Agustí Jaime, Martínez-Ciarpaglini Carolina, Monteagudo Carlos
Department of Pathology, Hospital Clínico Universitario-INCLIVA, University of Valencia, Valencia, Spain.
Am J Dermatopathol. 2014 Apr;36(4):e84-6. doi: 10.1097/DAD.0b013e318296fe84.
Primitive nonneural granular cell tumor of the skin was first described by LeBoit et al in 1991 as "primitive polypoid granular cell tumor." Few cases have been reported to date, all being polypoid or deep well-delimited lesions and formed by large spindle or polygonal granular cells with moderate nuclear atypia and increased mitotic activity. This granular cell population does not have a Schwannian, myogenic, melanocytic, fibroblastic, histiocytic, or epithelial differentiation. We report a case that fully satisfies the criteria for primitive nonneural granular cell tumor of the skin and, in addition, shows an extensive desmoplastic stroma. This desmoplastic variant of primitive nonneural granular cell tumor, which to our knowledge has not been previously reported, should be recognized to appropriately face the differential diagnosis with the malignant granular cell tumor, whose criteria for malignancy cannot be applied to primitive granular cell tumors.
皮肤原发性非神经颗粒细胞瘤最早由勒博伊特等人于1991年描述为“原发性息肉样颗粒细胞瘤”。迄今为止,报道的病例很少,均为息肉样或边界清楚的深部病变,由大的梭形或多边形颗粒细胞组成,核有中度异型性且有丝分裂活性增加。这种颗粒细胞群没有施万细胞、肌源性、黑素细胞、成纤维细胞、组织细胞或上皮分化。我们报告一例完全符合皮肤原发性非神经颗粒细胞瘤标准的病例,此外,还显示有广泛的促纤维增生性间质。据我们所知,这种原发性非神经颗粒细胞瘤的促纤维增生性变体此前尚未见报道,应予以认识,以便在与恶性颗粒细胞瘤进行鉴别诊断时能恰当地应对,因为恶性颗粒细胞瘤的恶性标准不适用于原发性颗粒细胞瘤。