Desmoplastic stromal changes in cutaneous neural granular cell tumors: An under-recognized histopathologic feature of diagnostic and prognostic importance

Oral granular cell tumors: an analysis of the clinical and histopathologic features of 126 tumors

OBJECTIVE

To characterize the clinical and histologic features of oral granular cell tumors (GCTs).

STUDY DESIGN

A retrospective search of the archives of our diagnostic oral pathology service was performed for GCTs diagnosed between 1989 and 2023. A total of 126 tumors in 122 patients were retrieved.

RESULTS

There was a female predilection with a female-to-male ratio of 2.3:1. The age range was 5-73 years (mean = 33.3). The most commonly involved site was the tongue (81.0%), followed by the lips (7.9%). Most GCTs were pink, but many lesions appeared yellow or white. Histologically, most GCTs were sessile masses comprised of sheets or nodules of tumor cells. Uncommonly, GCTs were pedunculated (3.2%), papillary (2.4%), ulcerated (3.2%), or desmoplastic (11.1%). Pseudoepitheliomatous hyperplasia, histologically mimicking squamous cell carcinoma, was present in 25.4% of tumors. While 65.9% of GCTs demonstrated positive surgical margins, only 3 tumors recurred.

CONCLUSIONS

To the best of our knowledge, this is the largest series of oral GCTs with a comprehensive analysis of the clinical and histologic features. It is important for clinicians and pathologists to be aware of the spectrum of features observed in GCTs in order to avoid erroneous classification as malignancy.

Atypical cytological presentation of granular cell tumour: Tumour-associated fibrosis may affect fine-needle aspiration cytology accuracy

The cytological features of granular cell tumour (GCT) are generally quite typical but, in some cases, the fine needle aspiration cytology (FNAC) diagnosis of GCT may be difficult or impossible because of unusual sites of onset or equivocal cytological features. In this report, two GCTs with atypical FNAC features are described in order to investigate the causes and provide possible diagnostic tips. From a series of nine histologically proven GCTs, two inconclusive FNAC cases were retrieved. Smears were poorly cellular showing isolated naked nuclei, anisonucleosis, granular chromatin and occasional small nucleoli. The background was finely granular in one case. Histological controls of these cases revealed marked fibrosis. Tumour-associated fibrosis in GCT is variable and does not seem to influence clinical behaviour but it influences the harvest and the integrity of granular cells collected by FNAC. When GCT smears are poorly cellular, attention should be paid to the granular background and to the few granular cells, if any, as they might be the only features to suggest a GCT.