Pustulo‐ovoid bodies of Milian in granular cell tumors

Epstein, Darin S.; Pashaei, Shayesteh; Hunt, Edgar; Fitzpatrick, James E.; Golitz, Loren E.

doi:10.1111/j.1600-0560.2006.00632.x

Cited by 38 publications

(22 citation statements)

References 11 publications

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“…Reported histologic Pustolo-ovoid bodies of Milan, which are aggregates of lysosomal granules, are rarely seen in cytology smears. [4] Cell blocks are of value as immunohistochemical stains for S-100 and CD 68 support the diagnosis of GCT. The CD 68 stains the lysosomes, and is not a specific histiocytic marker, as positivity may also seen in fibroblasts, dendritic cells, basophils, osteoclasts and tumors of these cells.…”

Section: Discussionmentioning

confidence: 99%

Is fine needle aspiration cytology a useful diagnostic tool for granular cell tumors? A cytohistological review with emphasis on pitfalls

2014

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Background:Granular cell tumors (GCT) formerly known as Abrikossoff tumor or granular cell myoblastoma, are rare neoplasms encountered in the fine needle aspiration (FNA) service. Named because of their highly granular cytoplasm which is invariably positive for the S-100 antibody, the classic GCT is thought to be of neural origin. The cytomorphological features range from highly cellular to scanty cellular smears with dispersed polygonal tumor cells. The cells have abundant eosinophilic granular cytoplasm, eccentric round to oval vesicular nuclei with small inconspicuous nucleoli. The fragility of the cells can result in many stripped nuclei in a granular background. The differential diagnosis occasionally can range from a benign or reactive process to features that are suspicious for malignancy. Some of the concerning cytologic features include necrosis, mitoses and nuclear pleomorphism.Methods:We identified 6 cases of suspected GCT on cytology within the last 10 years and compared them to their final histologic diagnoses.Results:Four had histologic correlation of GCT including one case that was suspicious for GCT on cytology and called atypical with features concerning for a malignant neoplasm. Of the other two cases where GCT was suspected, one showed breast tissue with fibrocystic changes, and the other was a Hurthle cell adenoma of the thyroid.Conclusions:These results imply that FNA has utility in the diagnosis of GCT, and should be included in the differential diagnoses when cells with abundant granular cytoplasm are seen on cytology. Careful attention to cytologic atypia, signs of reactive changes, use of immunohistochemistry, and clinical correlation are helpful in arriving at a definite diagnosis on FNA cytology.

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Section: Discussionmentioning

confidence: 99%

Is fine needle aspiration cytology a useful diagnostic tool for granular cell tumors? A cytohistological review with emphasis on pitfalls

2014

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“…None showed necrosis or evidence of the features generally associated with malignancy (14). One case (patient 11) classified as an atypical vulvar GCT exhibited tumor cells that contained prominent large granules surrounded by a clear halo, consistent with a pustuloovoid body of Milian (14,15). The nuclei in this case also showed a vesicular chromatin pattern with occasional prominent nucleoli (Fig.…”

Section: Isolated/synchronous Vulvar Granular Cell Tumormentioning

confidence: 81%

Isolated and Synchronous Vulvar Granular Cell Tumors: A Clinicopathologic Study of 17 Cases in 13 Patients

Papalas

Shaco‐Levy²,

Robboy³

et al. 2010

International Journal of Gynecological Pathology

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Granular cell tumors (GCTs) are benign Schwann cell-derived neoplasms occurring throughout the body. Vulvar GCTs are usually isolated, but occasionally multifocal. On account of their anatomic location, surgical interventions aiming for negative resection margins can result in significant morbidity. We describe the clinicopathologic features of 17 vulvar GCTs in 13 patients followed for an average of 7 years. The average age at presentation was 46 years, and 84% of the patients were black. The tumors were multifocal in 3 (23%) patients, and all, either at presentation or subsequently also developed extravulvar foci. Patients with multifocal vulvar GCTs were nearly 10 years younger at presentation than patients in whom the disease was isolated. The most common complaint was a slow-enlarging mass occasionally associated with pruritus or overlying hyperpigmentation. Clinically, the tumors were subcutaneous, mobile, and nodular (2.1 cm on average), without overlying ulceration, and most often were found in the labia majora (6/17). The neoplasms were histologically heterogeneous, but exhibited either a predominantly nodular (3/17) or infiltrative (13/17) pattern of invasion. Cytologically, the tumors displayed round to polygonal cells with a granular cytoplasm, small hyperchromatic nuclei with minimal pleomorphism, and less than 2 mitoses per 10 high power fields. One tumor (1/17) consisted of cells with predominantly vesicular nuclei and prominent nucleoli and was classified as an atypical vulvar GCT. All tumors so examined were reactive for S-100 protein. Eight of 17 tumor excision specimens had positive margins. Of these, 5 tumors remained stable whereas the other 2 with follow-up progressed to require reexcisions after periods of 14 and 8.0 years, respectively. All patients with excisions with negative margins remained stable. Patients with multifocal tumors did not have a higher risk of recurrence per tumor, compared with patients with isolated disease, regardless of the margin status. No patient died from her disease. As granular cell neoplasms have such a low risk or recurrence and behave generally in an indolent manner, aggressive therapy is usually unwarranted.

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“…8 Ayrıca bu büyük eozinofilik sitoplazmik granüllerin çevresinde berrak haloların görül-düğü cisimler (Milan'ın püstülo-ovoid cisimleri) izlenebilmektedir. 9 Tanı S100 ve nöron spesifik enolaz içeren immünohistokimyasal boyalar ile doğrulanmaktadır. Ayrıca "tümör inhibin-a", "calretinin", "galectin-3" ve "mesothelioma marker antibody (HBME)" ile değişik oranlarda boyanırken; "vimentin", "protein gene product (PGP 9,5)", "melanoma directed antibody", NKI/C3 ve CD68 de eksprese etmektedir.…”

Section: Zordurunclassified

A Rare Diagnosis: Antecubital Fossa Located Granular Cell Tumor: Case Report

Akbaş¹,

Duman²,

Yüksel³

et al. 2017

Turkiye Klinikleri J Dermatol

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Pustulo‐ovoid bodies of Milian in granular cell tumors

Abstract: In our series, POB were present in varying numbers in all the tumors studied. They appear to represent the heterogeneity of the lysosomes, giving the appearance of large granules that have partially detached from the adjacent cytoplasm. POB are an easily recognizable component of GCTs.

Cited by 38 publications

References 11 publications

Is fine needle aspiration cytology a useful diagnostic tool for granular cell tumors? A cytohistological review with emphasis on pitfalls

Is fine needle aspiration cytology a useful diagnostic tool for granular cell tumors? A cytohistological review with emphasis on pitfalls

Isolated and Synchronous Vulvar Granular Cell Tumors: A Clinicopathologic Study of 17 Cases in 13 Patients

A Rare Diagnosis: Antecubital Fossa Located Granular Cell Tumor: Case Report

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