Histopathology

The lesion is composed of plump eosinophilic cells with central small dark nuclei and abundant granular cytoplasm. The cells may be polygonal or elongated and have indistinct cell membranes, often giving the impression of a syn-cytium. The lesion is not encapsulated and the granular cells extend into adjacent tissues, typically skeletal muscle, where they appear to merge with muscle cells {477,2791}. Granular cells extend up to the epithelium, often forming small islands in the connective tissue papillae. The granules stain positively with periodic acid Schiff (PAS).

A characteristic feature of granular cell tumour is that in up to 30% of cases the overlying epithelium shows pseudoep-itheliomatous hyperplasia that may be misdiagnosed as carcinoma.

Immunoprofile

The lesion is strongly and uniformly positive for S-100 protein. Cells also express neurone-specific enolase, calretinin, inhibin-alpha and PGP 9.5, and show fine granular cytoplasmic positivity for the lysosome related antigen CD68 {764, 2791}.

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