Granular Cell Tumor
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Questions and Answers

What is the characteristic histological feature of the most well-known variant of malignant peripheral nerve sheath tumor?

  • Presence of mucin-producing glands
  • Lack of immunoreactivity for myoglobin
  • Presence of rhabdomyosarcomatous differentiation (correct)
  • Absence of necrotic areas
  • Which immunohistochemical marker is strongly positive in epithelioid malignant peripheral nerve sheath tumor?

  • Myoglobin
  • Desmin
  • S-100 protein (correct)
  • Cytokeratin
  • What is the term used to describe a malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differentiation?

  • Neurofibroma
  • Epithelioid MPNST
  • Malignant triton tumor (correct)
  • Angiosarcoma
  • What is the significance of recognizing areas of MPNST in a tumor with divergent differentiation?

    <p>It is essential for making a diagnosis of malignant triton tumor</p> Signup and view all the answers

    What is a differential diagnosis to consider in a tumor with divergent differentiation, if areas of MPNST are not recognizable?

    <p>Rhabdomyosarcoma</p> Signup and view all the answers

    What is a histological feature of epithelioid malignant peripheral nerve sheath tumor?

    <p>Presence of epithelioid cells</p> Signup and view all the answers

    What is a characteristic feature of malignant peripheral nerve sheath tumor with angiosarcomatous differentiation?

    <p>Presence of endothelial cells</p> Signup and view all the answers

    What is a prognostic factor to consider in a patient with malignant peripheral nerve sheath tumor?

    <p>History of type 1 neurofibromatosis</p> Signup and view all the answers

    What is a characteristic feature of psammomatous melanotic schwannoma?

    <p>Presence of melanin pigmentation and psammoma bodies</p> Signup and view all the answers

    Which of the following is a differential diagnosis for melanotic schwannoma?

    <p>Low-grade MPNST</p> Signup and view all the answers

    What is a characteristic location for schwannomas with a microcystic/reticular appearance?

    <p>Visceral locations, particularly the gastrointestinal tract</p> Signup and view all the answers

    What is a rare feature of otherwise typical schwannomas or those with epithelioid features?

    <p>Foci of small, round hyperchromatic cells forming rosettes</p> Signup and view all the answers

    What is the prognosis of psammomatous melanotic schwannoma?

    <p>It is a low-grade malignancy with a tendency for local recurrence and ability to metastasize</p> Signup and view all the answers

    What is a characteristic feature of the cells in a granular cell tumor?

    <p>Innumerable fine cytoplasmic granules and scattered larger eosinophilic globules</p> Signup and view all the answers

    Which of the following immunohistochemical markers is typically positive in granular cell tumors?

    <p>S-100 protein</p> Signup and view all the answers

    Which complex is psammomatous melanotic schwannoma a component of?

    <p>Carney complex</p> Signup and view all the answers

    What is a characteristic of schwannoma by electron microscopy?

    <p>Features of schwannian differentiation with a continuous and often reduplicated basal lamina</p> Signup and view all the answers

    What is the gross appearance of a neurofibroma?

    <p>Gelatinous</p> Signup and view all the answers

    Which of the following is a differential diagnosis for granular cell tumors?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic feature of neurofibroma?

    <p>Fibrous and vascular elements</p> Signup and view all the answers

    What is the significance of S-100 protein positivity in granular cell tumors?

    <p>It is a useful marker for distinguishing granular cell tumors from other tumors</p> Signup and view all the answers

    What is the term for the morphology of some granular cell tumors that have focal granular changes?

    <p>Granular cell change</p> Signup and view all the answers

    What is the name of the condition associated with plexiform neurofibromas?

    <p>Neurofibromatosis type 1</p> Signup and view all the answers

    Study Notes

    Differentiation in Malignant Peripheral Nerve Sheath Tumors

    • Malignant peripheral nerve sheath tumors can have divergent differentiation, such as angiosarcomatous and mucin-producing glands
    • Rhabdomyosarcomatous differentiation is characterized by the presence of rhabdomyosarcoma-like cells
    • This variant is often referred to as a malignant triton tumor
    • Diagnosis requires the presence of areas of recognizable malignant peripheral nerve sheath tumor

    Epithelioid Malignant Peripheral Nerve Sheath Tumors

    • Epithelioid malignant peripheral nerve sheath tumors exhibit strong S-100 protein immunoreactivity
    • They can have a lipoblastic component, accompanied by cells with signet ring–like features
    • Some epithelioid schwannomas can contain foci of small, round, hyperchromatic Schwann cells with scanty cytoplasm, simulating neuroblastoma

    Psammomatous Melanotic Schwannoma

    • Psammomatous melanotic schwannoma is a distinctive type of peripheral nerve sheath tumor
    • It occurs as a component of the Carney complex
    • It is characterized microscopically by the presence of melanin pigmentation and the deposition of psammoma bodies
    • It is regarded as a low-grade malignancy due to its tendency for local recurrence and ability to metastasize

    Granular Cell Tumors

    • Granular cell tumors are characterized by the presence of innumerable fine cytoplasmic granules and scattered larger eosinophilic globules
    • They can be challenging to diagnose and may be mistaken for other tumors
    • The precise line of differentiation of these rare tumors remains obscure
    • Granular cell change may also be found in a number of other unrelated tumors

    Neurofibroma

    • The gross, microscopic, and ultrastructural features of neurofibroma are distinct from those of schwannoma
    • The gross appearance of neurofibroma varies greatly from lesion to lesion
    • It is important to distinguish neurofibroma from schwannoma, despite the fact that in some instances the differential diagnosis may be difficult or that in isolated cases features of both lesions may coexist.

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    Description

    This quiz is about the characteristics and appearance of granular cell tumors, including their cellular structure and dermal permeation. It includes figures and descriptions of the tumors.

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