesciular nuclei with large [[nucleoli]]. | |||
*Mitoses (>2/10 [[HPF]] at 200x). | |||
*High [[NC ratio]]. | |||
*Pleomorphism. | |||
Predictive of poor outcome:<ref name=pmid9669341/> | |||
*Ki-67 >10%. | |||
==Special stains== | ==Special stains== | ||