An infiltrative variant of non‐neural granular cell tumor: a case report

Abstract

Dermal non-neural granular cell tumors are rare tumors of indeterminate lineage that typically present as well-circumscribed tumors with nuclear pleomorphism and mitotic activity. We describe a dermal non-neural granular cell tumor with a distinctive growth pattern with granular cells interspersed between collagen bundles. This asymptomatic papule arose on the scapula of a 46-year-old woman and consisted of a mixture of epithelioid and spindled granular cells. The immunohistochemical characteristics were similar to those of previously reported dermal non-neural granular cell tumors. Despite mild nuclear pleomorphism and dispersion of lesional cells among collagen bundles, mitoses were not present and Ki-67 staining indicated a low proliferative rate. In addition to being S-100 protein negative and NKI/C3 positive, our case was positive for PGP9.5 and weakly positive for neuron-specific enolase, a staining pattern similar to what has been observed for cellular neurothekeomas. Our case could represent a dermal non-neural granular cell tumor with unique architecture, a granular cellular neurothekeoma or a granular cell dermatofibroma. As both dermal non-neural granular cell tumor and cellular neurothekeoma are of indeterminate lineage, our case with features characteristic of both entities may suggest a common precursor or lineage for dermal non-neural granular cell tumor and cellular neurothekeoma.

Congenital Granular Cell Tumor of the Arm

“…Positive reactivity is seen with CD68, NKI/C3, NSE, and factor XIIIa. 7,8 The histomorphological appearance and absence of actin, desmin, and/or caldesmon immunoreactivity effectively exclude leiomyoma and leiomyosarcoma. 8,9 Basal cell carcinomas with granular cell change are usually of the nodular type with an immunohistochemical profile demonstrating reactivity with cytokeratins.…”

“…7,8 The histomorphological appearance and absence of actin, desmin, and/or caldesmon immunoreactivity effectively exclude leiomyoma and leiomyosarcoma. 8,9 Basal cell carcinomas with granular cell change are usually of the nodular type with an immunohistochemical profile demonstrating reactivity with cytokeratins. 10 Granular cell atypical fibroxanthoma usually presents as a rapidly enlarging dome-shaped nodule and typically located on sun-exposed areas of elderly patients.…”

“…3,5 Granular changes because of the accumulation of lysosomes can be observed in a variety of neoplasms, including leiomyoma, leiomyosarcoma, dermatofibroma, dermatofibrosarcoma protuberans, atypical fibroxanthoma, benign melanocytic lesion, melanoma, fibrous papule, angiosarcoma, basal cell carcinoma, metastatic tumors, and primitive nonneural GCTs (so-called primitive polypoid GCTs). [5][6][7][8][9][10][11] Primitive polypoid GCT was first described by LeBoit et al 6 in 1991. Subsequently, Lazar and Fletcher 7 reported a series of similar tumors that they named "primitive nonneural granular cell tumor."…”

Multifocal Granular Cell Tumor Presenting as an Esophageal Stricture

“…d Barium study noted a 4-cm stricture oral cavity, brain, and pituitary showed no reactivity to S-100 or neuron-specific enolase. More recently, several cases of cutaneous granular cells of non-neural origin have been reported [5][6][7][8]. Their propensity for being multricentric has been reported in as many as 10-15% of cases [9][10][11].…”

“…Most of these tumors are benign, although 2-4% have a malignant potential. Electron microscopy and immunohistochemical investigations in the recent past have attributed their origin to Schwann cells, although there has been some controversy with this regard [3][4][5][6][7][8]. On review of literature, to date, less than 300 cases have been described worldwide.…”