The neural histogenetic origin of the oral granular cell tumor: An immunohistochemical evidence

Abstract

Aims: Granular cell tumor (GCT) is a rare neoplasm that can appear in any site of the body, but most are located intraorally. Its histogenetic origin remains unclear. This report analyzes the immunoprofile of 15 cases of granular cell tumors, occurring in 13 women and 2 men and the lesions were located on the tongue or upper lip. Patient age ranged from 7 to 52. Methods: The patients demographic data and the cytological and architectural features of the lesions were analyzed in oral GCTs (n = 15). The lesions were also submitted to a panel of immunohistochemical stains with antibodies against S-100, p75, NSE, CD-68, Ki-67, Synaptofisin, HHF-35, SMA, EMA, Chromogranin, Progesterone, Androgen and Estrogen. Results: Among the fifteen cases analyzed, the most common location was the tongue (84.6%). Histologically, the tumors exhibited cellular proliferation composed mainly by polygonal cells presenting an abundant granular eosinophilic cytoplasm. The nuclei were central, and the cell membranes were moderately clear. No mitotic figures were observed. The immunohistochemical analysis showed positivity in all cases for S-100, p75, NSE and CD-68, and no immunoreactivity for Ki-67, Synaptofisin, HHF-35, SMA, EMA, Chromogranin, Progesterone, Androgen and Estrogen. Conclusion: The immunoprofile of granular cell tumors showed nerve sheath differentiation -lending support to their neural origin -and helping to establish a differential diagnosis between this lesion and other oral granular cell tumors, whether benign or malignant.

Oral granular cell tumor: a study of twelve cases in a Brazilian population

“…The immunoprofile of the GCT shows a strong and uniform positivity for S-100 protein (2,19). S-100 immunoreactivity (Fig.…”

“…In a study with 42 oral GCT, all cases were found to be positive for S-100 (19). CD-68 is another traditionally used marker for identifications of GCT (2,19). Positive reactions for CD-68 can be found in cells of Schwannian lineage, but also in macrophage and occasionally in fibroblastic lineage (19).…”

“…Granular cell tumor (GCT) or Abrikosoff's tumor was firstly described in 1926 and it is a rare benign soft tissue lesion that can occur in any part of the body, but over half of the cases are in the head and neck areas, and the tongue is the most common site (1,2). Due to the apparent association between GCT and skeletal muscle (3), it has also been known as granular cell myoblastoma and granulocellular rabdomyoma (4).…”

“…It can arise in any age, with a peak between 40 and 60 years. About the gender, some studies have demonstrated a female predilection (2,11). In the present manuscript, the data of all cases of oral GCT seen at a 5-year-period study in a Brazilian population was reviewed.…”

Typical Aspects of the Granular Cell Tumor of the Oral Cavity

“…Further this name was abolished due to S-100 and vimentin's positivity, as observed in the present case, favoring a neural origin of tumor cells. Other routine neural markers such p75 have also evidenced its nerve sheath differentiation [5]. On the other hand, the reason why these cells do not stain for S-100A6 protein, a form of S-100 protein found in other benign tumors of neural origin such schwannoma, neurofibroma, and palisaded encapsulated neuroma, needs to be clarified [6].…”