- Volume 17 Issue 4
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Lack of Utility of Cytokeratins in Differentiating Pseudocarcinomatous Hyperplasia of Granular Cell Tumors from Oral Squamous Cell Carcinoma
- Al-Eryani, Kamal (Oral Medicine and Orofacial Pain Center, University of Southern California) ;
- Karasneh, Jumana (Oral Medicine and Orofacial Pain Center, University of Southern California) ;
- Sedghizadeh, Parish P (Oral Medicine and Orofacial Pain Center, University of Southern California) ;
- Ram, Saravanan (Oral Medicine and Orofacial Pain Center, University of Southern California) ;
- Sawair, Faleh (Department of Oral and Maxillofacial Surgery, Oral Medicine, Oral Pathology and Periodontology, Faculty of Dentistry, The University of Jordan)
- Published : 2016.06.01
Granular cell tumor (GCT) of the oral cavity is a benign lesion. Half of oral GCTs demonstrate pseudocarcinomatous hyperplasia (PCH) of the mucosa which can mimic invasive islands of oral squamous cell carcinoma (SCC). Such similarity can be confusing when diagnosing or evaluating the two conditions, potentially leading to misdiagnosis or misclassification. Indeed, several misdiagnosed cases of oral GCT have been reported in the literature as OSCC or malignant oral GCT that resulted in unnecessary aggressive treatment for the affected patients. The aim of this study was to investigate if the cytokeratin pattern of the PCH can help in differentiating GCT from oral SCC. To distinguish between these two entities, we examined 12 patient specimens of oral GCT-PCH and oral SCC histologically and via immunohistochemistry (IHC) for CK13, CK17 and P75. The results suggest that the cytokeratin profile of PCH is similar to that of oral SCC. Therefore, consideration of IHC findings for epithelial markers alone may lead to erroneous diagnosis; thus, the presence of the granular tumor underneath the PCH and its immunopositivity for P75 or other neural definition markers can be essential to identify the underlying tumor and exclude oral SCC. Finally we recommend more studies on the molecular biology of PCH to understand how it can mimic oral SCC histologically without harboring its malignant phenotype clinically, which could have significant translational potential for understanding invasive oral SCC.
Granular cell tumor;pseudoepitheliomatous hyperplasia;pseudocarcinomatous hyperplasia;Squamous
- Abu-Eid R, Landini G (2006). Morphometrical differences between pseudo-epitheliomatous hyperplasia in granular cell tumours and squamous cell carcinomas. Histopathol, 48, 407-16. https://doi.org/10.1111/j.1365-2559.2006.02350.x
- Al-Eryani K, Cheng J, Abé T, et al (2013). Hemophagocytosismediated keratinization in oral carcinoma in-situ and squamous cell carcinoma: a possible histopathogenesis of keratin pearls. J Cell Physiol, 228, 1977-88. https://doi.org/10.1002/jcp.24364
- Freitas VS, dos Santos JN, Oliveira MC, et al (2012). Intraoral granular cell tumors: clinicopathologic and immunohistochemical study. Quintessence Int, 43, 135-42.
- Huyskens J, Geniets C (2014). Granular cell tumor in the breast mimicking breast carcinoma. JBR-BTR, 97, 289-90.
- Kitamura R, Toyoshima R, Tanaka H, et al (2012 ). Association of cytokeratin 17 expression with differentiation in oral squamous cell carcinoma. J Cancer Res Clin Oncol, 138, 1299-310. https://doi.org/10.1007/s00432-012-1202-6
- Lack EE, Worsham GF, Callihan MD, et al (1980). Granular cell tumor: a clinicopathologic study of 110 patients. J Surg Oncol, 13, 301-16. https://doi.org/10.1002/jso.2930130405
- Miettinen M, Lehtonen E, Lehtola H, et al (1984). Histogenesis of granular cell tumour--an immunohistochemical and ultrastructural study. J Pathol, 142, 221-9. https://doi.org/10.1002/path.1711420309
- Mikami T, Cheng J, Maruyama S, et al (2011). Emergence of keratin 17 vs. loss of keratin 13: their reciprocal immunohistochemical profiles in oral carcinoma in situ. Oral Oncol, 47, 497-503. https://doi.org/10.1016/j.oraloncology.2011.03.015
- Neville BW, Damm DD, Allen CM, et al (2009). Granular cell tumor. in "oral & maxillofacial pathology". 3rd ed. Philadelphia, Pa, WB Saunders Co: 536-7.
- Patti R, Almasio PL, Di Vita G (2006). Granular cell tumor of stomach: a case report and review of literature. World J Gastroenterol, 12, 3442-5. https://doi.org/10.3748/wjg.v12.i21.3442
- Tan KB, Tan SH, Aw DC, et al. (2013). Simulators of squamous cell carcinoma of the skin: diagnostic challenges on small biopsies and clinicopathological correlation. J Skin Cancer, 2013, 752864.
- Vered M, Carpenter WM, Buchner A (2009). Granular cell tumor of the oral cavity: updated immunohistochemical profile. J Oral Pathol Med, 38, 150-9.
- Wolber RA, Talerman A, Wilkinson EJ, et al (1991). Vulvar granular cell tumors with pseudocarcinomatous hyperplasia: a comparative analysis with well-differentiated squamous carcinoma. Int J Gynecol Pathol, 10, 59-66. https://doi.org/10.1097/00004347-199101000-00007
- Zhang M, Sun ZQ, Zou XP (2014 ). Esophageal granular cell tumor: Clinical, endoscopic and histological features of 19 cases. Oncol Lett, 8, 551-5. https://doi.org/10.3892/ol.2014.2152
- Mandibular intraosseous pseudocarcinomatous hyperplasia: a case report vol.10, pp.1, 2016, https://doi.org/10.1186/s13256-016-1052-y