Granular Cell Tumor

Granular Cell Tumor

Cyril Fisher, MD, DSc, FRCPath

Prominent pseudoepitheliomatous hyperplasia image can be seen overlying granular cell tumors. The tumor is unencapsulated, creating a sheet-like distribution of neoplastic granular cells.

High magnification shows that the cells are polygonal, with a slightly spindled appearance. The cytoplasm contains numerous eosinophilic granules and the nuclei are small, round to oval, and hyperchromatic.



  • Granular cell tumor (GCT)


  • Granular cell myoblastoma

  • Abrikossoff tumor


  • Benign tumor composed of poorly demarcated proliferation of plump granular cells

    • Distinct from congenital epulis of newborn (gingival granular cell tumor of infancy)


Schwannian Derivation

  • Thought to arise from Schwann cells

    • Positive with neural-associated antibodies

    • Granules represent senescent change with accumulation of autophagocytic lysosomes



  • Incidence

    • Rare

  • Age

    • All ages

      • Peak between 40-60 years

  • Gender

    • Female > male (2:1)

  • Ethnicity

    • Blacks affected more often than whites


  • Over 50% occur in head and neck region

    • Up to 70% of these develop in oral cavity (mucosa, tongue, hard palate)

    • Tongue is most common site

      • Dorsum more often than lateral margin

  • Skin

  • Nerve

  • Esophagus

  • Biliary tract

  • Neurohypophysis

  • Up to 20% of patients have multiple lesions


  • Most present as a single painless nodule

    • Usually have symptoms for < 12 months

  • Rarely, may present with Eagle syndrome

    • Elicitation of pain on swallowing, turning head, or extending tongue

      • Syndrome is thought to be caused by irritation of glossopharyngeal nerve


  • Surgical approaches

    • Complete excision with narrow margins

    • Laser excision can be performed


  • Excellent long-term prognosis

  • Recurrence/relapse/persistence is uncommon (˜ 10%)

  • Malignant GCTs very rare

    • Local recurrence in more than 30%

    • 50% metastasize, mainly to lymph nodes, lung, bone


General Features

  • Smooth-surfaced submucosal or subcutaneous nodule

    • Poorly demarcated

  • Cut surface firm, pale yellow or cream colored

  • In mouth, concurrent Candida infection can form white plaque


  • Mean: 1-2 cm

Jul 8, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Granular Cell Tumor

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