Atarbashi-Moghadam Saede, Lotfi Ali, Eftekhari-Moghadam Parsa
Dept. of Oral and Maxillofacial Pathology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Research Center, Dental School Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Dent (Shiraz). 2024 Mar 1;25(1):91-94. doi: 10.30476/dentjods.2023.98784.2108. eCollection 2024 Mar.
A granular cell tumor (GCT) is an unusual benign mesenchymal neoplasm with Schwann cells origin. The most common site is the dorsum of the tongue. It has a striking tendency to occur in females and is more frequent in adult patients. GCT typically shows an asymptomatic, slow-growing, single nodule. Histopathologically, it reveals a proliferation of polygonal cells with granular cytoplasm penetrating the adjacent muscles. In some cases, the overlying epithelium demonstrates pseudoepitheliomatous hyperplasia (PEH), which can complicate its precise diagnosis and may mimic squamous cell carcinoma (SCC). This paper presents a 58-year-old woman with a chief complaint of painless mass on the dorsal of the tongue for two years. The lesion was pink and circumscribed with firm consistency measuring 1×1cm. The surface of the lesion was intact. Microscopic examination demonstrated unencapsulated sheets of large, polygonal cells with abundant eosinophilic, granular cytoplasm, and vesicular nuclei. The overlying epithelium showed florid PEH and keratin pearl formation. S100 protein was positive diffusely. The diagnosis of oral GCT was made. Though GCT is a non-aggressive lesion, it may be confused with SCC due to florid PEH and keratin pearl formation. Although PEH is a neglected topic among oral pathologists, it is of great importance in the field of research. Diagnosis can sometimes be problematic because they mimic other lesions. The pathogenesis of PEH is still uncertain. Therefore, familiarity with these characteristics and determining the cause of the PEH leads to correct treatment. This article intends to raise the insight of oral pathologists about PEH in oral lesions.
颗粒细胞瘤（GCT）是一种起源于施万细胞的罕见良性间叶性肿瘤。最常见的部位是舌背。它在女性中发病的倾向显著，且在成年患者中更为常见。GCT通常表现为无症状、生长缓慢的单个结节。组织病理学上，它显示多边形细胞增生，其颗粒状细胞质穿透相邻肌肉。在某些情况下，覆盖的上皮表现为假上皮瘤样增生（PEH），这会使其精确诊断复杂化，并可能酷似鳞状细胞癌（SCC）。本文介绍了一名58岁女性，主诉舌背无痛性肿块两年。病变呈粉红色，边界清晰，质地硬，大小为1×1厘米。病变表面完整。显微镜检查显示大片未被膜包裹的大的多边形细胞，具有丰富的嗜酸性颗粒状细胞质和泡状核。覆盖的上皮表现为明显的PEH和角化珠形成。S100蛋白弥漫性阳性。诊断为口腔GCT。尽管GCT是一种非侵袭性病变，但由于明显的PEH和角化珠形成，它可能与SCC混淆。尽管PEH在口腔病理学家中是一个被忽视的话题，但在研究领域却非常重要。诊断有时可能存在问题，因为它们会模仿其他病变。PEH的发病机制仍不确定。因此，熟悉这些特征并确定PEH的病因有助于正确治疗。本文旨在提高口腔病理学家对口腔病变中PEH的认识。
