1/10. Granular cell traumatic neuroma: a lesion occurring in mastectomy scars.BACKGROUND: Granular cell changes can be observed in a variety of benign and malignant tumors, and are seen more commonly in granular cell tumors, which in about 5% of cases develop in the breast. Granular cells also have been observed in sites of previous trauma, such as surgery, and are found to be inflammatory reactions of histiocytic origin. methods AND RESULTS: We investigated, morphologically and immunohistochemically, 2 granular cell lesions occurring in mastectomy scars after surgery for carcinoma. Both lesions were composed of strands and nests of large granular cells, haphazardly set in a background of fibrous tissue, with sparse inflammatory infiltrates. Several tortuous hypertrophic nerve bundles were also embedded in the fibrous tissue. A few of these nerve bundles showed degenerative changes and contained granular cells. Immunohistochemically, granular cells were positive for S100 protein, neuron-specific enolase, vimentin, and CD68 antigen. CONCLUSIONS: We consider these proliferative lesions of peripheral nerves to have the features of both granular cell tumor and traumatic neuroma. These cases indicate that traumatic neuroma can undergo extensive granular cell changes and constitute a previously unrecognized entity, which we provisionally label granular cell traumatic neuroma. Granular cell traumatic neuroma has to be taken into consideration when evaluating lesions occurring at mastectomy scars and should be differentiated from malignant tumors with granular cells, such as apocrine carcinoma and alveolar soft part sarcoma.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/10. A case of atypical granular cell tumor of the neurohypophysis.A case of granular cell tumor (GCT) arising in the neurohypophysis of a 63-year-old woman is reported. The tumor consisted of ovoid, polygonal or spindle-shaped cells in a sheet-like or fascicular arrangement. Its abundant cytoplasm contained granules positive for diastase-resistant periodic acid-schiff reaction. Ultrastructurally, the tumor cells contained numerous polymorphic lysosomes of various densities. Immunohistochemically, the tumor cells were positive for S-100 protein, glial fibrillary acidic protein and Leu7, suggesting that the tumor originated from pituicytes that were thought to be modified astrocytes in the neurohypophysis and its stalk. The granular cells showed nuclear atypia, pleomorphism and increased mitotic activity. Therefore, the present tumor was considered as a histologically atypical GCT. Interestingly, proliferating cell nuclear antigen, Ki-67 and p53 were stained in a few tumor cells of this case. These findings indicate that the present tumor had a malignant potential.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/10. Pancreatic granular cell tumor combined with carcinoma in situ.A 58-year-old man was treated for a granular cell tumor (GCT) of the pancreas; a very rarely occurring tumor. The patient, who had been followed for 6 years due to alcoholic hepatitis, chronic pancreatitis and elevated carcinoembryonic antigen (CEA) levels from smoking, was admitted to our hospital for evaluation of back pain, diarrhea and constipation. The patient was diagnosed as having pancreatic head cancer using clinical imaging studies, and a pylorus-preserving pancreatico-duodenectomy was done. In the resected specimen, a white tumor measuring 13 mm in diameter was observed at the pancreatic head, and there was marked fibrous change surrounding the tumor. The microscopic appearance of the pancreas showed atrophy of acinar cells, fibrosis, and dilatation of the main pancreatic duct (MPD). Within the tumor were oval cells with low-grade atypia and an increased number of diffuse eosinophilic granules. Neither mitosis nor invasive findings were observed. Periodic acid-Schiff staining and immunohistochemical staining for the S-100 protein were positive, thus the tumor was diagnosed as a benign GCT. In addition, carcinoma in situ was found at the dilated MPD. Therefore, this patient was diagnosed as having GCT with carcinoma in situ of the pancreas. To the best of our knowledge, this is only the fourth case of GCT of the pancreas to be reported.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/10. Pituicytomas, a mis-diagnosed benign tumor of the neurohypophysis: report of three cases.Pituicytoma is a rare benign primary tumor of the neurohypophysis, occurring in the sellar and suprasellar spaces. We report here three new cases with immunohistochemical and electron microscopic study. Particular attention was paid to the expression of some cell adhesion molecules. These tumors were characterized by bundles of elongated cells strongly immunoreactive to anti-vimentin, S-100 protein, neural cell adhesion molecule and neuron-specific enolase antibodies. glial fibrillary acidic protein (GFAP) was not recorded. It expressed the very late antigen alpha2 (VLAalpha2), but not VLAalpha5, and lacked epithelial markers expression (epithelial membrane antigen, E-cadherin), and specific neuronal markers (synaptophysin, chromogranin, neurofilament). Staining for pituitary hormones was negative. At the ultrastructural level, tumor/blood vessel basal lamina and cytoplasmic intermediate filaments were observed but desmosome or pericellular basal lamina were lacking. In one case few secretory granules were recorded. Differential diagnoses include granular cell tumors, pilocytic astrocytomas and spindle cell tumors such as solitary fibrous tumors, fibroblastic meningiomas and schwannomas. However, the unique pattern of antigenic expression and ultrastructural features of pituicytomas distinguish this rare tumor. As a subpopulation of pituicytes (which are distinctive glial cells of the neurophypophysis), some pituicytomas do not expressed GFAP. This suggests that pituicytomas presumably arise from pituicytes at various stages of their differentiation.- - - - - - - - - - ranking = 3keywords = antigen (Clic here for more details about this article) |
