The neural histogenetic origin of the oral granular cell tumor: An immunohistochemical evidence

Aims: Granular cell tumor (GCT) is a rare neoplasm that can appear in any site of the body, but most are located intraorally. Its histogenetic origin remains unclear. This report analyzes the immuno profile of 15 cases of granularcell tumors, occurring in 13 women and 2 men and the lesions were located on the tongue or upper lip. Patient ageranged from 7 to 52. Methods: The patients demographic data and the cytological and architectural features of the lesions were analyzed in oral GCTs (n = 15). The lesions were also submitted to a panel of immunohisto chemical stains with antibodies against S-100, p75, NSE, CD-68, Ki-67, Synaptofisin, HHF-35, SMA, EMA, Chromogranin, Progesterone, Androgen and Estrogen. Results: Among the fifteen cases analyzed, the most common location was the tongue (84.6%). Histologically,the tumors exhibited cellular proliferation composed mainly by polygonal cells presenting an abundant granulareosinophilic cytoplasm. The nuclei were central, and the cell membranes were moderately clear. No mitotic figures were observed. The immunohistochemical analysis showed positivity in all cases for S-100, p75, NSE andCD-68, and no immunoreactivity for Ki-67, Synaptofisin, HHF-35, SMA, EMA, Chromogranin, Progesterone,Androgen and Estrogen. Conclusion: The immunoprofile of granular cell tumors showed nerve sheath differentiation – lending support to their neural origin – and helping to establish a differential diagnosis between this lesion and other oral granularcell tumors, whether benign or malignant (AU)

Intravascular papillary endothelial hyperplasia: Report of 4 cases with immunohistochemicalfindings

Intravascular papillary endothelial hyperplasia (IPEH) is a benign endothelial proliferation, usually intravascular,that may mimic angiosarcoma. In this report, four new cases of IPEH involving the oral region are described.The affected sites were the lower lip, labial comissure and the submandibular region. After clinical evaluation, thecomplete removal of the lesions showed a circumscribed and soft mass. Histologically, the major feature was areactive proliferation of endothelial cells composed of small papillary structures with hypocellular and hyalinizedcores arising in an organized thrombus. Immunohistochemical staining for CD34 was strongly positive in endothelialcells. Vimentin and laminin immunolabelling were also consistent with a vascular origin. In order to verifythe proliferative potential of the lesions, the Ki-67 antibody was used, revealing low percentage of labeled cells(<20%). No immunoreactivity for GLUT-1 was observed. Since the complete removal is curative, no additionaltreatment was necessary, and no signs of recurrence had been observed until now. Due to the particular features ofIPEH, it is important for pathologists and clinicians to become familiar with this lesion. Additionally, the specifichistological arrangement, including the absence of cellular pleomorphism, mitotic activity and necrosis, representsa guide to help in the differential diagnosis. Moreover, the vascular origin and the proliferative index should beassessed by immunohistochemistry in order to provide an accurate diagnosis (AU)

Intravascular papillary endothelial hyperplasia: report of 4 cases with immunohistochemical findings.

Intravascular papillary endothelial hyperplasia (IPEH) is a benign endothelial proliferation, usually intravascular, that may mimic angiosarcoma. In this report, four new cases of IPEH involving the oral region are described. The affected sites were the lower lip, labial comissure and the submandibular region. After clinical evaluation, the complete removal of the lesions showed a circumscribed and soft mass. Histologically, the major feature was a reactive proliferation of endothelial cells composed of small papillary structures with hypocellular and hyalinized cores arising in an organized thrombus. Immunohistochemical staining for CD34 was strongly positive in endothelial cells. Vimentin and laminin immunolabelling were also consistent with a vascular origin. In order to verify the proliferative potential of the lesions, the Ki-67 antibody was used, revealing low percentage of labeled cells (<20%). No immunoreactivity for GLUT-1 was observed. Since the complete removal is curative, no additional treatment was necessary, and no signs of recurrence had been observed until now. Due to the particular features of IPEH, it is important for pathologists and clinicians to become familiar with this lesion. Additionally, the specific histological arrangement, including the absence of cellular pleomorphism, mitotic activity and necrosis, represents a guide to help in the differential diagnosis. Moreover, the vascular origin and the proliferative index should be assessed by immunohistochemistry in order to provide an accurate diagnosis.