Granular Cell Tumors Differential Diagnoses

Updated: Dec 29, 2018
  • Author: Vladimir O Osipov, MD; Chief Editor: E Jason Abel, MD  more...
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DDx

Diagnostic Considerations

Pathologic differential diagnoses are discussed in Workup. Clinical differential diagnoses vary depending on the site of the granular cell tumor, as follows:

  • In submucosal granular cell tumors (eg, tongue, larynx, vulva), pseudoepitheliomatous hyperplasia of the overlying squamous epithelium may be misdiagnosed as squamous cell carcinoma. [13]  Coexistent granular cell tumors and squamous cell carcinomas of the head and neck have also been reported. [14]

  • Granular cell tumors of the breast may clinically, grossly, and microscopically simulate carcinomas of the breast.

Granular cell tumors may produce skin or deep fascial fixation and hence may be clinically and grossly indistinguishable from scirrhous breast carcinoma. At the microscopic level, approximately 50% of granular cell tumors have a diffuse infiltrative pattern and induce a stromal response similar to that of scirrhous breast carcinoma. Cytologically, however, granular cell tumors are distinguished by the presence of eosinophilic cytoplasmic granules and small round nuclei with dense chromatin. See the images below.

Granular cell tumor simulating squamous cell carci Granular cell tumor simulating squamous cell carcinoma.
Granular cell tumor underneath the squamous epithe Granular cell tumor underneath the squamous epithelium.
S-100 immunohistochemical stain. S-100 immunohistochemical stain.