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Presented by Ralph Hruban, M.D. and prepared by Whitney Green, M.D.
Case 1: 50 some year old woman with a history of smoking cigarettes was complained of a small nodule on her tongue.
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Question 1 of 1
1. Question
Week 576: Case 1
50 some year old woman with a history of smoking cigarettes was complained of a small nodule on her tongue.images/Case1_image1RH.jpg
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images/Case1_image5RH.jpgCorrect
Answer: Granular cell tumor
Histology: This lesion has two components. The squamous epithelium appears to infiltrate into the tissues. Keratinization is prominent in the deep tongues of squamous epithelium, and some of the nuclei are hyperchromatic. Deep to the squamous epithelium can be found large cells with small uniform nuclei and voluminous granular eosinophilic cytoplasm.
Discussion: Boy is this a scary case! The squamous epithelium looks all for the world like an infiltrating squamous carcinoma until one realizes that there is a granular cell tumor lying beneath the squamous lesion. Pseudoepitheliomatous hyperplasia over a granular cell tumor is a known mimicker of a squamous carcinoma. The atypical epithelium was confined to the area of the granular cell tumor, helping to rule out the extremely rare collision tumor. Necrotizing sialometaplasia is another mimicker of squamous carcinoma in this area.
Incorrect
Answer: Granular cell tumor
Histology: This lesion has two components. The squamous epithelium appears to infiltrate into the tissues. Keratinization is prominent in the deep tongues of squamous epithelium, and some of the nuclei are hyperchromatic. Deep to the squamous epithelium can be found large cells with small uniform nuclei and voluminous granular eosinophilic cytoplasm.
Discussion: Boy is this a scary case! The squamous epithelium looks all for the world like an infiltrating squamous carcinoma until one realizes that there is a granular cell tumor lying beneath the squamous lesion. Pseudoepitheliomatous hyperplasia over a granular cell tumor is a known mimicker of a squamous carcinoma. The atypical epithelium was confined to the area of the granular cell tumor, helping to rule out the extremely rare collision tumor. Necrotizing sialometaplasia is another mimicker of squamous carcinoma in this area.