5/10. Central granular cell odontogenic tumor: immunohistochemistry and ultrastructure.Central granular cell odontogenic tumors are rare, with only 30 cases having been reported. The tumors usually occur in the mandibular molar area and are seen as localized painless swellings in patients older than 40 years. We report an additional case that occurred in the posterior mandible of an elderly black woman. All reported cases of this tumor are benign, and cure is effected by localized surgical excision. Ultrastructurally, the cells contain numerous lysosomes and phagocytic vacuoles. Immunohistochemically, the granular cells were positive for vimentin, CD68, muramidase, carcinogenic embryonic antigen, and bcl-2. These features support a mesenchymal origin with a possible histiocytic lineage for the granular cells. awareness of the occurrence of this neoplasm is important to promote detection and differentiation from other intraoral granular cell lesions.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/10. Anaplastic astrocytoma with granular cell differentiation: case report and review of the literature.In contrast to the relatively common soft tissue form of granular cell tumor (GCT), intercerebral GCTs are rare neoplasms. The Schwann cell is the accepted cell of origin for soft tissue GCTs. However, the origin of intracerebral tumors is controversial. We report a case of a GCT intimately associated with an anaplastic astrocytoma. Immunohistochemical staining with glial fibrillary acidic protein demonstrated focal positive staining within the granular cells. Six GCTs from other body sites were stained with glial fibrillary acidic protein for comparison and all were negative. The granular cell component was diffusely positive for S-100 and negative for epithelial membrane antigen and cytokeratin. Ultrastructurally, filaments characteristic of astrocytic cells were demonstrated within some granular cells. Based on our light microscopic, electron microscopic, and immunohistochemical findings, the granular cell component of this anaplastic astrocytoma is likely astrocytic in origin. We propose that these tumors be designated astrocytic neoplasms with granular cell differentiation and their prognoses dictated by the grade of the glial component.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/10. Congenital gingival granular cell tumor. A case report.Congenital gingival granular cell tumor is a rare benign lesion of uncertain origin, which has been found only in newborn infants. This article describes one such case. Our immunohistochemical study employing antibodies against S-100 protein, epithelial membrane antigen, carcinoembryonic antigen, wide-spectrum keratin, desmin and vimentin yielded data supporting the theory of a mesenchymal cell origin for this lesion.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
8/10. An unusual round cell tumor of the tibia with granular cells.We present the clinical, radiographic and histopathologic findings of an unusual tumor that originated in the diaphysis of the tibia in a 10-year-old boy. Clinical symptoms had been present for approximately 2 years and radiographic abnormalities for > or = 8 months before biopsy and subsequent resection of the neoplasm. The child is doing well 4 1/2 years later. Microscopically, the tumor was not typical of any bone tumor with which we are familiar. It was a round-cell tumor with extensive fibrosis, prominent cytoplasmic granularity, and isolated immunoreactivity for vimentin, epithelial membrane antigen, and antichymotrypsin. Ultrastructural examination uncovered the presence of both well-formed desmosomes and cell-associated basement membrane material in addition to abundant phagolysosomes. classification of this tumor is a challenge; the differential diagnosis includes atypical adamantinoma, atypical Ewing's sarcoma, and small-cell osteosarcoma. We favor the former interpretation, although we raise the possibility that it may be a unique lesion.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/10. Gingival granular cell myoblastoma in newborns. Report of two cases.Granular cell myoblastoma is a relatively rare and, exceptionally, malignant tumor. Here we report on two cases found in the gingiva in newborns. None of the previously described congenital lesions has been malignant. The treatment is always wide surgical excision and observation for possible recurrence. Neuron Specific Enolase (NSE) and S-100 protein immunoperoxidase studies revealed that cells of the granular cell myoblastoma react positively for both antigens, thus confirming the neurogenic origin of this tumor.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/10. Malignant granular cell tumor: report of a case and review of the literature.The histological, immunohistochemical and electron microscopic features of a rare malignant granular cell tumor (GCT) arising in the left radial nerve of a 54-year-old man are reported. Despite a lack of local recurrence following extirpation, the tumor metastasized to the skull five years later. light-microscopically, both primary and metastatic tumors consisted of markedly atypical or pleomorphic neoplastic cells with abundant cytoplasm containing diastase-resistant periodic acid Schiff reaction-positive granules. These tumor cells were arranged in a sheet-like pattern with mitotic figures including atypical ones, and were frequently immunopositive for proliferating cell nuclear antigen and c-MET, the c-met proto-oncogene product. These findings reflect high-grade malignancy of the present tumor. In addition, the tumor cells were positive for S-100 protein and neuron-specific enolase. Ultrastructurally, a large number of intracytoplasmic granules featuring secondary lysosomes as well as long interdigitating cytoplasmic processes, intercellular intermediate junctions, discontinuous basal lamina-like structures, and stromal long-spacing collagen were observed. These findings indicated schwannian differentiation of the present tumor. In addition, based on a review of previously reported cases, the overall clinicopathological characteristics of malignant GCT were summarized.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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